Saturday January 19, 2019

Treatment for lower back pain poor, harmful globally: Lancet

Current treatments including opioids, injections and surgery to treat lower back pain -- the leading cause of disability globally

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Researchers study patterns of back pain. IANS

Current treatments including opioids, injections and surgery to treat lower back pain — the leading cause of disability globally — are useless, unnecessary and harmful, finds a series of studies in The Lancet. Globally, lower back pain affects more than 540 million people and the condition has doubled in the last 25 years.

The prevalence of the condition is expected to continue to increase with an ageing and increasingly obese population. Medical care with inappropriately high use of imaging, rest, opioids, spinal injections, and surgery is making the problem worse in both developed and developing countries, the findings showed.

desk job
Sitting on your work-desk for extended hours may be the reason for the shooting pain in your back and body. Pixabay

“The burden from low back pain has reached a tipping point where the condition is growing rapidly, is poorly understood and is being mismanaged medically — at cost both to the patient and to the healthcare system,” said Rachelle Buchbinder, Professor at the Monash University in Melbourne.

“Low-and middle-income countries are already emulating the low-value care that is endemic in high-income countries. “Across the globe (there is) inappropriately high use of imaging, rest, opioids, spinal injections and surgery. Doing more of the same will not reduce low back pain disability nor its long term consequences,” Buchbinder said.

People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.

Also Read: Lower Back pain reduced by muscle exercise

The researchers call for a coordinated international leadership to drive transformational change across health and social services and occupational settings to stop fragmented and outdated models of care. They also call for avoidance of the harmful and useless medical treatments through the adoption of a similar framework to drug regulation.

Public health campaigns need to address the widespread population and health professional misconceptions about the causes and prognosis of low back pain and the effectiveness of different treatments. IANS

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Researchers Examine Patterns of Back Pain

The bad news is that one in five experienced persistent back pain, said Canizares

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Researchers study patterns of back pain. IANS

Researchers have examined the patterns of back pain over time and patient characteristics in relation to the disability.

In addition, they have identified the extent of healthcare and medication use (including opioids) associated with different patterns.

Back pain is among the most frequently reported health problems in the world.

For the study, researchers from the University Health Network’s Krembil Research Institute in Toronto, Canada studied 12,782 participants for 16 years.

They provided data on factors including comorbidities, pain, disability, opioid and other medication use, and healthcare visits.

The results showed that almost half (45.6 per cent) of the participants reported back pain at least once.

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The study included four groups of pain: persistent (18 per cent), developing (28.1 per cent), recovery (20.5 per cent), and occasional (33.4 per cent).

The findings, published in Arthritis Care and Research, showed that the persistent and developing groups tended to have more pain and disability, as well as more healthcare visits and medication use than those in the recovery and occasional trajectory groups.

In addition, the recovery trajectory group increased the use of opioids and antidepressants over time.

“The good news is that one in five people with back pain recovered. However, they continued to use opioids and antidepressants, suggesting that people recovering from back pain need ongoing monitoring,” said lead author Mayilee Canizares, postdoctoral candidate from the varsity.

The bad news is that one in five experienced persistent back pain, said Canizares.

People with back pain are a heterogeneous group that may benefit from different approaches to management rather than a traditional one size fits all approach. The distinct groups identified in the study may represent opportunities for more individualised treatment and preventative strategies, Canizares noted. (IANS)