Revolutionary expose from The Lancet “The majority of cases of low back pain respond to simple physical and

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Revolutionary expose from The Lancet
“The majority of cases of low back pain respond to simple physical and psychological therapies that keep people active and enable them to stay at work,” explains Series author Professor Rachelle Buchbinder, Monash University, Australia. “Often, however, it is more aggressive treatments of dubious benefit that are promoted and reimbursed.”

Series author Professor Jan Hartvigsen, University of Southern Denmark comments:
“Millions of people across the world are getting the wrong care for low back pain. Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interests, and financial and professional incentives that maintain the status quo.”

“Low back pain is the leading cause of disability worldwide, affecting an estimated 540 million people at any one time. Yet, a new Series of papers in The Lancet highlights the extent to which the condition is mistreated, often against best practice treatment guidelines.”

Professor Martin Underwood, Warwick University comments:
“Our current treatment approaches are failing to reduce the burden of back pain disability”

The Global Burden of Disease study (2017) found that low back pain is the leading cause of disability in almost all high-income countries as well as central Europe, eastern Europe, North Africa and the Middle East, and parts of Latin America

NIHR Professor Nadine Foster, who is the lead author of one of the papers in the Series, explains:
“The gap between best evidence and practice in low back pain must be reduced. We need to redirect funding away from ineffective or harmful tests and treatments, and towards approaches that promote physical activity and function. We also need to intensify further research of promising new approaches such as redesigning patient pathways of care and interventions that support people to function…”

“Evidence suggests that …
– the first line of treatment being education and advice to keep active

“However, in reality, a high proportion of patients worldwide are
– encouraged to rest
– commonly referred for scans or surgery
– prescribed pain killers including opioids

All of which “are discouraged for treating low back pain.”

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