❇️ In most countries, whether rich or poor, back pain is the leading cause of disability, measured by the number of years lived in poor health (see Briefing). It often strikes people in middle age
❇️ The problem is not that back pain is undertreated…costs America an estimated $635bn a year—only a bit less than its defence budget.
❇️ In rich countries perhaps 80% of MRIs for back pain are unnecessary. The scans often find an “abnormality”, such as disc degeneration or a “slipped” disc. These are common even in people who do not suffer back pain, but desperate patients often demand swift intervention to “fix” the “problem” the scan has revealed. Surgery with unproven benefits, or which has been shown not to work, is common.
❇️ For most back pain, the best treatment is non-medical. Do some stretching exercises. Keep moving. Don’t give up work or lie in bed for days on end—that will probably make things worse.
❇️ Above all, be patient.
❇️The problem may not be your back; it may be that the brain’s pain-signalling system is not working properly—and, alas, medical science does not know why
❇️ The answer is to educate patients better, so they don’t feel they are being fobbed off when told to do stretching exercises. Doctors need better training, too—back pain gets short shrift in medical curriculums.
Most patients should be prescribed exercise and patience, not invasive surgery
Posted to FB on 2020-01-17 15:57:57