Most treatment is wasteful, wanton and wrong, tells the Lancet. The key is to try to keep walking and work, tells the GP Ann Robinson
Back pain is the biggest cause of disability globally, and most of us will have at least one nasty bout of it. But treatment is often wasteful, wanton and wrong,according to a series of papers in the Lancet.” Worldwide, overuse of inappropriate tests and therapies such as imaging, opioids and surgery means patients are not receiving the right care, and resources are wasted ,” it says.
It’s perfectly understandable to want a quick-fix solution to construct the pain go forth and maybe a scan to set your intellect at rest. But there isn’t a reliable instant answer. Scan don’t construct you better, and painkillers can be harmful. The vast majority of low back ache is musculoskeletal– caused by damage caused to ligaments, joints and muscles surrounding the spine. A tiny percentage is due to a serious or dangerous underlying cause that it was necessary to specific diagnosis and intervention- such as cancer, infection or a fracture.
An underlying cause is more likely if you have so-called red-flag symptoms; previous or current diagnosis of cancer, fever, unexplained weight loss and sweats, night ache, ache in the middle of your back rather than lower, inability to stand, urinate or open your bowels, or severe and unremitting pain that is getting worse.
The good news is that if your backache is musculoskeletal- and it usually is- 90% of cases will be better within six weeks. And that is irrespective of what you do. There’s no good evidence that interventions, ranging from Tens machines( which use a mild electric current ), acupuncture, physio, osteopathy and chiropractic to epidural injections and surgery, significantly affect the outcome. Prolonged bed rest- still advocated in some countries- is positively dangerous, as it can cause blood clotting( thrombosis) and builds recovery from back ache less likely.
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