Typical annual medical costs for back pain in is $6,096, while annual medical costs for those without pain is $3,516 .
Conventional health care has initially treated all types of back pain with pain drugs; analysis healthcare research recently shown this approach as inappropriate. American College of Physician guidelines now say that medication should be the last resort used when all other treatments have failed. It is a reversal of the preceding standard of care.
Why? Given that many patients with severe back pain improve regardless of treatment, doctors and patients should select non-drug treatment with spinal manipulation, or superficial heat, massage, acupuncture. If those treatments neglect, medications counseled are NSAIDs (ex. Cyclobenzaprine).
For chronic low back pain, proven successful are physical therapy, exercise, acupuncture, stress reduction, tai chi, yoga, progressive relaxation, biofeedback, low-level laser therapy, cognitive behavioral therapy, or spinal manipulation. In summary, recurring back pain should not be treated in the ER and only rarely in a doctor’s office.
Fewer harms occur with non-drug interventions, the guideline states. Recurrence or results do not change, and rarely enhance life quality. Ibuprofen) as first-line therapy, or tramadol or duloxetine as second-line therapy. Clinicians should simply contemplate adding narcotics only if potential benefits outweigh the dangers, and after these treatments fail. This can be opposite past standards of care.
The guideline states narcotics are associated with significant harms and seldom gain patients. Narcotics should be the last treatment option considered, avoiding short-acting narcotics. Conforming to the guideline will be challenging. We physicians despise being unable to fix” our patients’ symptoms. Full article can be found at back pain discussion forum.