Have You Ever Had Back Pain? Read Up!

“Father Dan, why are you so aggressive towards chiropractors? Why do you question alternative medicine?” Because I abhor scam artists and ignorance.
There are a lot of nice people in the world. Being nice doesn’t make you correct. Here is a truth: “When in pain or a fragile emotional state, otherwise rational people will takes irrational measures to alleviate the suffering.” Here is another: “The greatest salesmen are low self-esteem, fear, pain, sex and ignorance.” So before reading the article below keep these points in mind.

1) It’s YOUR tax dollars being pissed away.
2) Correlation does not equal causation
3) We are human. We are gullible. That’s where critical thinking and science step in.
4) Anecdotal evidence is not evidence. “My Mom did this and she felt great so it must work!”
5) Claims need proof. Bold claims need bold proofs.
6) Any time you are in pain, one of three things wil happen. You will get worse, you will stay the same or you will get better. If you have a headache and I give you a magic rock, there is a 66% chance the rock will eleviate the symptoms – possibly cure them.

I could go on, but keep those basics in mind and read the latest on back pain, pieced together from the full article at the International Herald Tribune.

Back problems are the leading reason for visits to neurologists and orthopedists, and the eighth leading reason for visits to doctors over all – ahead of fever, knee pain, rashes, headaches and checkups for healthy babies. More than 70 percent of adults suffer back pain at some time in their lives, studies show. A third have had it in the past 30 days. . . Yet for all the costs, for all the hours spent in doctors’ offices and operating suites, for all the massage therapy and acupuncture and spinal manipulations, study after study is leading medical experts to ask what, if anything, is doing any good.

A variety of studies have suggested that in 85 percent of cases it is impossible to say why a person’s back hurts, said Dr. Richard Deyo, a professor of medicine and health services at the University of Washington. And most of the time, the pain goes away with or without medical treatment. “Nearly everyone gets better; nearly everyone improves,” said Deyo, citing evidence from large epidemiological studies.

In a new study, researchers at Duke University, led by Dr. Xeumei Luo, used U.S. data from 1998. Back pain expenses, they say, included $11.1 billion for office visits; $4.5 billion for hospitalization; $3.9 billion for prescription drugs; $4.7 billion for outpatient services; and $1.1 billion for emergency room care, with the rest made up of such things as medical devices. The total, $26 billion, was a 30 percent increase from 1977 after adjusting for inflation.

“It’s not like there’s an explosion of new back pain,” said Dr. Steven Atlas, an assistant professor at Harvard Medical School, who investigates back treatments. “The number of cases isn’t increasing; the cost per case is increasing. There is a lot more that is being done, but the issue is, is it helping or not?” Treating back pain costs Americans $26 billion a year, or 2.5 percent of the country’s total health care bill, according to the Duke study, and far more if disability payments, workers’ compensation and lost wages are taken into account. The costs are continuing to rise, researchers say, as patients get ever more aggressive forms of treatment.

Back pain has always been around, like headaches or the common cold. What has changed, doctors say, are people’s expectations.”People say, ‘I’m not going to put up with it,’” Deyo said. “And we in the medical profession have turned to ever more aggressive medication, narcotic medication, surgery, more invasive surgery.”

But studies find little evidence that patients are better off for all the treatment.

Researchers wondered, for example, about the importance of disk abnormalities, so often seen when a back patient undergoes a magnetic resonance imaging, or MRI. So they examined people with no back pain. One study, of 98 such people, found that two-thirds had abnormalities like bulging or protruding disks, herniated disks and degenerated disks. A third had more than one abnormal disk.

But usually, he said, it may be more coincidence than cause and effect when an MRI scan finds an abnormal disk in someone with back pain. And even when a herniated disk causes the pain, the problem often goes away by itself. In a study published last year in The Journal of the American Medical Association, Deyo and his colleagues randomly assigned 380 patients with back pain to X-rays or MRIs. X-rays can reveal tumors or fractures but not abnormal disks.

Half the MRI patients had disk abnormalities, and the imaging patients, as a group, ended up with more intensive treatment – more doctor visits, physical therapy, acupuncture, massage and chiropractic manipulations – as well as more surgery. And while they were happier with their care, they fared no better than the X-ray patients. Within a few months, most patients in each group were feeling better and were back at work.

Dr. Nortin Hadler, a professor of medicine at the University of North Carolina, says that since no one knows the cause of most back pain, imaging is not much help. Nor, he says, are most treatments.”Maybe you’re better off not going to a doctor,” Handler said. [What Do YOU Think? Comment on this Post!] [Testify!]