You are here

Back Pain Treatment Not in Sync With Current Guidelines

Study finds increased use of opioids and nonguideline therapies (July 29)

According to a new study published in JAMA Internal Medicine, trends in back pain treatment strategies in the U.S. are “discordant” with current guidelines.

Investigators at Harvard Medical School report that opioid prescriptions and the use of nonguideline treatments increased between January 1999 and December 2010, while the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen decreased during the same period.

Using data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, the authors studied outpatient visits with a chief symptom and/or a primary diagnosis of back or neck pain, as well as those with secondary symptoms and diagnoses of back or neck pain. Assessments included imaging, narcotics, and referrals to physicians (guideline-discordant indicators). In addition, the authors looked at the use of NSAIDs or acetaminophen and referrals to physical therapy (guideline-concordant indicators).

Data were obtained from 23,918 visits for spine problems. The investigators found that narcotic use per visit increased from 19.3% in 1999–2000 to 29.1% in 2009–2010 (P P P P

The authors conclude that, despite numerous published guidelines, the management of back pain has relied on “guideline-discordant” care. Improvements in the management of spine-related disease represent an area of potential cost savings for the nation’s health care system, they add.

Source: JAMA Internal Medicine; July 29, 2013.

Recent Headlines

U.S., Australia, and Canada Approve Endometrial Cancer Regimen
Single daily pill combines hypertension, cholesterol drugs
Drug With Androgen Deprivation Therapy Cut Risk of Death by 33% Compared With Placebo + ADT
A Diabetes Drug For People Without Diabetes
Roche Drug Outperformed Standard of Care in Phase 2 Study
Nitrosamine Impurity Also Affects Other Ranitidine Drugs
Mesh Implants, Now Banned by FDA, Work as Well as Hysterectomy
One in Five Kids’ Office Visits Results in an Off-Label Rx
Related Settlement Would End Many but Not All Lawsuits