Extensive study reveals serious deficiencies in treatment of low back pain

Even today, health care resources are wasted on unnecessary examinations and ineffective and even harmful treatments. These are the conclusions of 3 extensive review articles published in the respected scientific journal The Lancet, in which 31 leading experts from 13 countries have compiled research evidence on the causes, risk factors and treatment of low back pain. Professor Jaro Karppinen from the University of Oulu is one of the contributors.   

“For example, spinal fusion surgery has become more common all over the world despite a lack of evidence to support the procedure,” says Karppinen. Overuse of strong opioids, that cause dependency and work disability, is a major problem - especially in the United States.

A lot of ineffective and even harmful treatments, which our health care system is unable to properly monitor, are also used in Finland. Among other things, we refer patients too often to spine imaging. Moreover, imaging findings are interpreted often incorrectly.

“On top of all this, the statements and actions of health care professionals, such as incorrect interpretations of imaging results, often cause unintended fear in patients that can prolong or worsen pain,” explains Karppinen.

On a global scale, low back pain is the most important disabling health problem. Finns are no different from any other population in this respect, and low back pain is one of the most common reasons for seeing a doctor in Finland as well.

“More than half a billion people are suffering from low back pain at this time point. In global terms, the disability caused by low back pain has increased by more than 50% over the past 25 years. The resulting problems are greater than those caused by lung, breast and intestinal cancer combined,” lists Karppinen.

In the Finnish Health 2011 survey, more than 40% of women and 35% of men had suffered from back pain during the previous 30 days.

Along with human suffering, low back pain has a high cost for society in the form of treatment-related costs and work disability. At the end of 2016, approximately 21,000 Finns were on pension because of back problems. The costs of these pensions totalled 280 million euros. In 2017, the costs of sickness allowance days were slightly over 100 million euros.

Exercise is the most effective form of treatment

Instead of being put on sick leave, patients should be encouraged to exercise and stay active, because exercise is an effective way to relieve low back pain.

“In cooperation with the employer, it’s important to plan the measures needed to modify the work to ensure the patient to continue working or return to the workplace quickly,” adds Karppinen

Karppinen works as a professor at the University of Oulu and as a specialist at the Finnish Institute of Occupational Health. He is a highly networked researcher who works in several multinational projects and cohort studies with research groups and universities located in, for example, Hong Kong, Australia, the USA and Great Britain.

 

Further information:

Professor Jaro Karppinen
Centre for Life Course Health Research, University of Oulu
jaro.karppinen(at)oulu.fi
+358 41 446 2859

www.thelancet.com/series/low-back-pain

In Twitter: #LowBackPain

 

Last updated: 6.4.2018