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Get Vertical: Don't Take Back Pain Lying Down

January 11, 2012 -- For people with the most common type of low back pain, imaging tests don’t give doctors much information that’s useful for diagnosis or treatment and a non-prescription pain reliever is the best choice if medication is needed. Despite that, 2010 data shows at least 26 percent of Oregonians who received care for a new episode of simple low back pain received an imaging test and approximately 15 percent filled prescriptions for narcotic pain relievers within 90 days.
January 11, 2012

January 11, 2012 -- For people with the most common type of low back pain, imaging tests don’t give doctors much information that’s useful for diagnosis or treatment and a non-prescription pain reliever is the best choice if medication is needed. Despite that, 2010 data shows at least 26 percent of Oregonians who received care for a new episode of simple low back pain received an imaging test and approximately 15 percent filled prescriptions for narcotic pain relievers within 90 days.

A new campaign launched as part of the Oregon Health Care Quality Corporation’s Partner for Quality Care initiative is educating people with low back pain on how to get the right care when they need it, while also staying active and avoiding unnecessary care that doesn’t improve their health.

The campaign is based on a recently released State of Oregon Evidence-based Clinical Guideline for the Evaluation and Management of Low Back Pain and includes a consumer booklet and interactive, online quiz to help people with low back pain take simple steps on their own to feel better.

Among the simple steps, the campaign urges people with low back pain to stay active because inactivity can actually slow down recovery. The campaign asks people with low back pain to carefully consider their treatment options, gives an overview of when they should see their doctor and provides safety tips for using pain relievers.

“Our goal is to provide resources to providers and to consumers that help people effectively manage low back pain without having to undergo tests and treatments that may not benefit them, and that have potential to do harm,” says Mylia Christensen, executive director of the Oregon Health Care Quality Corporation. “This is especially important in Oregon, which has the third highest rate of back surgery in the country, according to the Dartmouth Atlas Project.”

The state’s new clinical guideline was developed in partnership by the Oregon Health Care Quality Corporation, Oregon Health Authority and the Health Services Commission, Center for Evidence-based Policy at Oregon Health & Science University, and the Oregon Health Leadership Council.
The low back pain guideline is the first in a series of guidelines to be developed as part of the strategies outlined in Oregon’s Action Plan for Health, a comprehensive health reform plan created by the Oregon Health Policy Board in response to legislation passed in 2009.

“This collaborative effort to develop consensus on evidence-based guidelines for health conditions such as low back pain can create standards that ensure that high-quality, effective care is provided to every Oregonian,” says Jeanene Smith, MD, MPH, administrator of the Office for Oregon Health Policy and Research. “This effort is an important part of health care transformation that will lead to less variation in care and better health outcomes.”

According to the National Institutes of Health, Americans spend at least $50 billion each year on low back pain, and it’s the most common cause of job-related disability. According to the Department of Consumer and Business Services, MRI of the lumbar spine was among the top 15 workers’ compensation medical services in Oregon in 2010, with payments of $3.36 million for this service alone. This affects the quality of life for many Oregonians and costs millions of dollars for consumers, employers, health plans and the state.

“Medical evidence clearly shows that staying active helps people with low back pain heal faster,” says Valerie King, MD, MPH, director of research and policy at the Center for Evidence-based Policy at Oregon Health & Science University. “We hope that this campaign will reassure and encourage people dealing with low back pain to resume their usual activities as soon as possible and avoid unnecessary medical services which may do more harm than good.”

The Oregon Health Care Quality Corporation is part of Aligning Forces for Quality, the Robert Wood Johnson Foundation’s signature effort to lift the quality of care in 16 target communities and provide models that will help propel national reform. The low back pain campaign resources, including the consumer booklet and online quiz, as well as other resources to help Oregonians become better partners in their health care, are available on the Partner for Quality Care website.

Comments

Submitted by Anonymous (not verified) on Thu, 01/12/2012 - 10:27 Permalink

You article states, "For people with the most common type of low back pain, imaging tests don’t give doctors much information that’s useful for diagnosis or treatment..." I'm a chiropractor and the reason why that imaging doesn't show much is because it's a disorder of motion. The structures unable to distribute stress. Although the article states that pain relievers should be used, which I'm not completely against, when necessary, but most people prefer to not use medication. I also wholeheartedly agree with this statement in your article, “Medical evidence clearly shows that staying active helps people with low back pain heal faster,” says Valerie King, MD, MPH, director of research and policy at the Center for Evidence-based Policy at Oregon Health & Science University. 'We hope that this campaign will reassure and encourage people dealing with low back pain to resume their usual activities as soon as possible and avoid unnecessary medical services which may do more harm than good.'" I am an advocate of "walk it off" (when possible) and "use it or lose it." Not all chiropractors are the same, but modern chiropractic focuses on function and maximizing biomechanical distribution of stress on the structures to allow for normal movement. This allows the body to distribute the stresses placed upon it. Traditional chiropractic postulates "nerve interference" (I do not practice with that mindset), however, modern chiropractic deals primarily with motion and is totally consistent with the conclusions of your report. If you would like more information, please visit my website http://www.drtchiro.com Medical doctors used to advocate bed rest for back pain (not anymore), which chiropractors have never advocated, but have consistently preached movement. Many MD's may prescribe physical therapy, however, if the dysfunction of movement is not addressed adequately, the strengthening of the musculature by exercise may only partially correct the problem, but may offer some relief. Modern chiropractic care would be beneficial by allowing you to move better and faster than you could do it on your own, even though it may be possible to "work it out" by stretching and exercise, by yourself. Quality chiropractic care has many documented studies to demonstrate it's effectiveness. I advocate chiropractic care and exercise to fix a problem, then strengthen it, once it the motion and functional component has been addressed.
Submitted by Anonymous (not verified) on Thu, 01/12/2012 - 13:24 Permalink

I agree with the comment above. Some people in sports now go with MICE, movement, ice, compression, and elevation. Some skip ice and elevation. Water exercise gives motion and even compression. This is my choice, but then I am an exercise instructor.