It’s Getting Worse????

I am the first one to admit that treating patients with low back pain is not for sissies. There is no great way to sub-classify patients with low back pain and it is difficult to predict which intervention is going to be best for a given patient. However, there are some general recommendations which just about every up-to-date treatment guideline recommends. These are things like stay active, no need for imaging in most cases and avoid opioids.


Despite the solid evidence behind these recommendations, a recent study out of Harvard showed that primary care physicians are getting worse at treating patients with low back pain. Over a 11 (1999-2010) year period the study found a 106% increase in referrals to other physicians, 57% increase in advanced imaging, a 51% increase in the use of narcotics and a 0% increase in physical therapy referrals (20%).

It would be frustrating to see no improvement over 12 years, but this significant movement in the wrong direction is a hard pill to swallow. I wonder what it will take to change the medical culture in our society.

Apparently a 90 billion dollar a year price tag is not enough.


Categories: Low-Back

2 replies »

  1. Interesting article. My girlfriend is a family medicine doc and she refers to PT but she is also very much pathology oriented. From what we know about pain science I can see how looking for abnormalities can create problems instead of help fix them.

  2. Wow.

    All the more need for certified P.T.’s.

    I’d recommend the CWcHP certification, it brings P.T.’s directly into healthcare. I think, granted your passion to share this information with community, that you would make a fantastic candidate for certification, certification that increases the number of clients you or your clinic are caring for.


    Keep it up!

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