Low back pain still being treated incorrectly, often including unnecessary surgery
Millions of people around the world are getting the wrong treatment for low back pain and South Africans are no exception, according to new research from The Lancet. As a result patients are not getting the relief they need and resources are being wasted on interventions that do not work.
Worldwide, low back pain is the leading cause of disability, affecting about 540-million people at any one point in time, according to the Lancet series on low back pain, published on Wednesday. In Africa, more than a third of people suffer from some form of back pain at any point in time.
Many of these people are being prescribed potentially addictive opioid painkillers and referred for expensive scans and surgeries when their problems could be managed through cheaper, safer and less invasive therapies, said study contributor Quinette Louw, of the division of physiotherapy at Stellenbosch University’s faculty of medicine and health sciences.
"It’s important to recognise that in most cases low back pain will resolve on its own. We need a major education campaign to tell people to stay active, continue working and only see a professional if there is no sign of improvement," she said.
"Research has repeatedly shown that most patients get the wrong care for low back pain. The implications are costly interventions, which have low value. Decision-makers from low-and middle-income countries must be made aware of these pitfalls in order avoid wasting scarce resources and harming patients," she said.
South African primary healthcare facilities routinely prescribed opioid painkillers, and in the private sector many patients were also likely to be subjected to a battery of inappropriate investigations and surgery, she said.
The Lancet series suggests many of the mistakes of high-income countries like the US are well established in low-income and middle-income countries. Rest is frequently recommended in low-and middle-income countries, and few resources are available to modify workplaces.