ABC Breakfast: Back pain is being ‘mismanaged’ with ineffective and harmful treatments, experts warn
A team of international health experts has accused the medical fraternity of “mismanaging” back pain and providing “ineffective and harmful” treatments.

In three papers published in the esteemed Lancet medical journal, the Australian and international authors assert that low back pain has increased dramatically in recent years and is now the leading cause of disability globally.

They find there is an over-reliance on scans, surgeries and opioids prescriptions to treat a problem that could be more effectively addressed through self-management and less-invasive physical and psychological therapies.

Key points:

  • Back pain an increasing global problem
  • Now the leading cause of disability globally
  • More than 3.7 million Australians experience back pain on any given day
  • Australian experts warns US-style opioid crisis was a cautionary tale

Monash University researcher, Professor Rachelle Buchbinder, is the lead author of one of the three papers and said a radical shift in thinking was required.

“The burden from low back pain has reached a tipping point where the condition is growing rapidly, is poorly understood and is being mismanaged medically — at cost both to the patient and to the healthcare system,” she said.

“It’s a problem in Australia. A large number of people are receiving low-value care that wastes a lot of money, it’s ineffective and sometimes harmful.

“And at the same time they’re not receiving the evidence-based care that could actually help them.

“Both clinicians and the public have misconceptions that we can identify a cause and therefore we can treat something specific.”

Professor Buchbinder said back pain should not be treated as an “injury”, but as an issue that comes and goes and in many cases can be effectively managed.

A growing issue

The Lancet papers found that globally, years lived with disability caused by low back pain increased by 54 per cent between 1990 and 2015, primarily due to population increase and ageing.

It is estimated 540 million people worldwide are now affected by back pain at any one time, while in Australia more than 3.7 million people experienced this type of pain.

The papers found that an ageing global population, urbanisation, sedentary lifestyles and the emergence of new technologies would likely exacerbate the problem.

Australian back pain expert, Professor Chris Maher, is the lead author of another of the Lancet papers and said a better understanding of the issue was needed.

“There are safe, effective treatments for low back pain; the challenge is ensuring patients get the right care at the right time,” he said.

The paper he co-authored found despite very few cases of back pain constituting a medical emergency, patients in Australia frequently go to the emergency department.

And that while surgery has “at best a very limited role for low back pain”, Australian studies showed frequent use of spinal fusion.

The US is a cautionary tale

Professor Buchbinder’s paper cited the ongoing opioid addiction crisis in the US as a worst-case scenario if the medication-oriented approach to low back pain wasn’t shifted.

Back pain in Australia

  • Australia spends $4.8 billion a year on management of low back pain
  • Back pain reduces Australia’s GDP by $3.2 billion a year
  • 50 per cent of Australians suffered from back pain in the past month

Source: Monash University

“Increased use of ineffective and potentially harmful treatments has wasted limited health care resources and caused harm,” the paper reads.

“The current epidemic of addiction and rising mortality resulting from increased opioid prescribing in the US over the past 20 years provides a dramatic example of the disastrous effects of harmful medical intervention.”

Professor Buchbinder’s paper found that funding for low back pain research was “limited and unco-ordinated” and called for the establishment of a global network of experts to pool their experience and research.

Source (See Video): ABC Breakfast – http://www.abc.net.au/news/2018-03-22/back-pain-is-being-mismanaged-health-experts-warn/9570188

by Alan M. NSW. March 2018
I was a non-believer. How could something like this work. You can’t feel it but some how it just works!!!  It works like acupuncture but with no needles and you can use it in your own home, anytime, anywhere.  (reviewer has used Painmaster since approximately October 2015. The reference to acupuncture is the reviewers description only)

by Madelele M. VIC. March 2018
I have been diagnosed with severe osti arthritis in my neck, back, knees and feet that has affected my mobility, and at times I have found it difficult to cope with the pain and discomfort. However for several years I managed my condition with exercise, (paracetemol), and when required anti – inflammatory medication. Due to several factors my Doctor was not keen on prescribing the anti-inflammatory medication. Three years ago I had two operations and radiation treatment for breast cancer. I considered the surgery and treatment effected my mobility and it became more difficult to manage my arthritis condition. I experienced severe neck pain. An MRI confirmed I had “severe to gross” damage to parts of my neck. My Doctor tried several avenues to assist me. However I got little, if any relief. The anti – inflammatory medication helped my overall mobility to an extent, however did nothing for my neck. I was referred to a specialist who confirmed diagnosis, and suggested I go on stronger medication. I did not want to do this for several reasons. I was the carer for my husband who was suffering from asbestosis fibrosis. Also, I found if I did take stronger drugs they only relieved the pain for a short time and left me feeling very drowsy.

I was referred to a physiotherapist after several months. He did help me a little. I had this cracking noise when I moved my neck and his treatment fixed this problem. I did all I could to improve my situation, heat bags,physio, exercise, (paracetemol), natural medications. I began to just live with the situation. About two years ago my daughter who is a nurse was visiting a women in a nursing home to dress her wound. She was wearing a Painmaster, and my daughter enquired about what it was. She told her story saying it was the only thing that had given her any relief from her back pain. My daughter followed up and presented me with all the information. I will say I was very cynical at first, however I was also desperate at the time so I said I would give it a trial. Well I did and almost from the start it gave me relief. I am so grateful for that conversation my daughter had. My Doctor or physio had never heard of the product. My Doctor was very impressed with my response. She bought several Painmaster’s for her daughter who suffered neck pain. She reported that her daughter had also found relief from using Painmaster. I used the Painmaster daily for approximately six months. I then began to realise I did not need to be using it all the time. I also have a problem with back pain and at times get Sciatica down my leg. When the Sciatica flares up I now use the Painmaster to settle it down. I found with my back pain I had to make sure I place it in the right spot. I only need to use the Painmaster now for my back on a needs basis. My neck has healed for the moment. I am very careful not to aggravate my condition. I take magnesium supplements and (paracetemol) when required. There is no doubt in my mind, Paimaster worked for me. When I look back on that time when I was in constant pain with my neck, I can feel tears in my eyes. I am grateful to feel so much better. Life is good. I am surprised more people do not use it, I have recommended to friends and family. They say they must try it. However I am not sure they do. Perhaps they were not as desperate as I was for relief. I know this review turned out to be a long story, however it was my story of a very distressing time in my life, and I did not really know how to make it shorter.

By D.Thompson
WA. March 2018
My doctor referred me to a specialist who decided i needed a full shoulder reconstruction 12 mths ago.Everything was set to go when other health problems arose so having to cancel the operation. My pain at night was equal to 8/10 & couldn’t get to sleep.

Using Painmaster on my shoulder allowed me to go to sleep within 10 minutes, even allowing me to sleep on the bad shoulder. The pain is bearable when upright so only use the patches at night.This has given me another 12 months before i will have the operation due to the degeneration. Tried (extra strength paracetamol) but only lasts for half an hour were the Painmaster lasts for as long as you have it on. Well done & would recommend anyone should give it a go.
Shoulder_Painmaster

Bad Ankle – Only Use Painmaster
By J.Riley
VIC. March 2018
I have quite a bad Ankle and do not use any medication, the only thing I do is I have my (Painmaster) patches on all the time. I swim every day in my pool so I take it off and put it back on again when I finish my swim. Some times when I am busy afterwards and forget to put it on again, it gets very painful later in the day. So I know that I have to put it on straight out of the pool. I have Osteoarthritis in that Ankle so it is painful. I’m a 78 year old lady.ankle_pain