An investigative review published this month in JAMA Internal Medicine, Prevention of Low Back Pain, seeks to determine the effectiveness of preventing low back pain as discussed in multiple media reports.
Researchers affiliated with the George Institute for Global Health at the University of Sydney in Australia and other institutions, surprisingly finding few high-quality studies among some 6,000 conducted worldwide, selected 23 found to be methodologically robust for their review.
Researchers concluded “success” in preventing low back pain is “discouragingly limited,” with favorable results achieved solely through exercise – of any kind.
Professor Chris D. Maher, PhD, FACP, overseer of the review, defined pain prevention “success” in The New York Times as:
A reduction in “the risk of having an episode of low back pain in the next year by 45%.”
An NPR report by Rae Ellen Bichell interpreted the results even more pessimistically, with exercise reducing the risk of repeated low-back pain in the year following an episode by only between 25 and 40 percent.
Think about this for a moment.
The best medical result for those who exercise is a 45% chance of a low back pain nonrecurrence for one year.
Why would medical professionals deem this a successful result: the best treatment answer to chronic back pain prevention is patients should exercise regularly, and even then less than half will achieve relief?
Is any other disease studied so little? With conclusions revealing such unpromising results?
The most enlightened finding of this latest review should be an eye-opener to everyone in the healthcare industry: modern medicine does not understand the cause of chronic low back pain.
Lower back pain is the leading cause of disability worldwide. According to global burden of low back pain estimates, “…further research is urgently needed.” And yet we see a scarcity of high-quality studies.
Until now, few studies systematically examine what really works against repeated back pain and what doesn’t. —Gretchen Reynolds, NYTimes Well blog
While this latest review brings attention to the lack of research, it also highlights how the medical profession’s approach to the problem is wrong.
The direction of research must change.
To move forward and relieve this global burden, low back pain medical research must escape old thinking, and move to a new intelligence.
Says sports medicine and pain expert Sean Wheeler, M.D.: “The medical community, including medical insurers, must understand cause.”
Yet, the answer to the causation question has been found, with the needed shift in thinking about cause of chronic back pain is maddeningly small and intuitive. Recognition of this change is what spins the entire discussion of low back pain on its ear.
Says Dr. Wheeler:
We should all be challenging the status quo of accepted back pain treatment practice.
I offer a viable alternative from our global inertia in the pages of UPRISE, where I systematically identify and challenge the manner and methodology of how my profession has understood and treated back pain during the past 40 years. In UPRISE I put forth solutions. And call for more ideas and further research.
Is this where the revolution gains traction?
What will it take for individual healthcare professionals, insurers, and philanthropic donors to question what they’ve been taught and believe about chronic back pain?
Let us question, and challenge. It’s time for everyone within the healthcare industry to move to a new mastery for patients everywhere.
