Back Pain Treatment Results Getting Worse

The following is from OMCA (Occupational Managed Care Alliance, Inc.) in a newsletter dated August 9, 2013.  Pressure upon physicians to "do something" from patients, as well as the ever-present risk of medical malpractice claims, seems to be moving many physicians away from well-established, more conservative, treatment of non-specific back pain. While this may not be exclusive to workers' compensation claims, it certainly appears to be a driving factor in the increasing medical costs for treatment of 'routine' low and mid back strain type conditions.


A new study published in JAMA Internal Medicine and highlighted in Medical Economics concluded that “physicians have gotten worse at following well-established guidelines for treating routine back pain.”

Researchers, led by the Harvard Medical School faculty, analyzed data from 24,000 visits for spine problems (both acute and chronic) over the last decade and concluded:

Narcotic usage increased 50%

Scans (CT/MRI) increased 50%

PT and X-rays were unchanged

NSAIDs (Motrin, Advil, Aleve, etc.) usage decreased 33%

Referrals to specialists (e.g. orthopedic surgeons) doubled!

Dr. Bruce Landon, an author of the study, is quoted as follows:

“When patients first present with back pain, the majority of them will have complete resolution of their symptoms within a couple of months.”

“The most worrisome findings were the rapid rise in narcotic prescriptions.”

“Narcotics have not been shown to improve back pain, and they can lead to addiction.”


With back pain being one of the most common reasons claimants/patients see a doctor (with an $86 billion annual price tag), this is pretty strong stuff.

Potential explanations why physicians ignore the conservative treatment guidelines include:

Price insensitivity (by both patients and doctors)

Patient demands (for quick answers and fast resolution)

Fear of malpractice liability.


Don’t allow your patients/claimants to be subjected to unnecessary diagnostics, ineffective surgeries and risky exposure to addictive narcotics.

We can help you follow the stinkin’ guidelines.

Call us. We can do better.

William Faris, JD
Chief Executive Officer