2 Your Health: Brue Chiropractic

The medical mismanagement of back pain: the real story behind the serious mistakes doctors are making in daily practice.

Dr. Craig Brue

The above headline recently appeared in news journals around the country. What are the recommended guidelines that MD’s are not following for the treatment of back pain?

The main guideline that MD’s are not following is in the overutilization of narcotic drugs for back pain. The most common narcotics prescribed for pain are Vicodin, Percocet, and Oxycodone. Last year, more than 15,000 people died from the use of narcotic drugs. Doctors are being criticized for the over-utilization of addictive narcotics because NSAIDs (aspirin, ibuprofen, or naprosyn) will usually give temporary pain relief.

The second guideline for back pain that is being ignored is the overuse of costly MRI studies. An MRI should be reserved for those patients that may require surgery or further diagnostic testing. It is seldom necessary to order an MRI study within the first four-six weeks of an episode of back pain. Conservative management should be tried before ordering expensive imaging studies.

A recent study published in the Annals of Internal Medicine reported that when it comes to neck pain, the best medicine is no medicine at all. The findings of the study revealed that after 12 weeks the patients who used a chiropractor or exercised were more than twice as likely to be pain free compared to those who relied on medicine. Dr. Lee Green, a family medicine professor at the University of Michigan, had this comment for ABC News regarding the use of medication for neck pain: “Neck pain is a mechanical problem, and it makes sense that mechanical treatment works better than a chemical one.”

The third mistake that physicians make is a prompt referral to a spine surgeon or pain clinic. Pain management clinics usually offer spinal injections and stronger medication for the treatment of back pain. Pain management is not necessarily better management, but it is always riskier and more expensive management. A recent article from USA TODAY revealed that “Unnecessary surgeries might account for 10-20% of operations in some specialties, including spinal surgeries. About 10% of all spinal fusions paid for by Medicare in 2011 were not necessary.”

What can we learn from the medical mismanagement of back pain? The most important lesson is this. Do the most conservative treatment first. The most conservative treatment for back and neck pain is chiropractic care. A chiropractic physician will evaluate the biomechanics of your spine by examination and x-ray studies. An accurate diagnosis will lead to the best treatment protocol. Chiropractic treatment is the safest way to treat back and neck pain because a chiropractor does not utilize drugs or surgery. If you need additional medical help, your chiropractor will refer you to the appropriate health care provider.

These are the most effective treatment guidelines for back and neck pain: chiropractic first, medicine second, pain injections, and surgery last.

Dr. Craig Brue is an author, lecturer and chiropractic provider in SaddleBrooke, AZ.