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Treatments for chronic back pain may not be clinically supported

In the war against chronic back pain, a recent study suggests that treatment approaches may have strayed from clinical guidelines.

In a 12-year period between 1999 and 2010, researches examined outpatient data from nearly 24,000 patients suffering from spine problems or pain. Researchers specifically used only patient data where a diagnosis of neck or back pain had been made as a primary or secondary issue affecting the patient.

The diagnoses seem to be supported by reliable measurements, gathered from diagnostic imaging equipment such as MRI and CT scans. However, the diagnostic approach may have been premature in some cases. Researchers observed that imaging scans increased from 7.2 to 11.3 percent over that period.

Researchers also found that the treatment prescribed for neck or back pain included a wide variety of offerings, ranging from referrals to other health professionals, such as physical therapists, to medication, steroids and/or narcotics. Although physical therapy and anti-inflammatory medication are supported by clinical data, the use of narcotics is not.

From a perspective of Social Security disability benefits, the divergent -- and potentially unsupported - approaches taken to the diagnosis and treatment of back pain may not serve an individual unable to work and in need of Social Security disability insurance payments. The Social Security Administration typically requires substantial evidence of how a disabling condition affects an individual, and whether treatment options permit that individual to continue working. As a disability benefits attorney might agree, that burden of evidence is already high. The instant study might have an adverse effect of making SSA officials even more stringent in their approval of SSDI applications.

Source:, “Back Pain Tx Not Syncing with Guidelines,” Cole Petrochko, July 29, 2013

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