Back Pain Moves Most to Choose Hands-On-Therapy:
Chiropractor, Massage, Acupuncture
Over fifty-percent of those given a prescription drug
received an opioid pain reliever, despite the fact that there is very
little research to support their use, finds Consumer Reports
study
April 6, 2009 When people have a back ache they
want hands-on treatment, like from a chiropractor, physical therapist or
even acupuncture. Yet, forty-five percent of those who took prescription
drugs said they helped a lot, according to a new survey by the
Consumer Reports Health Ratings Center.
Fifty-eight percent rated chiropractic/spinal
manipulation as helping their back pain a lot. And, massage (48%) and
physical therapy (46%) were close runners up.
Consumers also rated their satisfaction with
practitioners, telling Consumer Reports they were more likely to
be highly satisfied with the back pain treatment received from their
chiropractors (59%) than from their primary care physicians (34%).
About 80 percent of U.S. adults have at some point
been bothered by back pain. To compare which treatments helped most,
Consumer Reports surveyed more than 14,000 subscribers who had
lower-back pain in the past year but had never had back surgery.
Consumer Reports asked its subscribers to
rate a comprehensive list of potential remedies along with their
satisfaction with the health-care professionals they visited. Most
respondents had tried five or six different treatments on average.
In a special online report at
www.ConsumerReportsHealth.org, the Consumer Reports Health
Ratings Center analyzes the medical evidence for each of 23 treatments
side by side with consumers experiences and provides recommendations
and cautions. The site includes a free diagnostic tool for back pain.
Here are some
survey highlights:
● The percent of people highly satisfied with
their back pain treatments and advice varied by practitioner visited:
Professional
Highly Satisfied
Chiropractor
59%
Physical therapist
55%
Acupuncturist
53%
Physician, specialist
44%
Physician, primary care
34%
● Many of the respondents to the Consumer
Reports survey said the pain interfered with sleep, sex, and efforts to
maintain a healthy weight. Eighty-eight percent reported that their
back pain recurred through the year. And over half of survey
respondents also reported that low-back pain severely limited their
daily routine for a week or longer.
● Forty-four percent of survey respondents found
exercise helpful, making it the top self-help measure. And a surprising
58 percent of respondents wished that they had done more exercises to
strengthen their backs in the past year.
● Although lower-back pain is the fifth most
common reason people go to a doctor, 35 percent of the people surveyed
by Consumer Reports said they had never consulted a professional. Most
of them had severely limiting pain for less than a week. Many of those
with more prolonged pain who didn't see a health-care professional said
it was because of cost concerns or because they did not think
professional care could help.
Concerns About Rising Use of Narcotics
More than fifty-percent of those given a
prescription drug received an opioid pain reliever, despite the fact
that there is very little research to support their use for acute
low-back pain.
There are almost always better solutions than
opioids for low-back pain. They have numerous adverse effects such as
drowsiness, respiratory depression, constipation, and nausea, to name a
few. And overdose is a big concern, sending increasing numbers of
patients to emergency rooms as opioid prescriptions rise, said Dr. Orly
Avitzur, a board-certified neurologist and medical adviser to Consumers
Union. Dr. Avitzur discusses her concerns about narcotics in her 5
Minute Consult, available online at
www.ConsumerReportsHealth.org.
Getting Treatment
When back pain is severe, a visit to a primary care
doctor is a reasonable first step. A doctor can help rule out disease,
such as infection or cancer, and refer a patient to a hands-on
practitioner who might be covered by health insurance.
Using self-help approaches to ease the pain or
seeing a chiropractor or physical therapist as a first step might be
okay for a recurrent, familiar back problem. Research suggests that
chiropractic manipulation can reduce acute low-back pain, and many,
though certainly not all, of the respondents who tried it said it
helped.
Use Caution with Surgery
If back pain is unrelenting and no other treatment
has seemed to work, a doctor might suggest seeing a surgeon. Consumer
Reports conducted a separate survey of almost 1,000 consumers who had
back surgery in the past five years.
Those who had back surgery had tried nine to 10
treatments and described themselves as much more impaired by their pain
than people with back problems who did not have surgery. Just 60
percent of the back-surgery respondents were completely or very
satisfied with the results. But satisfaction depended on the diagnosis
and the type of surgery.
Those with degenerative disk disease (arthritis of
the spine) were far less likely to be highly satisfied with surgery (54
percent) than those with a herniated disk (73 percent) or spinal
stenosis (71 percent).
But not everyone does so well. More than 50
percent of respondents reported at least one problem with recovery,
finding it lengthier and more painful than they had expected. The most
common regret was that more post-surgery rehabilitation was not planned.
Indeed, 16 percent of back-surgery respondents said that their back pain
did not improve, and half of those said it became worse after surgery.
Consumer Reports advises patients that are
told they need surgery to get a second opinion from another
practitioner, preferably one who is not a surgeon. If surgery is the
best approach, find out if the selected surgeon is board-certified and
ask how many operations he or she has performed. Patients should be
aware that significant problems during recovery may be underestimated;
it helps to have plans to adjust to such challenges.
A summary of the survey is available in the May
2009 issue of Consumer Reports.
Information Source:
About the Consumer Reports Health Ratings Center
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ratings of thousands of products and services for the expertise and
independence they represent. The Consumer Reports Health Ratings Center
uses similar approaches to produce ratings tables, selecting the best
sources of research to rate health care services, drugs, devices,
institutional providers, and eventually physicians and other
practitioners. The Health Ratings Center (www.ConsumerReportsHealth.org)
currently provides Best Buy Drugs (BBD) ratings on prescription
medications for more than 20 common medical conditions; a wide array of
healthy living products such as sunscreens and gym equipment; thousands
of natural medicines; and treatment options for more than 200 conditions
and diseases.
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an expert, independent nonprofit organization whose mission is to work
for a fair, just, and safe marketplace for all consumers and to empower
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April 6, 2009 When people have a back ache they
want hands-on treatment, like from a chiropractor, physical therapist or
even acupuncture. Yet, forty-five percent of those who took prescription
drugs said they helped a lot, according to a new survey by the
Consumer Reports Health Ratings Center.