Dr. John N. Mafi, a fellow in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, said back pain is the fifth-most common reason for doctor visits and accounts for more than 10 percent of all appointments made with primary care physicians.
Published guidelines for routine back pain advise use of non-steroidal anti-inflammatory drugs such as NSAIDs or acetaminophen and physical therapy. Within three months of these treatments back pain usually resolves, Mafi said the research showed.
However, "Routine back pain increasingly relies on advanced diagnostic imaging, referrals to other physicians and use of narcotics, with a concomitant decrease in NSAIDs or acetaminophen use and no change in physical therapy referrals," Mafi, the study's lead author, said in a statement.
In addition to the extra cost, unnecessary treatment is not only expensive, but also can come with complications, Mafi said.
A meta-analysis concluded narcotics offer minimal benefit to relieve acute back pain and have no proven efficacy in treating chronic back pain.
Overuse of imaging may not result in immediate problems but exposure to ionizing radiation can lead to further health complications such as cancer, Mafi noted.
"Increased use of advanced imaging represents an area of particular concern," Dr. Bruce Landon, the study's senior author, said. "Early in the course of back pain, such imaging is almost always wasteful. Moreover, there are almost always some abnormalities, which increases the likelihood that a patient will undergo expensive spine surgery that might not improve their outcomes over the longer term."
The findings were published in Internal Medicine.
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