Back pain is one of the most common health complaints, affecting more than one in four adults every year, and a popular reason for physician visits. But most people recover from back pain whether they’re treated medically or not, says Wolf Mehling, a professor of medicine at the University of California at San Francisco.
For people who do see a doctor, research shows that while the vast majority get better, a small percentage get worse. In a recent study, Mehling and his colleagues interviewed 521 people six months after they’d seen doctors for acute back pain; 81 percent of them were completely recovered or much improved, while 16 percent were the same or slightly improved and 3 percent were worse off.
The American College of Physicians guidelines for back pain generally recommend over-the-counter pain medication, rest and exercise for initial treatment for “nonspecific” back pain, which means pain that is not clearly linked to injury or disease. Yet many people go to the doctor for nonspecific back pain, where they are often given prescription pain relievers and/or are sent for expensive tests. (Of course, if you have severe pain and/or have been injured, you should go to the doctor immediately.)
A recent study categorized treatments offered in nearly 24,000 patient visits for back or neck pain in a 12-year period. (This sample did not include people with “red-flag” symptoms such as pain radiating down the leg, which can indicate a nerve problem.) Prescriptions for opiate pain medication increased, from 19 percent in 1999-2000 to 29 percent in 2009-2010; likewise, referrals to another physician increased from 7 percent to 14 percent, and CT or MRI scans increased from 7 percent to 11 percent. These trends run counter to clinical practice guidelines for acute spine pain, such as those published by the American Pain Society and the American College of Physicians, the study says.