Docs, patients not following back pain treatment guidelines

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KANSAS CITY, Mo. --  Back pain is one of the most common reasons people go to the doctor.  New research finds doctors and patients are increasingly turning to treatments that are not recommended by experts instead of those that are.
 
Mary Jane Wingett never imagined that ten minutes of pulling weeds would land her on the physical therapy table.  But she's glad her doctor referred her to Steve Adams, a physical therapist in Kansas City North.  Guidelines for back pain treatment recommend physical therapy.   
      
"For my part, the physical therapy is definitely a better avenue than being on pain medication forever," says Mary Jane.
 
Guidelines recommend acetaminophen or non-steroidal anti-inflammatory medicines for back pain.  But a new study finds their use dropped over a ten-year period.  Use of narcotics, strong pain medicines, increased even though guidelines don't recommend them. 
 
"That's been proven not to help in the long-term at all.  Patients have to learn how to manage their own pain outside of the medications," says Adams.
 
The study in JAMA Internal Medicine also found that referrals to specialists such as back surgeons increased.  So did referrals for CT scans and other expensive imaging tests even though guidelines say they're unnecessary. 
 
On the other hand, physical therapy referrals didn't increase.   
   
"Some patients don't want to put out the time and effort to go through a strengthening, flexibility, retraining how-the-back works program," says Adams.
 
Brad Rumble has put in the time although he says recently, he's had to use more pain medicine.  
 
"I don't want to take too much," says Rumble.
 
With therapy and exercises at home, maybe he won't have to forever.  

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