Science Snippet: Sources of Lower Back Pain

Most adults suffer lower back pain some time or another, and for some it may be debilitating. Unfortunately, the source of such pain is also a pain for physicians to diagnose and, all too often, unnecessary surgery is performed. A number of physicians have begun looking at data that show that that non-surgical approaches may have better outcomes. For example, spinal fusion that “welds” together adjacent vertebrae is shown to yield no better outcome than supervised exercise and therapy. Also, studies indicate that psychological stress may be a better predictor of back pain than standard diagnostic methods. The bottom line is that back pain is very common and probably overtreated, its origin is often difficult to ascertain, and emotional state may be a major contributing factor. (Deyo and Weinstein, 2001, New England Journal of Medicine, vol. 344, Feb. 1; G. Kolata, 2016, “Why ‘Useless’ Surgery Is Still Popular,” The New York Times, Aug. 4; Deyo et al, 2009, “Overtreating Chronic Back Pain: Time to Back Off?” J. American Board of Family Medicine, Jan.-Feb., pp. 62-68; S. Graham, 2004,, May 17)

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