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Better results for back pain treated according to medical guidelines



A study by University of Utah Health and MDGuidelines researchers found that people with lower back pain miss 11 more working days in a year when they only receive treatments for back pain that are not recommended by medical evidence-based guidelines compared to people treated according to guidelines .

Data for the study, released Thursday, came from California workers' compensation claims between 2009 and 2018 for 60,000 workers who had uncomplicated, acute back pain or exertion, which researchers considered the most common workplace injury.

The researchers then tracked whether treatments prescribed at clinic visits during the first week after the injury were categorized as recommended or non-recommended in the peer-reviewed American College of Occupational and Environmental Medicine guidelines, assuming that similar treatment patterns would continue at subsequent clinical visits. . The researchers then calculated the number of lost working days in the first year after injury, according to a statement.

They found that 1

4% received only non-recommended treatments, 51% received a mixture of non-recommended and recommended treatments, 14% received only recommended treatments and 21% received no medical intervention.

Of these, workers who received recommended treatments in combination with non-recommended treatments saw an intermediate benefit and lacked a median of eight working days during the year compared to those who received exclusively recommended treatments.

The study found that the most common non-recommended treatments were prescriptions for opioids, which are discouraged because they aggravate weakness instead of exercise and can be addictive, and X-rays, which can lead to misdiagnosis. The most commonly recommended treatments were non-steroidal anti-inflammatory drugs and muscle relaxants.

The study also found that the treatment method that changed most drastically was opioid prescriptions, which fell by 86% over nine years. Researchers said the large reductions in opioid prescriptions for lower back pain suggest that "extra incentives, such as insurance that refuses to pay for non-recommended treatments, increase compliance with the guidelines."

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