A new article in the Lancet, written by researchers at the University of Sydney, reveals a global problem of unnecessary tests and treatments for back pain, such as imaging, opioids, and surgeries.

University of Sydney author Professor Chris Maher said millions of people across the world are getting the wrong care for low back pain.

“More care does not mean better care. More aggressive treatments for low back pain have little proven benefit and have the potential to make things significantly worse for patients.

“Evidence suggests that low back pain should be managed in primary care, with the first line of  treatment being education and advice to keep active and at work.

“However, in reality, a high proportion of patients worldwide are treated in emergency departments, encouraged to rest and stop work, are commonly referred for scans or surgery, or prescribed pain killers including opioids, which are discouraged for treating low back pain.”

Associate Professor Manuela Ferreira said “but they don’t fund interventions that are helpful including physical and psychological therapies for chronic low back pain.”

Associate Professor Paulo Ferreira said: “The series highlights the need to address widespread misconceptions in the population and among health professionals about the causes, prognosis and effectiveness of different treatments for low back pain.”

What are the common issues related to the management of low back pain in Australia?

• When patients visit a GP for low back pain, they are often prescribed pain medication without receiving guidance or education on how to self-manage their condition.

• Approximately one third of physiotherapists support the use of outdated and ineffective treatment methods for their patients.

• Many chiropractors mistakenly believe that patients with acute low back pain require imaging.

• While back pain is ideally treated in community facilities rather than hospitals, there has been a rise in hospital admissions for back pain over the past decade.

• More individuals are opting to call emergency services when experiencing low back pain instead of following guidelines to consult their GP, physiotherapist, or chiropractor.

• Among older individuals with back pain, there is a growing tendency towards increased use of spinal fusion surgery despite evidence suggesting its ineffectiveness, high cost, and potential risks.

• GPs are advising patients with low back pain to stay off work until pain-free, a practice that can impede recovery.

• Medicare's limit of five allied health consultations is insufficient for delivering a typical exercise program for chronic low back pain.

• GPs who claim to have a special interest in low back pain are more prone to providing incorrect treatments for the condition.