Ali H. Mesiwala, MD, FAANS
Low back pain remains a costly, debilitating problem for many adults in the United States. As this study outlines, it is the third most common and costly medical problem for which adults are treated. As the natural history of back pain and its multiple causes are better understood, a reduction in the use of unnecessary diagnostic tests and treatments has occurred. This study supports earlier studies that have demonstrated a downward trend in the use of low-value services, such as sophisticated imaging, epidural steroid injections, surgery and opiate use over the last decade. Other, less invasive treatments, such as physical therapy, acupuncture, yoga and Pilates, have proven to be of great value and can be used long term with little, if any, side effects or detriment.
As one would expect, with more detailed history taking and physical examination, and a better understanding of the anatomy which causes back pain, patients who truly require invasive treatments are more appropriately evaluated and dealt with and return to full function and unrestricted life as a result. As we continue to improve our understanding of the spine and pain, we expect similar trends to continue, reducing health care costs, unnecessary procedures and prescription of opiates.
Ali H. Mesiwala, MD, FAANS
Board-certified neurosurgeon
DISC Sports & Spine Center
Newport Beach, California
Disclosures: Mesiwala reports being a consultant for NuVasive, LifeSpine, SI-BONE, Abbott, Providence Medical Technologies and Neo Medical; and receiving royalties from SI-BONE, NuVasive and LifeSpine.
