Costs to treat lower back pain skyrocket. Experts ask: Is it necessary?
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(HealthNewsDigest.com) – COLUMBUS, Ohio) – If you are fidgeting in your chair while reading this because you suffer from back pain, you’re not alone. One in four Americans share your pain* and the cost to treat back problems is skyrocketing. Among Medicare patients, consider:
‣ Costs for steroid injections to treat back pain are up 629%*
‣ Pain pill prescription costs have shot up 423%*, and
‣ Surgeries to treat lower back pain are up 220%.*
But is all that really necessary?
Experts at the Center for Personalized Healthcare at Ohio State University Medical Center say, because we don’t yet understand all we should about back pain, many patients are likely getting drugs, expensive tests or even surgeries they may not necessarily need.
“Typically in medicine we’ve grouped people together, and we see this across many different areas and disciplines” said Jimmy Onate, PhD, Co-Director of the OSU Sports Medicine Movement Analysis & Performance Research Program. “But no two back problems are the same, and we shouldn’t take the same approach to teat them.”
In an effort to more personally diagnose and treat patients, Dr. Onate has teamed up with Ohio State University’s College of Engineering and Bill Marras, PhD, Director of the Biodynamics Laboratory. “What we’re learning is that everybody has their own ‘motion signature’” said Marras. “So, we’ve developed what we call personalized biomechanics models of the spine. We take a CT scan and an MRI of a patient’s spine and build a model of them specifically, as opposed to a generic spine” said Marras.
Researchers then load that information into a computer and put patients through a series of tests. Patients wear a type of vest with various sensors that chart their movements with pinpoint accuracy, and plot the health of their spines.
“We’ll have them basically play a video game with their back and depending on how they perform on that, that tells us whether they have a deficit or not” said Marras. “Based on that information, we can help determine how patients should be directed, whether it’s education, physical therapy or some type of surgery.” If an operation is necessary, added Marras, “we could work with the surgeons to help them understand the implications of their surgeries.”
To put their model to the tests, researchers at Ohio State University Medical Center won’t have to go far. They plan to find, test and follow a group of nurses to see just how their backs work and, if necessary, correct any issues before they get worse.
The back and, more broadly, the trunk of the body “is the foundation for every other movement” said Dr. Onate. “If you don’t have control of the trunk, you really have a difficult time doing everything else.” And few people know that as well as nurses. “They have to move patients, they have to help people get in and out of bed” said Marras, “so, there’s often very large stresses on their spine and we’re trying to look at the implications of those types of motions.”
As a nurse in a rehabilitation facility, Barb Porterfield can relate. “Oh, yes. We’ve had different nurses who’ve had strained backs, who have pulled muscles” said Porterfield. “Many have been off at various times because they’ve pulled their backs doing something.”
So for the next several months nurses like Porterfield may be asked to help researchers get to the bottom of lower back pain. “What personalized modeling helps us do, is actually bring that person’s actual physiology and mechanics into the model” says Marras. And allows doctors to predict or react to back problems that are not taking a physical toll on patients, but a financial drain on our medical system. “It really looks at individual differences” said Onate. “That’s the key.”
*Over-treating Chronic Back Pain: Time to Back Off?, Journal of the American Board of Family Medicine, Volume 22, No. 1, Feb. 2009. Online: http://www.jabfm.org/cgi/content/full/22/1/62
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