This Just In: Myths about Treating Back Pain Are OutA fresh approach for helping injured workers get back to work sooner is gaining ground. The newer ideas may eventually replace outmoded ones that are based on back pain myths. One such myth is that back pain happens because of physical loads and forces from activity (like work). Treatment is thus aimed at limiting the patient's activity. Health providers who cling to this idea often caution their patients about doing too much. These doctors may even order patients to rest in bed.
However, new evidence shows that workers with back pain do better when encouraged to get back to normal activities as soon as possible. Researchers studied how well this new approach helped workers with back pain get back on the job.
The study was done in Norway and included 457 patients, all of whom had been out of work for more than eight weeks. The participants were randomly placed in either a control or treatment group. The control group simply followed the advice of their general practitioner. Patients in the treatment group were given a thorough evaluation by a spine doctor and a physiotherapist. When there were no major medical concerns, the patients were informed about their good prognosis and were shown ways to stretch, train, and walk as part of a home program. They also got advice about how to take care of their back, and they were encouraged to resume normal activity.
The researchers gauged the success of treatment by the number of people who got back to work. People in the treatment group got back to work sooner than those in the control group. And by the end of the study period, a higher percentage of patients completing the treatment program had gotten back to work. These patients, say the authors, "seem to benefit from maintaining activity as normal as possible, as compared with inactivity and bed rest."
There are several themes in this new model of treatment. Medical professionals examine and inform patients. Health providers offer enthusiasm and instill optimism about the positive benefits and results of treatment. They encourage patients to get back to normal life activities by helping them overcome fears of having pain. In this way patients avoid becoming inactive and show a greater ability to get back to work.
Dispelling old myths takes time. So it shouldn't be expected that practitioners would readily move toward this new approach to back care. The growing volume of studies with results like the ones in this article may help speed acceptance of the new model.
Eli Molde Hagen, MD, et al. Does Early Intervention With a Light Mobilization Program Reduce Long-Term Sick Leave for Low Back Pain. In Spine. August 1, 2000. Vol. 25. No. 15. Pp. 1973-1976.
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