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  • ‘too soft on back pain’

    BACK pain costs Britain a million years in lost productivity annually, with GPs signing patients off work too easily, a study has found.

    A series of reports in The Lancet reveals an epidemic of lower back pain is being exacerbated by doctors’ readiness to prescribe drugs when they should be encouraging exercise.

    Last night, medical leaders condemned as “unconscionable” the readiness of GPs to order therapies that did not work. Most chronic back pain cases respond only to exercise and psychological treatment, but research suggested clinicians felt unable to deny their patients painkillers in the same way antibiotics were overprescribed.

    Instead, they should emphasise the importance of a positive attitude and satisfaction at work as the best means of staving off pain in the long-term, experts said. Back pain cases have risen more than 50 per cent globally since 1990, the study showed. However, the cost to productivity in Britain appears proportionately higher than several comparable nations, with a million years of working days lost among a population of 65 million. The figure equates to more than five lost working days per person each per year.

    By contrast, the US loses three million years per annum but has a population of 326 million, while Australia loses 300,000 years with 24 million

    The Chartered Society of Physiotherapy said the research should prompt “serious reflection” among clinicians. Steve Tolan, head of practice, said: “That so many people start out with minor back pain and go on to suffer life-changing consequences is bad enough; that healthcare professionals contribute to that is unconscionable.”

    Most lower back pain responds to simple exercise and psychological therapies aimed at keeping people active and at work, say NHS guidelines.

    But according to the study in The Lancet, these are often ignored in the UK, with medics ordering unnecessary surgery and scans.

    Professor Martin Underwood, from Warwick University, said current approaches were failing. “It’s something we’re not equipped to deal with,” he said. “Patients understandably look for a cure but the reality is we don’t have a cure. We don’t understand what causes the vast majority of back pain.”

    UK figures show lower back pain accounts for 11 per cent of the disability burden from all disease, costing the country more than £10.7  billion a year. The condition was named by The Lancet as the leading cause of disability worldwide, with 540 million people affected at any one time.

    Professor Jan Hartvigsen, from the University of Southern Denmark, lead author of the study, said: “Millions of people are getting the wrong care.” He added funding should focus on prevention, better tests and better treatments.

    Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said family doctors were “mindful” of clinical guidelines.

    “We know that being active and working is good for patients’ health, so GPs and our teams will readily advocate lifestyle changes to patients that can help ease their pain and keep them in work,” she said. “But for some patients, particularly in more serious cases, there is a limit to how realistic a significant amount of exercise is.”