People with back pain use many types of medical interventions, but often not those with the strongest evidence of effectiveness, such as therapeutic exercise, according to a Newswise article based on a study in the April 1 issue of Spine.

In a random telephone survey, researchers from the University of North Carolina, identified 732 adults with chronic low back pain. The respondents were asked in detail about the types of back pain treatments that they used. The respondents saw a wide range of physicians and other health professionals – averaging 21 visits to almost 3 different health care providers each year. Medications were widely used, with narcotics used by 61% of patients and muscle relaxants by 31%. Over the past year, more than 1/3 of patients had undergone advanced imaging procedures, such as CT and MRI scans. Respondents also reported using treatments such as traction, corsets or braces, or electrical nerve stimulators, the article says. 

At the same time, the use of research-proven treatments was relatively low. Fewer than half of patients had a prescription for exercise, and only 30% had seen a physical therapist in the past year. Just 3% of patients had gone through a structured rehabilitation program—one of the few treatments with moderately strong evidence of effectiveness.

As in previous studies of back pain, many patients had symptoms of depression. However, few of these patients were taking antidepressant medications or seeing a mental health professional. The authors voiced concern about the overuse of narcotics and other medications and the underuse of exercise, antidepressants, and other proven treatments, says the article.