News archive
Epidural Steroid Injections Offer Only a Marginal Benefit for Patients With Sciatica
The BackLetter Vol 35, No 8, August 2020
“…according to an updated review from the Cochrane Collaboration, epidural steroid injections only offer a marginal benefit–and one that may not be clinically relevant. This suggests that epidural steroid injections may be overpromoted and overused…the treatment benefits are small, mainly evident at short-term follow-up, and may not be considered clinically important by patients and clinicians.”
Does Inactivity Lead to Disc Degeneration Over the Long Term?
The BackLetter Vol 35, No 7, July 2020
“Less physical activity over a time period of 14 years correlated with an increase of disc degeneration of the thoracic and lumbar spine after adjustment for age, sex, BMI, hypertension and diabetes mellitus…no significant correlations between degree of disc degeneration, degree of physical inactivity, and back pain were observed.”
Does Back Pain Stem From Work?
The BackLetter Vol 35, No 6, June 2020
“Unfortunately, most back pain–80% to 95%–cannot be ascribed to any particular cause or occupational exposure…Back pain is extremely common in and out of the workplace…There is an unfortunate bias towards blaming back pain on work because of antiquated workers’ compensation and disability regulations. To gain workers’ compensation in the US applicants have to document that a back injury arose in the course of work. Some back problems–such as traumatic falls and fractures–obviously stem from an injury sustained in the course of work. But most cases of back pain have uncertain causation…Back ‘injury’ is a social construction, not a valid clinical diagnosis.”
A Fresh Look at Back Care in the United States: Outrageously Expensive, Sadly Ineffective
The BackLetter Vol 35, No 5, May 2020
“U.S. society has thrown huge sums of money at these problems. Yet there haven’t been any significant improvements in the overall prevalence of low back pain or back-related disability.”
Usual Care for Back Pain All Too Often the Wrong Care-Despite 25 Years of Evidence-Based Guidelines
The BackLetter Vol 35, No 4, April 2020
“A recent systematic review from Australia confirms a long-standing suspicion: that people with back pain all too often get the wrong kinds of care. This is undoubtedly a major contributor to the huge international back-pain disability crisis.”
Beware of Paid "Patient Influencers" Promoting Controversial Treatments in Medicine and the Media
The BackLetter Vol 35, No 3, March 2020
“Drug and device companies have long relied on physicians and other healthcare providers to promote their products to the medical field and the general public…some companies are branching out and employing ‘patient influencers’ to help market their products. And, unlike physicians, the patient influencers often do not disclose their financial ties.”