Low Back and Neck Pain: Who Really Cares About Finding a Solution?

December 16, 2010

In a prior blog, I reported that most individuals struggling or disabled by low back or neck pain actually have a condition that is rapidly reversible. That means that, regardless of how long they’ve had their pain, if it’s rapidly reversible, and it usually is, it can still be turned around and corrected, providing the proper type of evaluation and treatment is undertaken.

This is very exciting news for two different very large groups. The first and obvious one is comprised of those who are personally experiencing pain in their back or neck and trying to endure all the day-to-day consequences of it. There are millions of you out there.

When you seek care, you are so often prescribed unproven and questionably effective treatments that are typically based on your clinician’s theories or favorite type of care. When your pain and impairment persist, some of you understandably turn to “alternative care” methods, most of which have even less scientific basis. With further failure to recover, you understandably seek spinal imaging (CT scans and MRIs), injections, and even surgery.  Some of you are even rushed to expensive, painful, even risky procedures within days of the onset of your symptoms, justified by the intensity of your pain, your high level of impairment, and the hope the surgeon offers of returning to normal quickly.

But there is a second group that also suffers, but in quite a different way.  Your suffering is primarily economic.  You are the employers who often tremble as you watch your employees with back or neck pain go off to consult with one of a wide assortment of clinicians in your community who prescribe an equally wide array of treatments. Some employees recover quickly, often on their own, but many do so very slowly and often only partially, while others simply do not recover. Most of you, along with your risk managers, see some clinicians be more effective and caring than others but usually with limited predictability of a successful recovery.  Some treatments may even stretch your sense of appropriateness.  Despite your best efforts to control them, your costs for these spine disorders have been steadily increasing, in fact skyrocketing, over the past 10 years with no evidence you are purchasing any better quality of care for all you’re spending.

There are two other prominent stakeholders that are also discussed at length in my book Rapidly Reversible Low Back Pain. They are the clinicians who care for these disorders and the spine researchers who investigate them. Neither of these groups directly suffer from either the physical or economic pain.  In fact, they both make their living on the existence and even persistence of back and neck pain.

So it is the patients and their employers who directly suffer and have most at stake in finding a solution.

However, the good news for members of all four groups who sincerely seek cost-effective solutions is that significant progress is being made. There is considerable data clearly showing that most LBP is rapidly reversible and that costs can be cut dramatically by identifying those individuals early in their care.  In a properly incentivized world, there should be widespread clamoring for this knowledge by all stakeholders.

So how do these various groups objectively determine who has and does not  have rapidly reversible back or neck pain? Concise and evidence-based answers are now available in the scientific literature and are the focus of my two books entitled “Rapidly Reversible LBPand “Solving the Mystery. Please take a few minutes to read the Foreword and well as a few published book reviews for RRLBP.

It remains my hope that these books will be catalysts for progress in bringing more understanding and know-how to our management of back and neck pain.

Dr. Ron

Ronald Donelson, MD, MS

SelfCare First, LLC
See the new patient education book: “Solving The Mystery: The Key to Rapid Recoveries for Back and Neck Pain” at http://www.selfcarefirst.com


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