Millions of Days Taken Off Work for Back Pain!
According to the
NHS, work-related back pain caused the loss of 7.5 million working days during just one year in 2010 – 2011 ~ and this figure is not unique, it is similar for many other years as well. That is a lot of time off work and must have a big impact on the economy, so treatments for back pain are constantly being researched.
The Lancet has just published the results of a research trial that took place in Australia, which looked at the efficacy of prescribing paracetamol for people with acute lower back pain (24 July 2014). This research was a randomised, controlled trial with over 500 subjects in each group, taken from primary care centres in Sydney and the results show that paracetamol is no more help than taking a placebo at aiding recovery from acute lower back pain!
The findings of this research therefore ‘question the universal endorsement of paracetamol in this patient group’. This traditional way of dealing with acute back pain is shown, for instance, in the NHS Choices website which mainly advocates ‘keeping active and if necessary take over-the-counter painkillers‘. No wonder the pain often lingers.
Causes of Back Pain
Some back pain is caused by illness or an accident but the NHS states that the majority of problems are caused by ‘bad posture while sitting or standing, bending awkwardly, or lifting incorrectly’ – what F M Alexander called ‘habits of mis-use‘. Addressing such habits and learning to improve our body-use is a cornerstone of the Alexander Technique and it is now recommended by the NHS as a method of reducing long-term back pain. This recommendation comes as a result of the major ATEAM Research Trial in 2008 that showed lessons in the Alexander Technique were more helpful for people with chronic lower back pain than were either massage or an exercise regime prescribed by doctors.
Prevention is Surely Better than Cure.
I suggest that it would be far more helpful to use the AT sooner, in order to help reduce acute back pain before the problem becomes chronic and therefore a long-term problem.
Even better is to
learn and to use the Alexander Technique in order to let go those habits of mis-use of which we are mainly unaware, until an AT teacher can help us to recognise them, and help ourselves prevent back problems from developing in the first place.
Update
The British Medical Journal, BMJ, have published another paper by the Australian Research Team 31 March 2015. This is an overview of 15 randomised controlled research trials exploring back pain and the effectiveness of using paracetamol.
The outcomes showed that paracetamol did not help back pain, caused liver toxicity and did not improve the quality of people’s lives! – and this is what is usually recommended as the first line of defence to help back pain!
You can read an ouotline of the findings below, as reported in the BMJ. As a result of this research, the medicines safety regulator is assessing the safety of over-the-counter drugs and the National Institute for Health and Care Excellence, NICE, is awaiting the results of the review before making any decisions about whether or not to continue recommending paracetamol for lower back pain and arthritis. It may recommend exercise instead.
Some of this research has been in the public domain for over a year. However the ATEAM Research Trial which showed that the Alexander Technique was more helpful than exercise for lower back pain and improved the quality of people’s lives, was published back in 2008. How long will it take NICE to understand the implications of this research into the effectiveness of the Alexander Technique and to act on it by recommending AT lessons for back pain, instead of toxic drugs?
You may see the outline of the findings below:
‘What is already known on this topic
Clinical guidelines recommend paracetamol as first line a
nalgesic drug for both spinal pain (neck and low back pain) and osteoarthritis of the hip and knee
The evidence base supporting these recommendations has recently been called into question
What this study adds
High quality evidence suggests that paracetamol is ineffective in reducing pain and disability or improving quality of life in patients with low back pain
There is high quality evidence that paracetamol offers a small but not clinically important benefit for pain and disability reduction in patients with hip or knee osteoarthritis
Though high quality evidence shows that patients taking paracetamol are nearly four times more likely to have abnormal results on liver function tests compared with those taking oral placebo, the clinical relevance of this is unclear.’