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Surgery for Back Pain? Think Again

If you or someone you know is suffering from back pain, don't rush off to get surgery. There is considerable evidence supporting the value of conservative, nonsurgical treatments for back pain; further, a study in The New England Journal of Medicine asserts that surgery is overused for the treatment of back pain.

The study in question, which served to defined guidelines for low back pain (LBP) treatment, states that intervention is only recommended for back pain that persists beyond three weeks. Among the treatments recommended to minimize the recurrence of chronic LBP were intensive strengthening exercise and aerobic conditioning. Also, the study states that radiography and more advanced imaging procedures (i.e., MRI) are overused and should be considered only in cases of severe nerve pain, loss of function, or suspicion of underlying systemic disease. And here's the most important point: Surgery should only be considered after all conservative methods have failed.

Among these alternatives to medical intervention, the report finds chiropractic care to be effective and massage therapy to show promise. The study does not recommend bedrest for chronic LBP or pain from nerve involvement. The main recommendation, based upon this study's new guidelines, is a rapid return to normal activities, which includes a regular regiment of exercise to keep the back and leg muscles conditioned.


Deyo R, Weinstein J, et al. Low back pain. The New England Journal of Medicine 2001:344(5), pp363-369.

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