Tens of thousands of patients are given a ‘useless’ back-pain injection that costs the English National Health Service (NHS) nearly £40 million ($567 million) each year
- Patients demanding a ‘quick fix’ are given the treatment at £540 per procedure
- Doctors are advised not to give the therapy but instead recommend exercise
- Previous research suggests painkillers and rest are wrongly being prescribed
- Such ‘treatments’ often slow patient recovery, with benefits being ‘modest’
- NHS bosses vowed to crack down on pointless treatments that cost £180 million
Tens of thousands of patients are being given a ‘useless’ back-pain injection, which costs the NHS nearly £40 million every year, an analysis suggests.
Patients that demand a ‘quick fix’ for their discomfort are being given the treatment, priced at £540 per procedure, despite doctors being told to recommend back-pain sufferers be more active or try psychological therapy.
This comes after research released last month suggested many patients are needlessly being prescribed strong painkillers, wrongly told to rest or even undergoing unnecessary surgery in a bid to treat lower-back pain.
According to Professor Martin Underwood, from Warwick University, who led the research, such ‘treatments’ often slow patient recovery, with any benefits being ‘modest at best’.
Yesterday, health-service bosses vowed to crack down on pointless back-pain treatments, with needless surgeries, scans and injections costing the NHS up to £180 million annually.
Lower-back pain affects at least four in five people at some point in their lives, with around one in five sufferers developing chronic discomfort lasting a year or more.
Doctors use injections ‘as a way of getting someone out the door’
According to an analysis of NHS data by The Times, 70,608 steroid injections into patients’ facet joints, which make spines flexible, occurred last year, compared to 62,570 five years ago.
Guidelines released in both 2009 and 2016 advise against the procedure.
Figures also show 8,044 operations that fuse spinal bones together were carried out last year, up from 7,224 between 2012 and 2013.
Such surgery can benefit patients with specific conditions or injuries but is ineffective for general back pain.
Mike Hutton, a consultant surgeon who leads an NHS project to help improve spinal units, said: ‘Operating on back pain thought to be arising from facet joints or discs is not a good operation and probably costs the taxpayer a lot of money.
‘Sometimes the clinician may be using this as a way of getting someone out the door if they have nothing else to offer.’
Mr Hutton went on to say patients’ expectations are often too high, with them assuming doctors are capable of fixing any discomfort.
He adds people should be wary of undergoing risky spinal surgeries unless there is a strong chance it will benefit their symptoms.
GPs vary hugely in their back-pain approaches
Mr Hutton’s project shows patients have widely different experiences when it comes to presenting to their GPs with back pain, with some being referred to a spinal surgeon straight away.
He believes this may be due to physical and psychological rehabilitation programmes, which have been proven to work, often being unavailable.
By cutting back on ‘useless’ steroid injections and surgeries, money could be invested into such programmes, Mr Hutton adds.
According to Rahul Seewal, a consultant in pain medicine, steroid injections may make patients feel better initially but fail to resolve any underlying problems.
Yet, such invasive procedures are still preferred by doctors over psychological approaches, he adds.
NHS figures also show 10,906 ‘radiofrequency denervations’, which burn away troublesome nerves, were carried out last year, compared to 9,023 between 2012 and 2013.
According to NICE, this procedure should be a last resort.
Speaking of the findings, Julie Wood, chief executive of NHS Clinical Commissioners, which represents bodies that fund care in England, the NHS Clinical Commissioners is in discussions with NHS England to create guidelines supporting the most cost-effective back-pain remedies.
Yoga and massage are more effective than painkillers
Research released last month shows simple exercises and stretches are more effective at easing back pain than analgesics.
Professor Underwood said: ‘Our current treatment approaches are failing to reduce the burden of back-pain disability.
The researchers reviewed evidence from both high and low-income countries around the world to build up a global picture of the extent of the back-pain problem and how it was being managed.
They concluded lower-back pain is the world’s leading cause of disability but is often treated using aggressive approaches that have not been shown to work.
NICE advises people with back pain be prescribed exercise, drugs such as ibuprofen, or both at the same time.
Yet growing evidence shows painkillers are largely ineffective and can do more harm than good, with massage, exercise and yoga being preferable.
Previous studies have shown opioid painkillers, which are prescription drugs that include morphine, tramadol and oxycodone, provide only ‘minimal benefit’ for lower-back pain.
Yet, recent figures estimate they are still prescribed to around 40 per cent of back-pain patients.
Steve Tolan, head of practice at the Chartered Society of Physiotherapy, said doctors are too quick to medicalise treatments.
He said: ‘That so many people start out with minor back pain and go on to suffer life-changing consequences is bad enough.
‘That healthcare professionals contribute to that journey is unconscionable.’
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