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BackPage Online, May 2018

doi: 10.1097/01.BACK.0000532712.68975.07
Articles
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The Myth of Good Posture

A common view in the spine field, and among the general public, is that poor posture is a major risk factor for low back pain. Yet, scientists do not even agree about the definition of good posture. And despite myriad assertions of a relationship, there is no conclusive scientific evidence that spinal posture plays an important role in the prevention or treatment of low back pain.

Here is a link to a well-balanced article on posture and back pain from The Guardian: www.theguardian.com/lifeandstyle/2018/mar/05/are-you-sitting-comfortably-the-myth-of-good-posture.

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Did Opioid Manufacturers Buy Off Chronic Pain Groups?

Opioid manufacturers channeled millions of dollars to chronic pain treatment advocacy groups. These groups, in turn, publicly supported the position that opioids are a safe and effective treatment for chronic pain, according to a recent report by US congresswoman Claire McCaskill of Missouri.

“Initiatives from the groups in this report often echoed and amplified messages favorable to increased opioid use and ultimately, the financial interests of opioid manufacturers. These groups have issued guidelines and policies minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for overprescription and misbranding,” according to McCaskill.

Notably, many of these groups also strongly criticized the 2016 guidelines from the Centers for Disease Control and Prevention that recommended limits on opioid prescriptions for chronic pain—the first national standards for prescription opioids and a key federal response to the ongoing epidemic.

Here is the full report, titled “Fueling an Epidemic:” www.scribd.com/document/371410327/Fueling-an-Epidemic.

And here is a link to an article on that report from the website of National Public Radio: www.npr.org/sections/thetwo-way/2018/02/13/585290752/drugmakers-spent-millions-promoting-opioids-to-patient-groups-senate-report-says.

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Time to Step Up Efforts to Eliminate Unnecessary Care—in the Spine Field and Elsewhere

Growth in healthcare spending in the United States continues at unsustainable levels. And Americans get a poor return for their medical investments. They pay far more than residents of other countries for common medical interventions. Yet, the outcomes of American patients often lag those of their offshore peers.

Many hope that reorganization of medical services or bold technological innovations will somehow bail the United States out of its healthcare crisis. However, in an eloquent essay in USA Today, surgeon Marty Makary, MD, of Johns Hopkins pointed out that the fundamental problem of the US healthcare system is the high level of unnecessary care. According to various estimates, more than a third of medical care is completely unnecessary. And to get healthcare spending under control, Americans need to redouble their efforts to eliminate wasteful procedures. And there is no better place to start than the elimination of unnecessary and/or wasteful back pain and spine procedures.

Here is a link to Makary's article: www.usatoday.com/story/opinion/2018/02/26/how-bezos-buffett-and-dimon-can-solve-our-too-much-medical-care-crisis-marty-makary-column/349638002/.

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