New Federal Guidelines Call Most Back Treatment Useless

Important new guidelines issued by a federal agency study group provide powerful ammunition for insurers fighting against over treatment for lower back problems. The guidelines include many findings that completely validate what insurers have argued for some time.

Key conclusions in the guidelines are that for most patients, symptoms will disappear on their own within a month; that the expensive tests and therapies now often used to diagnose and treat lower back problems are largely useless; that x-rays and MRIs should be discouraged unless symptoms indicate more serious underlying conditions, such as fractures, tumors, infections or spinal nerve problems; and that surgery appears to benefit only about one in 100 patients with acute low back pain, and is recommended within the first three months only where there is evidence of serious spinal problems or particular leg symptoms that indicate nerve conditions, fractures or dislocations.

The new guidelines also state that surgery and some common therapies, such as extended bed rest and muscle relaxants, actually can be harmful in some cases. According to the panel of experts, resting in bed for more than four days “can weaken muscles and bones and delay recovery.” The panel recommended instead the use of acetaminophen and certain anti-inflammatory drugs, and gentle exercise such as walking, swimming or cycling to help maintain and build tolerance to physical activity. The panel also found that some chiropractic, specifically spinal manipulation, can be beneficial, particularly within the first four weeks.

The new guidelines were compiled by a panel of medical experts assembled by the Federal Agency for Health Care and Policy Research. The panel reviewed thousands of studies, and its recommendations are expected to be regarded as the new standard of care in the medical industry. They are an important new source that can be relied on by defense experts in litigation, as well as by adjusters negotiating with plaintiffs’ counsel at any stage.

REPRINTED BY PERMISSION, “FRAUD FIGHTER TIMES.”
An insurance defense newsletter published by Del Tondo & Sheehan, Los Angeles.