Injured workers should start with non-surgical therapies for back pain first, study finds

May 12 2011
Certain jobs, especially those that involve lifting heavy objects, climbing or bending, have been known to increase the risk of injuries, whether traumatic or stemming from the wear-and-tear that may lead to low back pain over time.

While many employees are covered by workers' compensation funds, it is still important for researchers and public policy leaders to understand which procedures are effective in order to stem the rising tide of healthcare costs.

In a recent study published in the journal Spine, researchers from the University of Cincinnati College of Medicine found evidence that spinal fusion surgery - a common treatment for lower back pain - may not always be the optimal solution and can lead to unsatisfactory long-term outcomes.

The scientists analyzed compensation data for more than 700 Ohio workers who had this type of spine surgery for conditions ranging from degenerative disc disease to herniated discs and nerve root disease.

After comparing these patients' outcomes - in terms of their ability to return to work, disability levels and the need for strong painkillers - two years after their procedure, the researchers found that these individuals, on average, fared worse than the control group. The latter was composed of people with the same conditions who underwent non-surgical treatments, such as physical therapy.

Specifically, while only a quarter of spinal fusion patients were able to resume work, more than 60 percent of those without surgery were working two years later. Moreover, a total of 11 percent of the former group were on permanent disability, but only 2 percent of those who opted for non-invasive treatments were similarly affected.

In their conclusions, the authors wrote that while they do not advocate abandoning fusion altogether, they believe the procedure should be "cautiously considered," and only for conditions for which it has been proven to work.