(NewsUSA) - Even as outrage over the national fungal meningitis outbreak continues to mount, cooler heads are asking questions that could have long-term ramifications for the way we treat back pain.
Almost all of the hundreds of people who've died or been sickened received shots of what authorities now believe was contaminated steroid medication, traced to a since-closed Massachusetts compounding pharmacy, intended to relieve their back pain. That number is expected to grow as thousands more patients exposed to the tainted medication are tracked down.
The larger question being debated is this: With more than a quarter of adults experiencing back pain in any given three-month period, according to the National Institutes of Health, how safe -- or even just financially worthwhile -- are the plethora of expensive high-tech diagnostics, drugs and surgical interventions used to treat the condition? And could far less invasive chiropractic care be a better alternative?
"These [steroid injections] are one of the most overused procedures in the U S.," Dr. Steven J. Atlas, the director of Primary Care Research & Quality Improvement Network at Massachusetts General Hospital, told the Boston Globe.
And even many surgeons -- whom Atlas has also previously criticized for being more interested in billing than counseling caution -- now admit that some patients are actually worse off after going under the knife. This following many studies not only casting doubt on the benefit of such procedures as spinal fusion, but -- in the case of the popular fracture-treating vertebroplasty -- unequivocally recommending against it as the American Academy of Orthopedic Surgeons did in 2010.
All of that -- plus the risks of overdosing on, or becoming addicted to pain meds, and relying on cortisone that can mask but not heal the pain -- recently led to a groundbreaking decision by the University of Pittsburgh Medical Center-affiliated health plan that has proponents of chiropractic care feeling vindicated. Since January 2012, candidates for spine surgery must first have gone through a three-month course of conservative management that includes the option of chiropractic care, an evidence-based approach involving manual and/or instrument manipulation of the spine as well as exercise, health and lifestyle counseling.
"There needs to be a safer way to address back pain," says Dr. Gerard W. Clum, D.C., a spokesperson for the Foundation for Chiropractic Progress (www.yes2chiropractic.org). "These high-tech, invasive medical interventions can be worse than the condition and don't seem to be getting many individuals any closer to relief."