Researchers recommend multidisciplinary approach of low back pain

Researchers calculated the costs of management of low back pain and found that an integrated and step-wise approach within a multidisciplinary setting forms a better use of the available resources. The study is published in the September issue of Pain Practice.

Within a multidisciplinary pain center, treatment possibilities include pharmacological treatment, rehabilitation programs, cognitive behavioral therapy, psychological counseling, as well as minimally invasive interventional techniques such as epidural steroid administration, (pulsed) radiofrequency and implantable neurostimulators, and drug delivery pumps. Comparison between the practices in Belgium and the Netherlands revealed that where multidisciplinary pain clinics are less well-implanted, the health care costs for low back pain are higher due to a more intensive use of surgery and consequently, the long-term management of failed back surgery syndrome.

Data show that when the available treatment possibilities are used in a multidisciplinary and step-wise approach, more invasive surgical treatment options may be avoided, resulting in considerable savings of health care budgets.

“Patients should be aware that medical imaging and spine surgery are not always the mandatory steps in the management of lower back pain,” states Jan Van Zundert, MD. “Psychological counseling and cognitive behavioral therapy offers the possibility to have better insight in the patient’s perception on what causes pain and how to improve physical activity. Percutaneous interventional techniques can be used when conventional treatment fails. The patient might work together with health care professionals to achieve a satisfactory level of pain reduction and quality of life.”

Low back pain may become a chronic disease in approximately 8% of patients. Researchers suggest that physicians with different specialties should work together to establish a diagnostic and treatment program for each individual patient, including multidisciplinary and intradisciplinary consultation that would allow for avoiding invasive treatment options where less invasive modalities may still be effective.