Low Back Pain Treatment Moving from Low Value Services to Holistic Solutions

As one of the most common and disabling conditions among adults, low back pain can be treated in numerous ways. However, many treatments have proven ineffective and potentially harmful. Published guidelines have been updated to avoid low-value services like overuse of diagnostic imaging, opioids, spinal injections, and surgery. Researchers examined trends over nine years to see how quickly providers were moving away from these low-value services. Understanding treatment trends is helpful when designing holistic programs for low back pain.

Findings: Services recognized as low value for low back pain, such as surgery, imaging, and opioids, decreased during the study timeframe, while mental health and acupuncture services increased. 

What’s Next: Elevance Health is focusing on scalable programs that deal holistically with back pain for people of varying condition severity. The research led to a decision to engage with a scalable, holistic solution for reducing pain without surgery, imaging, or opioids. Elevance Health is also pilot-testing other digital tools for its various health plans using virtual physical therapy.

Methodology: A cross-sectional study looked at claims for more than 2 million commercially insured U.S. patients who had repeated claims for low back pain at least eight weeks apart between 2011 and 2019. Each patient was monitored for 12 months after the first claim. Nine mutually exclusive cohorts were defined during the period by limiting observations to each person’s first claim date. Use of potentially low-value services, outcomes, and costs were examined.

Read the Study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788754

“Surgery carries complication risks and often doesn’t resolve pain, while patients can become dependent on opioid medications,” said Tim Pham, senior researcher for Elevance Health. “It’s clear that patients and their healthcare providers are seeking out other approaches to pain relief.”