Doctors are set to start prescribing exercise instead of medication and bed rest for lower back pain sufferers, as new clinical guidelines dismiss traditional treatments as inappropriate for most.
The clinical care standard, released by the Australian Commission on Safety and Quality in Health Care on Thursday, advocates for a shift away from imaging tests, bed rest, pain medication and surgery.
The treatments are of limited use for managing most people with low back pain, according to the commission, and imaging can lead to unnecessary concern, or the wrong type of care for patients.
Instead, the clinical standard gives health practitioners a road map for how to manage patients' low back pain episodes early on, pushing for a more effective and less risky approach.
The standard recommends people with low back pain exercise, overcome psychological barriers to recovery including thoughts and emotions about pain, and tackle social obstacles like work and stress at home.
"With this new standard, we are aiming to break the cycle and prevent a new episode of low back pain becoming a chronic problem for many Australians," commission clinical director Associate Professor Liz Marles said.
The standard - the first nationally for low back pain - is a leap forward for patients who often get treatment across different healthcare disciplines and receive conflicting advice, Ass. Prof Marles said.
Early back pain should be managed consistently across professions, Curtin University musculoskeletal physiotherapy Professor Peter O'Sullivan said.
The new standard is the best chance to remove barriers to effective treatment for patients, especially given the ageing population, growing obesity rates and Australians' increasingly sedentary lifestyle.
"The evidence shows, and the standard reaffirms, that regular and graduated movement and activity are central to a better outcome for many people with an acute low back pain episode," Prof O'Sullivan said.
"Patients with low back pain may avoid physical activity and work, and potentially become fearful, depressed or anxious, which can lead to higher risk of disability.
"Unfortunately, sometimes the advice given to people with low back pain can reinforce unhelpful beliefs and responses to pain."
The conversations patients had with healthcare practitioners were integral to recovery, and people with a new episode of low back pain who did not recover after six weeks should be reassessed, Prof O'Sullivan said.
Back pain costs Australia's health system $4.8 billion each year, according to the commission, and is the number one reason behind lost work productivity and early retirement.
