A new study, published in the Journal of the American Medical Association Internal Medicine, identified five national trends in back pain management and spine-related care from 1999 to 2010 that are unsupported by published clinical guidelines.
Using nationally representative data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, researchers identified 23,918 visits for spine problems. Approximately 58 percent of patients were female, and mean age increased from 49 to 53 years during the study period.
The study identified the following five trends between 1999 and 2010:
• The use of nonsteroidal anti-inflammatory drug or acetaminophen per visit decreased from 36.9 percent in 1999 to 24.5 percent in 2010.
• The use of narcotics increased from 19.3 percent in 1999 to 29.1 percent in 2010.
• Physical therapy referrals remained unchanged over the study period at approximately 20 percent.
• Physician referrals, on the other hand, increased from 6.8 percent to 14 percent over the study period.
• The number of radiographs remained stable at approximately 17 percent, whereas the number of CTs or MRIs increased from 7.2 percent to 11.3 percent during the study period.
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