Australian Institute of Health and Welfare 2019. Back problems. Cat. no. PHE 231. Canberra: AIHW. Viewed 20 September 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare. (2019). Back problems. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Back problems. Australian Institute of Health and Welfare, 30 August 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare. Back problems [Internet]. Canberra: Australian Institute of Health and Welfare, 2019 [cited 2019 Sep. 20]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
Australian Institute of Health and Welfare (AIHW) 2019, Back problems, viewed 20 September 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
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Back problems are a range of conditions related to the bones, joints, connective tissue, muscles and nerves of the back. Back problems are a significant cause of disability and lost productivity.
Almost 2 in 5 (38%) people with back problems said pain "moderately" interfered with daily activities in 2017–18
1 in 6 Australians (16%) had back problems in 2017–18. That’s 4.0 million people
2nd leading cause of disease burden overall in Australia 2015, accounting for 4.1% of Australia’s total disease burden
Analgesics (or painkillers) are commonly used to manage back pain. Analgesics include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics.
Recent clinical practice guidelines from Australia and various other countries for management of low back pain have discouraged using pharmacotherapy as a first choice, and suggest medications only to those who have not adequately responded to non-pharmacological interventions (such as physical therapy). Guidelines encourage GPs to discuss with patients the risks and realistic benefits of medications before prescribing. If medications are used, they should be used at the lowest effective does and for the shortest amount of time possible .
The most common medications prescribed for back problems managed by GPs include opioids, paracetamol/opioid analgesic combination and NSAIDs. Paracetamol alone may not be effective in managing acute lower back pain, and is no longer recommended in treatment [2–5]. NSAIDS are recommended for both acute and chronic back pain management [2, 4, 5]. Opioids are commonly prescribed for lower back pain , however all guidelines suggest caution in using these medicines due to the increasing concern for potential harm . Guidelines state opioids should only be used if expected benefits outweigh the risks for patients, and should not be used long term .
Compared with people without chronic low back pain, people with chronic low back pain make greater use of pain-related medications and health care resources .
Pain is the main symptom of most back problems and treatment can be complex. This can be complicated by the existence of other comorbidities. As pain treatment is given at the same time as other treatments, serious drug interactions can be an issue .
Some general treatment strategies for chronic diseases can benefit people with back problems. For example, lifestyle modifications such as diet, exercise, weight control, and reducing smoking have been shown to be beneficial .
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