Back Pain Treatment News
CIGNA HealthCare launches new approach to back pain
CIGNA UK HealthCare Benefits is changing the way it deals with members suffering from lower back pain, in line with best practice guidelines developed for use in the NHS.
Employers and employees will be given access to free online tools offering support and advice on how to manage the condition. These tools are based on the best practice guidelines issued to the NHS by the National Institute for Health and Clinical Excellence (NICE).
The NICE guidelines – which cover persistent or recurrent non-specific low back pain that has lasted for between six weeks and a year – focus on self-management through the provision of advice and information. They promote exercise and advise people with low back pain to carry on with normal activities as far as possible as well as a maximum of nine sessions of “manual therapy”.
Simple lower back pain is one of the most common musculoskeletal disorders. It is estimated to affect around one-third of the UK adult population each year. It poses a challenge for insurers and employers because although there is often not an identifiable cause of the pain it can cause significant levels of workplace absence. Although it is now widely recognised that people suffering from the condition are best advised to continue their normal activities, the belief that bed rest is necessary remains strong. A study published last year showed that over a quarter of GPs and physiotherapists continue to recommend that patients with low back pain stay off work, despite national guidelines to the contrary.
Cognitive behavioural therapy (CBT) has also been shown to be an effective treatment for back pain and CIGNA HealthCare Medical Manager Stephanie Macdonald confirmed that the insurer’s nurse case managers are able to refer members for this treatment where appropriate.
Aviva has offered its Back Up service for over two years to members of its corporate, SME and individual plans. The case management service, designed to ensure that members with back and neck pain receive early intervention and tailored support, has been found to reduce physiotherapy sessions by 37.5%.
CIGNA’s head of product management, Kirsty Jagielko said: “The issue of back pain in the UK is a high cost to employers and should not be ignored. By offering practical advice and information we can not only help the individual suffering from the condition but also help the employer understand and tackle the wider issue.”
New era for back pain treatment
It’s the most common reason for people to visit their GP and costs the UK an estimated £12.3bn a year, yet some Welsh professionals believe back pain could be diagnosed and treated at home. Clare Hutchinson reports
IF YOU are one of the eight-out-of-10 people in the UK to have suffered a bad back, you will know how painful it is – and how difficult it is to treat.
It is estimated that on any one day, there are 2.5 million people in the UK experiencing back pain, setting the NHS back £481m a year, while 119 million working days a year are lost through employees taking back pain-related sick days.
The Department of Work and Pensions shells out around £1.4bn a year on incapacity benefit for chronic back problems, and accompanying lost productionto UK businesses costs the economy £3.8bn.
But according to some of Wales’ most influential back care professionals, most back pain is something that is entirely treatable and should be kept out of the NHS altogether.
Those professionals have put together a map of medicine pathway for back pain, which is due to be rolled out to GPs and other health care professionals over the next few months.
Based on a number of guidelines, the pathway has been developed to provide an evidence-based resource for patients and health professionals managing back pain.
Along with the Assembly Government’s Welsh Backs campaign, the NHS Delivery and Support Unit are developing this pathway with clinical input from a range of health professionals and the Welsh Pain Advisory Board.
Ann Taylor, a reader at Cardiff University’s school of medicine, said: “It is medicalising back pain that makes it problematic.
“People are getting mixed messages and hearing unhelpful terms from doctors like ‘crumbling spine’ or ‘a touch of arthritis’.
“If anyone over the age of 30 went to the doctor and had a scan they would probably be found to have something wrong with their spine.
“Some 40% of us are wandering around every day with a prolapsed disc and it doesn’t cause us any problem whatsoever.
“What we see a lot of are people who have had a scan which has been bad and out of a fear of making it worse they stop moving, which is the worst thing you can do.
“The less you move, the worse your back will get and that is when you start seeing people going on incapacity benefit.
“It is scary when you look at the statistics: 20% of people who have been off work with back pain for a month will still be off a year later; while 50% of those who have been off work for six months will still be off a year later.
“Lower back pain is estimated to effect 60-80% of the population and a major part of the £500m cost to the NHS of back pain comes from people with lower back pain whose symptoms become chronic.
“Back pain is more costly to the NHS and the British economy than respiratory disease and cardiac disease, but it is not well-managed by the health profession and it is certainly not treated like a priority in the way it should be.”
She added: “Unlike in some other countries, we are not active participants in our care – we will just sit there and expect the doctor to give us lots of drugs and the pain will go away.
“Unfortunately, back pain isn’t like that and the message we want to get out is one of education and self-diagnosis.
“We want people to know what they can do if they get a bad back and to recognise that there are other factors, like obesity or smoking, that can contribute.
“The first time your back goes, it can be a scary thing. The pain can make people panic and think they have something very serious wrong with them, but the majority of the time it is not actually that serious.
“The main message we have is to keep active and to take painkillers if you need them. It is not helpful if doctors start sending people for scans when they don’t need them.”
Louise Cooke owns Wellfield Osteopathic Clinic in Roath with her business partner Brian McKenna.
The 47-year-old, from Penarth, has suffered from lower back pain for 20 years.
She said: “Like a lot of people, I have got a bit of wear and tear and had intermittent back pain over the years. I was in my late 20s the first time my back went. I had never had any trouble with it at all and it was completelyout of the blue.
“I was working as a video editor at the time and I’d put my feet up on the desk and was hit with instant agonising pain. I thought something dreadful had happened.
“My back was stiff, it was locked up and I couldn’t move and then the less I moved, the worse it got.”
Eventually, Louise’s work colleagues called an ambulance and she was taken to hospital, where she was told to go home and rest.
“It was the early 1990s and the standard advice was to rest in bed, which is of course the last thing you should do if you have back pain,” she said. “I spent about a week in bed, which I know now is really bad, and it did recover eventually.”
A couple of years later, with her back not getting better, Louise booked herself in to see an osteopath.
She said: “It provided me with some answers – and I must’ve been impressed, because I then trained to become an osteopath myself.
“I find it is about explaining what is wrong in the first place because many people don’t know how their bodies work. The main approach is to mobilise the joints and get the whole upper back working and moving better.”
Louise now exercises regularly at the gym to keep her back active and has not suffered serious back spasms in 18 months.
She added: “Staying active makes a big difference. It is really, really good for your core muscles and I’ve impressed myself with what a difference it has made.
“Seemingly, small things like the chair you sit on also make a big difference.
“My friends know now that if we go for coffee I will not sit on the sofas, but make sure I have a proper chair.
“I think it makes my job easier when I’m dealing with people who also have bad backs because, while everyone is different, I have a good idea of what works and what doesn’t.
“I think the more people know about back pain and the best way to deal with it the better, because when it first happens it can be very scary and it would be helpful to know the best way of dealing with it without having to run straight to the doctor.”