Costs vs. Benefits of Western Back Pain Treatments

In the world of medicine, there has long been a debate between the costs vs. benefits of Western medical treatments as opposed to alternative therapies. Here are some primers of the similarities, differences, costs, and benefits among the four therapies.

Costs: Primum non nocere is a Latin phrase that means "First, do no harm". Do no harm is an oath that all medical students take as they begin their educational and then clinical rotations in hospitals and clinics. But realistically, there are risks associated with almost any healthcare treatments, and some are riskier than others. For back pain treatments in general, the risks and side effects for some procedures, back surgery in particular, are very high, and may include months of rehabilitation and physical therapy. The oath Primum non nocere does no prohibit doctors from performing any diagnostic procedures or treatments that would pose a risk to patients, but it implies that there should be a thorough evaluation or risk against benefits before embarking on the treatment. For example, injections for back pain involve the possibility of infection involved in all skin punctures, as well as the possibility of a "spinal headache" that can happen if the sac around the spinal cord is punctured. These risks are exceedingly rare, and doctors will often decide to go along and perform the procedure if they think that the patient would receive significant back pain relief. Other procedures, such as spinal fusion surgery, have a much higher risk of complications associated with the procedure. Risks and complications associated with back surgeries such as spinal fusion include infection, the need for follow-up surgery if the bones don't fuse properly, risk of nerve damage. Even in the best of circumstances, the recovery time for this kind of operation is 6-12 months.

On the other hand, patients have reported significant benefits from alternative therapies such as Myotherapy, Reflexology, Chiropractic, and Magnetic therapy. Most or all alternative therapies involve no surgery, no invasive treatments (such as skin punctures), and minimal risks and recovery time. My gosh! Why would anyone subject themselves to western medicines that could blow a hole in their stomachs (hello NSAIDS) or invasive surgeries where many patients end up worse than ever, when there are alternatives out there that truly adhere to the Hippocratic oath, where healthcare practitioners promise to do no harm?

Well, the answer is complicated, and worthy of a long thesis beyond the scope of this article. But in general, here are some answers.

People trust and like their doctors. The healthcare system is maligned among liberals and conservatives alike. No matter what ethnicity, age, or socioeconomic background people are in, they are generally unified in the belief that "The System Sucks." Nevertheless, no matter what people think about the healthcare system in general, most like and trust their doctor, and will be cooperative with the treatment prescribed to them. For back pain, doctors will usually order diagnostic studies to determine the cause of the back pain, then order medications or physical therapy to treat the problem. If physical therapy doesn't work, then the doctor may prescribe stronger medications (narcotic analgesics), and/or pain management injections. If none of these treatments produce any back pain relief, then the doctor may finally consider back surgery.

Up next, we will take a closer look at cost vs. benefit analysis of western vs. eastern health systems towards the management of back pain.