Low back pain is the leading cause of disability worldwide, affecting an estimated 540 million people at any one time, but a new study finds that many of us aren't getting the right treatment for it.
A series of papers in The Lancet highlights the extent to which the condition is mistreated.
Evidence suggests that the first line of treatment is education and advice to keep active and at work.
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However, in reality, a high proportion of patients worldwide are treated in ERs, encouraged to rest and stop work, are commonly referred for scans or surgery or prescribed pain killers including opioids, which are discouraged for treating low back pain.
"It actually astounds me that that kind of advice being given out," says Dr. Scott Blumenthal, spinal surgeon at Texas Back Institute.
"A lot of doctors, particularly ER docs or primary care doctors, are under pressure to see so many patients. What's the easiest thing to do? They write a prescriptions, they say go to rest in bed and here's a referral for a specialist," says Dr. Blumenthal.
He says the majority of cases of low back pain respond to simple physical therapies that keep people active and enable them to stay at work.
Low back pain results in 2.6 million emergency visits in the USA each year, with high rates of opioid prescription.
A 2009 study found that opioids were prescribed to around 60% of ER visits for low back pain in the USA. Additionally, only about half of people with chronic back pain in the USA have been prescribed exercise.
"The spine is infinitely more complex than other joints in the body and if you stop moving, it'll get stiff and it'll hurt more, so you're creating a cycle going in the wrong direction rather than in the correct direction," says Dr. Blumenthal.
At MAC Speed and Strength in Plano, Amber Christopher has learned to modify exercise movements to ward off her back pain.
"Sometimes, I will have some muscle soreness, but it's more from, you know, the crazy leg days that we have here!" says Christopher.
Dr. Blumenthal says if your pain starts in your back and radiates into your leg, if you have fever or chills or if the pain doesn't go away after about a week, you should see a doctor.