The first national study to examine spending on a wide array of low-value health services among adults with commercial health insurance finds that while use of such services is modest, there is considerable potential for cost savings.
National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia.
Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available.
Several randomized controlled trials show yoga is an effective treatment. However, the comparative effectiveness of yoga and physical therapy, a common mainstream treatment for chronic low back pain, is unknown.
Patients with multi-morbid diabetes, arthritis, neurological, or long-term mental health problems have significantly lower health-related quality of life (HRQoL) than other people. The associations of physical health with HRQoL were stronger in the presence of long-term mental health problems.
Prediction rules have yet to be published for the interventions listed as brief pain-management programmes, but there is evidence that some tools are useful in detecting psychosocial aspects of low back pain and are predictive of poor outcomes.