New advice: pain management, rheumatology and rehabilitation

15 Mar 2018

Fifteen new recommendations on healthcare practices that clinicians and consumers should question have been developed by three medical faculties and associations and released by Choosing Wisely Australia this year, with low back pain a common theme.

The Australian Rheumatology Association warns against arthroscopies for symptomatic knee arthritis, advises avoiding imaging for low back pain and questions the way antinuclear antibody (ANA) testing is used.

The recommendation for spinal orthotics or bed rest for non-specific low back pain and splinting for managing stroke patients is questioned in the latest list of recommendations from the Australasian Faculty of Rehabilitation Medicine.

In its recommendations released on 14 February, the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists addresses the treatment of low back pain with medication and spinal fusion, chronic non-cancer pain and neuropathic pain.

On the prescribing on benzodiazepines for low back pain Dr Mick Vagg, pain medicine physician and Chair of the Faculty’s Professional Affairs Executive Committee said: “Low back pain is one of the most prominent pain conditions experienced by Australians. Up to 80% of people will experience low back pain at some point in their lives, with one in 10 being limited in their day-to-day activities and looking for relief.

“However, a recent review found there was no evidence to support people taking benzodiazepines as ‘muscle relaxants’ to relieve their low back pain, in addition to or instead of anti-inflammatory medicines.

“Like all drugs, there are risks associated with taking benzodiazepine including abuse, addiction, tolerance and overdose resulting in accidental death. We are urging healthcare providers and their patients to discuss the appropriateness of benzodiazepine use.”

Read the full media release.

To date, 173 recommendations have been released by Choosing Wisely Australia, with more to follow in the coming months. 

Last reviewed 08 March 2018