Stabbed in the back : confronting back pain in an overtreated society /
Nortin M. Hadler.
- Chapel Hill : University of North Carolina Press, c2009.
- xii, 204 p. : ill. ; 25 cm.
Includes bibliographical references and index.
Three marks of the past on the backs of the present -- Oh, my aching back -- The pall of persistence -- Doc, my back is killing me -- The quest for a better way; or, My name is Nortin and I'm a placebo? -- Invasion of the spine surgeons -- Backbreaking work -- The straw that broke the camel's back -- If you don't know where you are going, all roads will get you there.
For more than three decades as a physician and medical researcher, the author has studied the experience of low back pain in people who are otherwise healthy. He terms the low back pain that everyone suffers at one time or another "regional back pain." In this book, he addresses the history and treatment of the ailment with the healthy skepticism that has become his trademark, taking the "Hadlerian" approach to backaches and the backache treatment industry in order to separate the helpful from the hype. Basing his critique on an analysis of the most current medical literature as well as his clinical experience, he argues that regional back pain is overly medicalized by doctors, surgeons, and alternative therapists who purvey various treatment regimens. Furthermore, he observes, the design of workers' compensation, disability insurance, and other "health" schemes actually thwarts getting well. For the past half century, says the author, back pain and back pain-related disability have exacted a huge toll, in terms of pain, suffering, and financial cost. This work addresses this issue at multiple levels: as a human predicament, a profound social problem, a medical question, and a vexing public-policy challenge. Ultimately, the author's insights illustrate how the state of the science can and should inform the art and practice of medicine as well as public policy.