Stabbed in the Back: Confronting Back Pain in an Overtreated Society

Nortin M. Hadler knows backaches. For more than three decades as a physician and medical researcher, he has studied the experience of low back pain in people who are otherwise healthy. Hadler 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, Hadler 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 Hadler, back pain and back pain-related disability have exacted a huge toll, in terms of pain, suffering, and financial cost. Stabbed in the Back addresses this issue at multiple levels: as a human predicament, a profound social problem, a medical question, and a vexing public policy challenge. Ultimately, Hadler's insights illustrate how the state of the science can and should inform the art and practice of medicine as well as public policy. Stabbed in the Back will arm any reader with the insights necessary to make informed decisions when confronting the next episode of low back pain.

Read more Continue reading Read less FROM PUBLISHERS WEEKLY
Nobody's going to like Hadler's prescription for backache - neither patients, doctors nor the government. But here it is from the UNC professor and health-care reformist author (Worried Sick: A Prescription for Health in an Overtreated America) : get over it. The fact is that you may be best off if you do not tell anyone about your regional backache and try to get on with it, he declares. Hadler argues that no theory on what causes regional back pain has stood up to scientific testing, and the myriad of treatments do more to sustain an enormous treatment enterprise than ease the pain. Hadler presents an impressive survey of what doctors, chiropractors and surgeons now offer for back pain - and of the history and rationale for government disability programs. His conclusion is scornful. Predicaments of life such as back pain are not injuries, Hadler insists. [H]eadache, heartburn, sleeplessness, altered bowel habits, and many regional musculoskeletal disorders... do not respond to treatment as diseases because they are not diseases. That's what you call a bitter pill - but one that should trigger a much needed debate among health-care reformers. 5 illus. (Nov. 15)
Copyright Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to the hardcover edition. REVIEW
Stabbed in the Back is a major work of scholarship in an area relevant to every member of society. Nortin Hadler is one of the greatest contributors to this field, not only in the modern era but in the history of medicine. And this book represents the essence of his contributions to the field.--Mark Schoene, editor, The BackLetter

--This text refers to the hardcover edition. REVIEW
A bitter pill--but one that should trigger a much needed debate among health-care reformers.--Publishers Weekly



Relentlessly probes the effectiveness of common medical treatments and finds them wanting. . . . [A] compelling book.--Library Journal



"In this thought-provoking book, Hadler analyzes the evidentiary basis of the diagnosis and treatment of back pain with a fresh, no-nonsense razor.--Journal of the American Medical Association



The volume is well organized, giving a good historical and clinical overview of back pain and of what Hadler terms 'the backache industry.'--Choice



The next step [in health care reform] is the one Hadler is already confronting: how to really bring down costs as we move forward.--Progressive Pulse Blog

--This text refers to the hardcover edition. FROM THE INSIDE FLAP
For more than three decades as a physician and medical researcher, Nortin Hadler has studied the experience of low back pain in people who are otherwise healthy. With the healthy skepticism that has become his trademark, he takes the "Hadlerian" approach to backaches and the backache treatment industry, arguing that regional back pain is overly medicalized by doctors, surgeons, and alternative therapists and that the design of workers' compensation, disability insurance, and other "health" schemes actually thwarts getting well. --This text refers to the hardcover edition. ABOUT THE AUTHOR
Nortin M. Hadler, M.D., M.A.C.P., M.A.C.R., F.A.C.O.E.M., is emeritus professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill and attending rheumatologist at UNC Hospitals. His most recent book is By the Bedside of the Patient: Lessons for the Twenty-First Century Physician (UNC Press) . --This text refers to the hardcover edition. FROM THE BACK COVER
For more than three decades as a physician and medical researcher, Nortin Hadler has studied the experience of low back pain in people who are otherwise healthy. With the healthy skepticism that has become his trademark, he takes the "Hadlerian" approach to backaches and the backache treatment industry, arguing that regional back pain is overly medicalized by doctors, surgeons, and alternative therapists and that the design of workers' compensation, disability insurance, and other "health" schemes actually thwarts getting well. --This text refers to an alternate kindleedition edition. Read more Continue reading Read less