In 1998, Richard Deyo, MD, one of the most clear-thinking back pain experts in the U.S., published an article in Scientific American (paywall) explaining what was wrong with back pain treatment. Not a lot has changed. See his list of myths, complete with matching cartoons, on page 52; his book Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises is also a must-read.
For a general overview of what’s out there, visit the website of NIAMS: the National Institute of Arthritis and Musculoskeletal and Skin Diseases. It’s one of the research institutes of the National Institutes of Health. Click here to get a decent overview of options and issues. It’s not perfect—it’s possibly influenced by the FDA, an agency that is very much under the thumb of pharmaceutical companies and device manufacturers—but a it’s decent source to start with.
The Dartmouth Atlas provides shocking data about the prevalence of spine surgery here.
If you’re interested in how surgeons and device manufacturers wound up in bed together, you’ll want to have a look at the website for the Association of Medical Ethics. Use the Doctor Payments search tool to find out how much surgeons have been paid to consult on a specific product.
The investigative reporting organization called ProPublica is creating an increasingly robust and truly eye-opening source of information regarding the payments that drug and device companies make to doctors in return for promoting their drugs. This database—broken down by state, which is more convenient—has been assembled by the superb investigative reporters at ProPublica. Start with this article that explains how patients can use the database. The database is here.
The Washington State Agency Medical Directors website harbors some progressive thinking on the matter of dealing with dependency on opioid painkillers. It’s kind of technical, but worth inspecting. While you’re on the site, click on the PDF called Cautious, Evidence-Based Opioid Prescribing.