This is an interesting report and may go some way to explain the vast difference in surgery rates for back pain in the US compared to the rest of the world.
In Europe far more people opt for rehabilitation and preventative measures than surgery. The fact is, MRI scans are seen as having no downside because they don't use ionising radiation. But because the causes of most back pain are complex and poorly understood, the fact is that MRI scans are rarely conclusive, but you can usually see SOMETHING that may be worth operating on, if only because the back generally deteriorates with age.
Surgery for back pain is a pretty drastic measure in many cases. People should seek simpler solutions first, such as pain relief, physio treatment, improving their general health and weight, and improving their posture
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Dr Phil Worthington of NY 5:26AM October 16, 2009