The University of Pittsburgh Medical Center Health Plan, on January 2012, implemented guidelines for the management of chronic low back pain. This health plan, which is affiliated with the School of Medicine, outlines the measures that must be taken by a patient before receiving authorization for low back surgery.

One of the measures that must be taken by the low back pain patient includes a 3 month course of conservative treatment, including physical therapy, chiropractic care and medication.

As stated in the December 2011 UPMC Health Plan Physician Partner Update, “We feel strongly that this clinical initiative will improve the quality of care for members who are considering low back surgery, and that it will facilitate their involvement in the decision- making process.”

This is an encouraging statement that has been made by UPMC. They are showing leadership by promoting conservative care prior to invasive surgery. These measures also put more responsibility on the patient to get involved with treatment and the decision making process. This will in turn help the patient get the best outcome possible.

This viewpoint is something that we have discussed with many patients. First start with
conservative therapy, like chiropractic and physical therapy, therapy that is successful and has minimal side effects. Then move to the more risky and invasive procedures, if needed. We feel that with these measures in place and accepted by more doctors, there will be a higher quality of care and provide better outcomes for patients.