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224 pp., 6.125 x 9.25, 5 illus., 4 figs., 12 tables, notes, index

Cloth
ISBN  978-0-8078-3348-3
Published: November 2009

Stabbed in the Back

Confronting Back Pain in an Overtreated Society

By Nortin M. Hadler, M.D.


Awards & Distinctions

2012 Prescrire Prize for French edition

Nortin 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.

About the Author

Nortin M. Hadler, M.D., M.A.C.P., F.A.C.R., F.A.C.O.E.M., is 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 Worried Sick: A Prescription for Health in an Overtreated America (UNC Press).


Reviews

"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."
--JAMA

"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

"Nortin Hadler exposes the overmanagement of a sometimes-contrived disease with a compelling body of scientific investigation."
--Mehmet Oz, M.D., New York Presbyterian Hospital, College of Physicians and Surgeons, Columbia University

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