About $213 billion is spent each year on unnecessary drugs, hospital stays, and visits to emergency rooms and doctors’ offices, according to a recent report by the IMS Institute for Healthcare Informatics. And that excessive care is more than just a waste of time and money. Tens of thousands of Americans each year go the ER for side effects from unnecessary drugs, for example. And any unneeded surgery poses an unwarranted risk of infection and other complications.

Why so much treatment? “A lot of doctors think that’s what patients want,” says Daniel Morgan, M.D., an associate professor of medicine at the University of Maryland School of Medicine and lead author of a 2015 study in JAMA Internal Medicine outlining some of the top overused medical treatments. “But most people don’t want a treatment unless it can help them.”

Here’s a look at seven drugs and procedures that doctors often recommend—but that you may not actually need:

1. Acetaminophen for Back Pain

Why it’s usually not needed: Physicians often recommend acetaminophen (Tylenol and generic) for lower-back pain, but a 2015 review in the British Medical Journal concluded that the drug simply doesn’t help much or at all for that kind of pain. In fact, it may hurt more than it helps: Patients taking acetaminophen were almost four times more likely to have abnormal results on liver-function tests than those who took a placebo. “If you go even a bit higher than the recommended upper limit, you can get a toxic dose and develop liver damage,” says Morgan. (Read more about the potential dangers of acetaminophen.)

When it’s warranted: Most of the time, it’s not. New-onset lower-back pain “usually resolves on its own, with moderate activity like walking, and with heat and stretching,” Morgan says. During that time, consider pain relievers such as ibuprofen or naproxen, which appear to be more effective for back pain because they also ease inflammation. If you can’t take one of those drugs, acetaminophen is an option as long as you take no more than 3,250 mg per day. If pain persists longer than two weeks, ask about physical therapy, which is effective but underused. (Read more about when you need imaging tests for back pain.)

2. Opioids for Chronic Pain

Why they’re usually not needed: One in five patients who sees a doctor for chronic pain walks out with a prescription for hydrocodone (Vicodin and generic), oxycodone (Oxycontin, Percocet, and generic), or another opioid. The drugs can be necessary for severe, acute pain, such as after surgery.

But those drugs don’t work well over time. “Your body gets used to them, and you have to take more and more to reduce pain,” explains Lewis Nelson, M.D., an associate professor of emergency medicine at NYU Langone Medical Center. That increases the risk of overdose: The rate of opioid-­related deaths has tripled over the past 15 years, according to the Centers for Disease Control and Prevention. Yet more than 90 percent of patients who survive an opioid overdose are put back on the drugs, according to a December 2015 study in the Annals of Internal Medicine. (Read more about the dangers of excessive use of opioids.)

When they’re warranted: If other treatments—anti-inflammatories such as ibuprofen (Advil and generic) and naproxen (Aleve and generic), exercise, physical therapy, spinal manipulation, massage, and acupuncture—don’t help, opioids may be an option. Your doctor should monitor you for signs of addiction, such as moodiness and risk-taking behavior.

3. Antibiotics for Sinus Infections

Why they’re usually not needed: Sinus infections account for about 20 percent of outpatient antibiotic prescriptions, but more than 90 percent of cases are caused by viruses or allergies. “Antibiotics only work against bacteria,” says Linda Cox, M.D., an allergist in Fort Lauderdale, Fla., and past president of the American Academy of Allergy, Asthma & Immunology. “Many physicians still prescribe them because they feel pressure from patients or because they mistakenly believe they work.” Even infections that are caused by bacteria usually resolve on their own within two weeks.

Antibiotics also carry risks: One in four people taking the drugs suffers dizziness, stomach upset, rashes, or other side effects. In addition, overuse can breed "super bugs," bacteria resistant to antibiotics, undermining the effectiveness of the drugs. You’re best off with simple remedies: rest; warm liquids; breathing warm, moist air; gargling with salt water; and rinsing your nose with a saline spray.

When they’re warranted: Antibiotics are necessary for sinus problems only if tests confirm that your infection stems from bacteria and if the symptoms remain severe for more than a week or so, or if you develop a fever higher than 101.5° F. In that case, ask your healthcare provider about generic amoxicillin. The usual course of a week costs only about $4, and it works as well as Augmentin, a brand-name counterpart. (Read more about treating sinus infections.)

4. Bone Meds for Osteopenia

You need bone drugs only if a DXA scan shows outright osteoporosis.

Why they’re usually not needed: Two-thirds of new osteoporosis prescriptions may be inappropriate, according to a January 2016 study in JAMA Internal Medicine. “Part of the problem is many women get screened for weak bones in their 50s even though they don’t have risk factors,” says lead author Joshua Fenton, M.D., associate professor of family and community medicine at the University of California, Davis. (The National Osteoporosis Foundation and other groups don’t recommend a bone density scan in most cases until age 65.)

Many of those people are given osteoporosis drugs even if the test shows only mild bone loss (osteopenia). But there’s little evidence that drugs help that problem. And the medications—including alendronate (Fosamax and generic), ibandronate (Boniva and generic), and risedronate (Actonel and generic)—can sometimes damage bone and cause side effects such as difficulty swallowing and heartburn.

For mild bone loss, try weight-bearing activity (such as walking), getting at least 1,200 mg of calcium and 600 IU of vitamin D daily, avoiding smoking, limiting alcohol, and limiting the use of drugs such as steroids, proton-pump inhibitors, and certain antidepressants.

When they’re warranted: You need drugs if your bone tests show outright osteoporosis. In other cases, they are usually needed only if you have osteopenia and other risk factors. (Your doctor may be able to estimate your risk using the online tool developed by the World Health Organization.)

5. Surgery for Low-Risk Prostate Cancer

Why it’s usually not needed: If you receive a diagnosis of prostate cancer—based on a biopsy that finds cancerous cells in the gland—you may be advised to immediately have surgery or radiation. But in many cases, neither is necessary. About 70 percent of prostate cancers are low-risk, meaning the tumor is small and growing so slowly that it will never become life-threatening. “In most of these cases, a man will eventually die of a completely unrelated condition,” says Michael Barry, M.D., a prostate cancer specialist at the Dana-Farber Cancer Institute in Boston. In addition, both treatments can lead to sexual and urinary problems such as impotence and leaking urine. And radiation can cause other problems, too, such as fatigue, which may be a particular concern to older, frail patients.

Research shows that you’re often better off choosing an option known as active surveillance, where your physician watches your cancer closely and performs regular checkups including repeat prostate-specific antigen (PSA) blood tests. If the cancer continues to grow, you can start treatment. But only about 12 percent of men with those low-risk prostate cancers opt for that approach, according to a 2015 UCLA study in JAMA Oncology. “The first reaction, among both patients and their physicians, is to say, ‘There’s cancer here; let’s get rid of it,’ ” Barry says.

When it’s warranted: After your biopsy, find out your Gleason score—a measure of how aggressive your cells look. If your score is higher than 6 (on a scale of 2 to 10), prompt treatment may make more sense. In other cases, monitoring the disease with follow-up PSA and other tests is often sufficient.

6. Urinary Catheters in the Hospital

Why they’re usually not needed: If you’re admitted to the hospital, doctors may want to insert a urinary catheter, a tube that’s threaded through your urethra into your bladder, allowing urine to drain into a bag. But catheters can get placed for inappropriate reasons, according to a 2015 review in the Annals of Internal Medicine that updated guidelines on when the catheters should be used. “Unfortunately, there’s a temptation for hospital staff to use a catheter for longer than the patient needs because it may be more convenient,” says Jennifer Meddings, M.D., lead author of the recent review and assistant professor of internal medicine and pediatrics at the University of Michigan.

Catheters are breeding grounds for infection—bacteria can travel along the outside or inside of the catheter into the bladder or kidney. For every day you have a catheter inserted, the bacteria in your urine rise by 5 percent, increasing your risk of developing a urinary tract infection, research suggests. And when you get an infection in a hospital, it’s more likely to be with drug-resistant bacteria, Meddings says, requiring stronger antibiotics for longer periods of time and increasing the risk of complications. “The patient and the family need to ask every day if the catheter needs to stay,” she says. (Read more about the risks of having a urinary catheter in the hospital.)

When they’re warranted: You don’t want a urinary catheter in the hospital unless you absolutely need it. “For example, if you were critically ill, you may need a catheter so your doctor can measure your hourly urine output until you are stabilized,” Meddings says. (See our hospital Ratings, which includes information on infection rates caused by urinary catheters.)  

7. Surgery for Clogged Kidney Arteries

Why it’s usually not needed: In one study, almost 7 percent of people older than 65 were found to have renal artery stenosis, a narrowing of the arteries that carry blood to one or both of the kidneys. Early RAS is usually symptomless, but it may be present in about 10 to 40 percent of patients with serious cases of high blood pressure and can lead to kidney failure. “Most of the time, it’s found during evaluation for uncontrolled hypertension, kidney insufficiency, or acute pulmonary edema,” explains Anthony Bavry, M.D., an interventional cardiologist at the Malcom Randall VA Medical Center and the University of Florida in Gainesville.

Sometimes your doctor may recommend surgery to open up those blocked arteries. But there’s no evidence that people who have the procedure—which has a mortality rate of up to 2.5 percent and can cause kidney failure—fare better than those who take medication to reduce blood pressure, according to a 2014 study done by Bavry. “It makes intuitive sense that if you open a blockage, you’ll improve blood pressure and preserve kidney function,” Bavry says. “But research has shown that’s not the case.”

When it’s warranted: You may need the procedure to unblock your arteries if you have recurring pulmonary edema (fluid buildup in your lungs) as a result of high blood pressure that can’t be controlled even with multiple medications. For most other patients, reducing blood pressure, losing weight, and lowering cholesterol have the same effect.