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Overtreated: Dealing with back pain

Tue Jun 8, 2010 12:00 AM EDT
health, us, glance, pain, back-pain, med, overtreated
The Associated Press, STF
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— Back pain can be one of the most debilitating kinds of pain, but most people get better with time.

Some advice:

_See a doctor quickly if the pain is accompanied by "red flag" symptoms that include trouble urinating, leg weakness, numbness or pain, fever or unintentional weight loss.

_With run-of-the-mill back pain, prepare to allow a month to six weeks to see if it goes away on its own.

_Don't expect an X-ray or MRI before then unless the doctor suspects a serious problem.

_Try over-the-counter pain relievers such as anti-inflammatories before seeking prescription pain relief. Old-fashioned steps such as heating pads and firm mattresses also are recommended.

_If the pain doesn't go away in that month to six weeks, ask about rehabilitation or exercise therapy. There are specific exercises recommended for different kinds of pain.

_If surgery is recommended, ask why that's the best option, what are the risks and what would happen if you don't operate — what other options you might try instead. Seek a second opinion. Your doctor or insurer also may offer "decision aids," DVDs or booklets that describe the pros and cons of each option.

___

Sources: American College of Physicians/American Pain Society guidelines; National Institutes of Health; spine surgeons.

© 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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  • Public Discussion (2)
tdk022755

I am a nurse of 32 years and all I can say is DO NOT, DO NOT, have back surgery if you can avoid it in any way. Unless you have a traumatic injury that may result in loss of motor control below the level of the injury or something like a tumor compressing the spinal cord, leave it alone and try other methods. I cannot tell you the number of patients that I have seen who have back surgery who never ever get better and for most of them the surgery makes the problem worse. I have a back problem myself and I can tell you from experience that strengthing your abdominal muscles, using an anti-inflammatory medication and good body mechanics will help you more than surgery. As we get older a lot of us develop small fractures and buldging discs but they do not require surgery unless you have cord compression that is causing neurological symptoms below the level of the injury. I have, for example, pain down the back of both my legs and some weakness in my right leg but I do not have a surgical problem. I have steroid injections a couple of times a year. I DO NOT take narcotics (that is a never ending cycle of needing more and more medication for pain and it is not worth it) and I just use good body mechanics. I don't lift heavy objects. I have learned to live with the discomfort and to compromise in other ways. Most of us CAN live with back pain if we don't expect that we will be completely pain free all the time. I am almost never pain free but my pain level is such that I can live with it.

If you decide to have surgery, make sure you get at least one second opinion and go see a neurosurgeon that has expertise in specifically back surgery. Go to the largest center that you can that does a lot of these types of surgeries. You want someone who does this type of surgery as a speciality. Check the doctor out completely before you have any surgery. Because remember, you may just be making your problem worse.

    Reply#1 - Tue Jun 8, 2010 3:43 AM EDT
    Megidoloan

    Seconding this! In my previous line of work, I had dozens of cases where people had back surgery for pain. Not one of them got relief from it - most of them actually got worse. You couldn't pay me to have back surgery.

    Nonetheless, accepting that you're never going to be completely pain-free sucks. Like you, I cope by getting my pain down to a "tolerable" level. I'm on narcotics because I'm allergic to just about everything else, and the tolerance bit worries me. I actually have an appointment later this week with my pain doctor because the stuff I'm using now doesn't work as well anymore, but I don't want to be on anything stronger.

    But yeah, stay away from surgery.

      #1.1 - Tue Jun 8, 2010 5:58 PM EDT
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