Back Pain Medication and Addiction

Back pain.

Those two words together send shivers – or rather a lightning bolt of discomfort – down my spine as I write this article. Ranked as the third most common reason for doctor’s office visits, back pain is the single leading cause of workplace disability worldwide. However, according to a new article published by Harvard Women’s Health Watch this October, babying your back pain might actually delay its healing.

Despite the National Institutes of Health listing back pain as one of the most common medical problems in the United States, the mechanism behind its healing is very enigmatic. For example, when a person scrapes their knee, the pain associated with that injury gradually dissipates as the wound heals.

We all know the drill.  Apply pressure to the affected area, dab on some Neosporin, and cover it up with a fresh bandage. Then, after a couple weeks, remove your band-aid and violà!  All better, right? Unfortunately, the underlying mechanism behind back pain relief doesn’t work like that.

Contrary to popular belief, the prevalence of back pain does not increase with age.  In fact, back pain is more often reported in middle age populations rather than elderly ones (i.e. those aged 60 and over).  This seems counterintuitive since disc degeneration generally increases over time. So what does that mean?

These findings suggest that the back pain healing process is more neurological than physical (a la our scraped knee example). However, look at our country’s MRI data. As medical imaging becomes more widely-accessible, millions of cases exist in which individuals report pain-free lifestyles despite ugly-looking MRIs – and vice versa. According to Dr. James Rainville of New England Hospital in Boston, this is due to our body’s nervous system adapting to our discomfort.

The prescribing of painkillers and recommendation for surgery – two standard treatments for back pain – are often expensive and somewhat ineffective. For instance, one article suggests that 20% of all back pain surgical patients undergo additional surgeries in their lifetime in hopes of alleviating the original source of pain. With over $80 billion USD spent per year on back pain treatment, this can be a costly approach.

I know the majority of you are thinking, “Well, great… You’re telling me surgery is too costly, painkillers cause more harm than good, but my back pain still exists. So what should I do?” Rest and relaxation seemed to do the trick in our scraped knee example. But, not in this case…

Dr. Rainville notes that, “There is no evidence that being careful will slow the process of disc degeneration down.” On the contrary, movement seems to be the best approach to relief as it normalizes pain responses within our nervous systems. Rehabilitative processes designed to increase strength and flexibility in our spines have shown to be more effective than rest and relaxation in some cases.

Ultimately, back pain causes most individuals to give up previously enjoyable activities (i.e. golf, cycling, and playing with kids) in fear of further pain or reinjury. However, current research suggests doing the opposite.  Instead of giving into the pain, Dr. Rainville and other physical therapists suggest to get moving.

Below are some suggestions recommended by the National Institute of Neurological Disorders to help treat your back pain:

✓  Get out of bed! Inactivity promotes muscle stiffness and reduces flexibility. This may actually increase your pain as well as other health conditions such as heart disease and depression. If you are bed-confined, look into an alternating pressure mattress in order to prevent bed sores and re-activate the oxygenation of your blood.

✓ Strengthen your spine. While the lifting of heavy weights can cause reinjury, consult with your doctor or physical therapist to devise a light-weight exercise program to strengthen your muscles. This will help build spinal support and help maintain neuromuscular function within the body. We suggest giving your local physical therapist or chiropractor a call.

✓ Alleviate the symptoms. Although over-the-counter medicine won’t solve the problem, the use of hot and cold packs should help make daily activities more tolerable. We advise you to consult with your primary care physician to make sure any medications are advisable and safe.