Back Pain: Causes and Treatments

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There's a good chance you or someone you care about has suffered with back pain that lasts a long time. Back pain is the second leading symptom seen by doctors in the United States. Now, one might think a powerful group of pain medicines can help relieve the agony. But it appears, their effectiveness, at least with back pain, might be overblown. Chronic back pain--meaning, pain that lasts more than three months--is reported in 19 percent of working adults. That's one in five! Thambal Yima will tell you first hand how debilitating it can be. She suffered five herniated discs, and two fractures a couple of years ago. “I went through all kinds of medical treatments. I was in so much pain to get up on the examination table I would scream.” She came in in intractable pain, certainly, sounding like someone, if there was someone, who would benefit from opioid pain medicines…drugs in the morphine family. These are drugs like fentanyl, percocet, oxycontin, and vicodin. They are powerful pain killers. But according to new research in the annals of internal medicine, the difference in pain relief between these medicines and placebo was not significantly different long term, believe it or not.

Dr. Charles Kim, a pain specialist at Mt. Sinai Medical Center, says, “If the patient has intractable pain that can just not be controlled, then it is wise to have it fully medically evaluated to see whether the person is a surgical candidate at that point or continue with conservative treatments. Yet, despite the lack of effectiveness, there is a potentially huge potential for substance abuse disorders when taking them, affecting as many as half of the patients. Patients can potentially become addicted, and may, over time, need higher and higher doses to get relief of pain. And trying to stop the medicine can lead to withdrawal symptoms."

Dr. Kim, who practices integrative medicine, combining eastern and western medicine, believes there is a time and place for these drugs. Dr. Kim says, “I think if it is used appropriately it is a wonderful way to improve someone’s pain, improve their life activities as well as their enjoyment of life. Using those medicines judiciously has helped a lot of my patients regain their life back.“ Still, there are many ways other than opioids to treat chronic back pain, including exercise therapy and alternative measures like acupuncture.

“I find that using those in addition to other medications can dramatically decrease the dependencies or uses to some of the other controlled substances,” says Dr. Kim Acupuncture, along with another alternative approach called cupping, worked incredibly well for Thambal when medicine didn’t. “I came in the hunchback of Notre Dame. It’s amazing, but it’s not really a miracle, it’s acupuncture.” The authors say the findings suggest that doctors should reconsider using opioid medications for treating chronic back pain, and consider other treatments with fewer side effects.

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