From the Fall 2015 issue of For Your Benefit newsletter
Despite staying active and developing strong core muscles many of us will be affected by back pain. Many patients are understandably anxious to have something done quickly to stop the excruciating pain. But rushing to do something can actually be harmful according to the American Academy of Family Physicians and Choosing Wisely® campaign. Up to 90 percent of people who see a doctor in the first three days of a back attack get better within two weeks, regardless of the treatment.
- Rush to have an X-ray, CT scan or MRI: These tests can reveal small abnormalities that aren’t the cause of pain, but can cause you and your doctor to pursue aggressive and unnecessary care. Radiation has risks and it’s important to avoid harmful radiation when possible. A recent study estimates that the 2.2 million CT back scans done in 2007 will lead to 1,200 future cancers. Imaging tests are also expensive and are subject to employee health plan copays and deductibles. Total costs range from $200-$290 for an X-ray and $1,080-$1,520 for a CT scan according to Healthcarebluebook.com. See the list section of the Choosing Wisely® website for more information on when you need or don’t need imaging tests for lower back pain, see the Choosing Wisely website.
- Stay in bed for an extended time: Bed rest was the standard of care for back-pain sufferers until a 2010 review reported that staying active helped speed recovery. Research shows that bed rest of longer than two days does not help and can even be harmful at four days or more, according to Choosing Wisely®.
- Take narcotic drugs unnecessarily: People who take narcotic pain drugs such as oxycodone (OxyContin and Percocet) and hydrocodone (Lortab and Vicodin) report more disability after six months compared to those who don’t. The longer you use an opioid, the higher the dose you will need- increasing the risk of addiction and side effects. Almost one third of back pain patients’ doctors prescribe these potentially addictive drugs according to Consumer Reports.
- Request a steroid injection: Although steroid injections are often prescribed to patients who suffer from back pain related to osteoarthritis, there’s no evidence that injections help these patients. Steroid injections can help those who have back pain with sciatica (leg pain from a pinched nerve), but the effects wear off by three months.
- Have needless surgery: Back pain usually is the result of arthritis, poor posture, and weak muscles. Surgery should be considered however, if there are severe back and leg symptoms lasting three months or so that are indisputably linked to a herniated disk or spinal stenosis (according to the September 2014 Consumer Reports on Health).
- Stay physically active: “Try to maintain everyday activities and stay physically active while avoiding activities and postures that make it worse, such as lifting and twisting,” says Dr. Jeffrey Katz, a Harvard Medical School professor and editor of the Harvard Special Health Report: Low Back Pain: Healing and Your Aching Back. Stretching and walking are helpful for expediting recovery. When you are ready, move on to exercises that strengthen your abdomen, back and legs. Sometimes your doctor will refer you to a physical therapist to learn the proper form for these exercises.
- Take over-the-counter painkillers such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory ibuprofen drugs (Advil and Motrin) for short term relief: These drugs can be effective in alleviating pain and reducing swelling on a short-term basis. Be aware that long-term use of ibuprofen can cause stomach ulcers and other complications, so be sure to follow the directions and limit long term use. You doctor may also prescribe a muscle relaxant.
- Use Ice and Heat: For the first three days, apply ice to your back. Thereafter, apply heat: a heating pad, electric blanket, warm bath or shower.
- Consider alternative treatments and find out if your plan offers discounts: some of the GIC’s health plans offer discounts on massage therapy, cognitive-behavioral therapy, yoga, progressive muscle relaxation or other treatments. Your doctor may also prescribe physical therapy.
- Surgery and imaging tests may be necessary: See your doctor as soon as possible if you experience leg weakness, pain radiating from the buttock to a leg, have an accident or fall, or fever over 102°F, experience loss of control of your bowel or bladder, problems with your reflexes, have a history of cancer, or unexplained weight loss. You might have a condition requiring active medical intervention.
This information provided by the Group Insurance Commission .