February 25, 2019 – Dr. Steven Goldstein told listeners to his weekly podcast that not only were opioid pain killers not the best option for treating back pain but that they could make the situation worse. Dr. Goldstein is a well-known neurologist and the founder of the Houston Healthcare Initiative Podcast. The podcast can be heard on iTunes, Soundcloud and at www.houstonhealthcareinitiative.org.
Why is Back Pain Such a Common Condition?
According to Dr. Goldstein there are numerous reasons. “The disk material that is in between each vertebral body deteriorates as we age,” he told listeners. “It is the shock absorber that protects the spine when weight is carried. The back and spine can be displaced from a sudden heavy lift or from an injury such as an auto accident and is commonly known as a slipped disk but is more likely when disks are degenerated. Other common causes of back pain include sprain of paraspinous muscles or sprain of ligaments that hold the spine in place.
Sprains can also occur in the small joints of the spine known as facet joints or in the ‘Sacroiliac joints’ where the tail bone connects to the pelvis. Arthritic changes in the spine can flare and cause pain, seemingly without any injury. In the majority of cases the back pain will resolve with a short period of rest followed by gentle aquatic exercise to strengthen muscle and tighten ligaments. Contrary to popular opinion the pain from a slipped disk will respond to this treatment in most cases unless there is continued pressure on a nerve root exiting the spine. Studies show 90% will resolve in 12 weeks.
Chronic Back Pain
Chronic back pain is defined as pain that persists for 12 weeks or longer. “In my practice, the most common cause is the use of opioids in the early acute phase of the illness,” Dr. Goldstein said. “What happens is that the narcotic is effective in relieving the back pain. The patient unwittingly gets up and goes about normal activity. If there is inflammation from a slipped disk or sprained muscles or ligaments the extra activity will make the condition worse.”
Instead of opioids, Dr. Goldstein recommends patients use the pain as their ‘friend’. “If a given activity is causing pain, stop doing it and lie down. If the pain is so severe that a strong narcotic is necessary, lie down and rest for 3-4 hours until the medicine wears off before trying to do any activity.”
The Houston Healthcare Initiative is a medical co-op that is a non-profit company, owned by the members to provide ‘insurance’ at greatly reduced costs. To learn more visit, www.houstonhealthcareinitiative.com.