Four Common Mistakes in Treating Back Pain
Written by Editor   
Saturday, August 23, 2014 12:50 AM

Consumer Reports reports that with back pain, less really is more. Aggressive tests and treatments can waste your money and actually slow your recovery. Here are four common mistakes in treating back pain.

Mistake 1: Rushing to test

Scans often show small abnormalities that aren’t the cause of the pain but can prompt you and your doctor to pursue unnecessarily aggressive care. In addition, X-rays and CT scans expose you to unnecessary radiation.

Mistake 2: Lying down

For decades, doctors recommended bed rest for back-pain sufferers. But a 2010 review found that patients advised to stay active reported less pain and a faster recovery. And new guidelines say that doctors should urge patients to resume normal activities as soon as possible and caution against staying in bed for longer than four days.

Mistake 3: Taking the wrong drugs

Doctors prescribe almost a third of back-pain sufferers potentially addictive narcotic pain drugs such as oxycodone and hydrocodone. But people who take the drugs report more disability after six months compared with those who don’t. And the longer you use an opioid, the higher the dose you’ll need. That increases the risk of addiction and side effects, and makes it less likely that the drugs will help if you do need them, such as after surgery.  

There’s another treatment to question: steroid injections. Some doctors prescribe them for pain related to osteoarthritis, but there’s little evidence that they help for anything other than back pain with sciatica (leg pain from a pinched nerve). Even then, effects wear off by three months.

Start with generic versions of over-the-counter ibuprofen or naproxen. They’re just as safe and effective as brand-name versions, including Advil and Aleve, and they’re cheaper. But those drugs can cause cardiovascular and gastrointestinal problems, so stick with generic acetaminophen if you have heart disease, stomach ulcers, or gastritis. 

Mistake 4: Having needless surgery

The number of back surgeries continues to rise each year. A 2013 study of Medicare patients found a 214 percent increase between 2000 and 2010. “There’s this perception that back surgery must work since it’s so expensive and requires so much recovery time.”But it often doesn’t. That’s partly because back pain often stems from arthritis, poor posture, weak muscles, and similar problems that can’t be fixed with surgery. Even when the pain is caused by such conditions as a herniated disk or spinal stenosis (a narrowing of the spinal column), conservative treatment is often enough.

Alternative treatments for back pain

There is limited research that the following therapies might help some people. Consider trying one if basic self-help steps don’t work. Asking your doctor for a referral may make it easier to get insurance coverage.

• Spinal manipulation can be done by a chiropractor, an osteopath, or a physical therapist. Go to the American Chiropractic Association, the American Osteopathic Organization, and the American Physical Therapy Association for more information.

• Massage reduces muscle stiffness and might prompt the release of pain-relieving endorphins in your brain. Go to the American Massage Therapy Associationand National Certification Board for Therapeutic Massage & Bodywork to learn more.

• Acupuncture appears to help some, and not just because of the placebo effect, research suggests. Go to the American Academy of Medical Acupuncture and the American Academy of Acupuncture and Oriental Medicine.

• Viniyoga, which combines breathing techniques, simple postures, and deep relaxation, may be the most effective form of yoga for back pain. Go to the American Viniyoga Institute.

• Cognitive behavioral therapy helps you recognize and change negative feelings and thoughts related to chronic back pain. Go to the Association for Behavioral and Cognitive Therapies.