Tips to Manage Back Pain (Part 2)
Sometimes back pain goes away as fast as it came on. In some situations it stays longer than you want. Either way, I hope these tips can help you navigate through this problem.
1. Choose your physician or other health professional carefully, then listen to their advice. I can’t tell how many patients want their back pain to go away but when I recommend something the patient says that they do not want to do that. For example, I may recommend taking ibuprofen. I will then get the response, “I don’t take drugs.” Then I may recommend epidural steroids and I hear, “I don’t want any injection.” Then I send the patient to a chiropractor and I hear, “I don’t believe in that.” The list goes on. In the end, I am not exactly sure why the patient came to me when EVERY treatment I offered was rejected. This does not mean to accept any treatment blindly and without question. On the contrary, be open to any and all suggestions and try to stay away from biases that carry over from rumors and hearsay. Evaluate each piece of advice with an open mind and then make a decision.
2. Surgery is neither aggressive nor conservative. Surgery has a role in back pain, but not a large role. When properly indicated, surgery will always be a good choice. When not indicated, it is unnecessary and a problem for the patient. Get 2-3 opinions if surgery is recommended.
3. Don’t be afraid to take it easy for some time period. You may not be able to return to 10 mile runs for 6-8 weeks. This is not the end of the world. Respect the pain and the injury. If you do not, your back will tell you.
4. Try to return to reasonable activities and work as soon as you are cleared to do this. Too many people stay out of the mainstream of work and this causes a culture of not wanting to get better. If your doctor feels it’s safe to return to work in some capacity, then you should do so.
5. Make sure you do all you can to get a real diagnosis. If the doctor was with you for 3 minutes and never laid a hand on you, the diagnosis of back pain is probably wrong. A good history and physical examination is often correct 85-90% of the time. Tests like MRI’s should be used to either confirm a diagnosis already known or to distinguish between one or two different diagnoses. Since many people over age 50 have significant findings on their MRI even if these patients do not have back pain, be careful with MRI’s not connected to a comprehensive office visit. The finding in the office needs to correlate with any test.
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