This is what happened today… One of my patients who is a dear friend of mine walked into the clinic to tell us that her MD ordered her to cancel Physical Therapy she started for her low back pain condition. She was confused, worried and didn’t know what to do next.
Her physician told her that she has arthritis so she should schedule an MRI, cancel her Physical Therapy appointments and go home to take drugs.
The cold hard truth is that well-meaning doctors and other healthcare practitioners may be able to identify muscles and bones and have years of education in treating pain… but they still don’t understand how back pain is truly created in the body and what to do to treat the root cause of the problem. Some of them are not familiar with (or simply not following) current guidelines for treating back pain. Finally, the tools they have are limiting, outdated and created to target symptoms, not the true cause of back pain.
I have to be completely honest with you… Some of them will even turn a blind eye to all nasty side-effects and not hesitate to prescribe medication. The scary thing is that you will be ordered MRIs, prescribed drugs, pain medication, corticosteroid injections and even surgery. Even though most of this proved to be ineffective, dangerous and even harmful.
It is my obligation to let you know that you are putting yourself at risk by taking pain, anti-inflammatory and corticosteroid medication. You are risking a chance of falls, strokes, cardiovascular events, tissue damage, stomach bleeds, overdose and addiction…
Pain medication is helpful in treating pain but does nothing to change root cause of the problem.Pain medication is also risky since it is increases risk of falls by 4 times. It will prevent you from operating machinery, and working. Also it will make you unsafe and unfit to drive or even parent your kids. And the horrible thing is that over the time, it will lead to addiction because your body will create resistance and ask for more.
According to Washington state Interagency Guideline on Prescribing Opioids for Pain, “Adverse events from pain medication include constipation, nausea and vomiting, dizziness, and drowsiness. More serious long-term consequences have only been identified from observational and epidemiological investigations; these include abuse, inhibition of endogenous sex hormone production with resulting hypogonadism and infertility, immunosuppression, falls and fractures in older adults, neonatal abstinence syndrome, cardiac arrhythmia related to methadone, sleep disordered breathing, opioid-induced hyperalgesia, nonfatal overdose hospitalizations, emergency department visits, and death from unintentional poisoning.” Read more here.
In result, the latest guideline from American College of Physicians states: “Physicians should consider opioids as a last option for treatment and only in patients who have failed other therapies, as they are associated with substantial harms, including the risk of addiction or accidental overdose.”
For patients with chronic low back pain, ACP recommends that physicians and patients initially select non-drug therapy with exercise, multidisciplinary rehabilitation, mindfulness-based stress reduction, motor control exercise (MCE), progressive relaxation, low level laser therapy, joint mobilization and manipulation.
ACP’s recommendations for treating low back pain were published in “Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society” in 2007 and updated and expanded in Feb, 2017.
I want you to know that American College of Physicians is the largest and most prestigious organization of physicians in the USA. Their clinical practice guidelines are developed through a rigorous process based on an extensive review of the highest quality evidence available, including randomized control trials and data from observational studies. Therefore, if your physician is prescribing pain medication FIRST, you should know that you are receiving sub-standardized care.
The good news is that the new law created to protect patients from opioid epidemics and death by overdose by creating guidelines and most recently establishing “no pill after 7 days” rule. This law is is basically banning pain medication prescription beyond one week of duration and is enforced in state of WA in July, 2017. These are two sites where you can learn more here this: Opioid prescribing and 7-day rule.
“You should go and get an MRI.” Does this sound familiar?
Then, you should know that MRIs are expensive, inaccurate for low back pain and and show low correlation in between back pain symptoms and imaging studies. This pretty much means that MRI results are useless in back patients. Why do physicians still order these? Hard to tell because scientific support is not on their side. Read this scientific study about accuracy of MRI in low back pain patients to learn more.
I know you feel frustrated and discouraged. You have tried a lot of things. You have been told “You are old, this is normal part of aging.” or “You have arthritis, nothing can be done.”
This must be hard and I am sorry you are suffering…
You would think that going to a healthcare professional like a doctor, chiropractor, or acupuncturist would be the answer… but it’s not.
Massage can help but does not address all aspect of back pain and does not fix the problem completely. Chiropractic can help but is not addressing fault lines and imbalances of musculature so results are not always optimal and permanent. Medication is just masking symptoms and not treating the root cause of the problem. Click here to read the comprehensive guide to the new science of treating low back pain.
And the scary truth is some have ulterior motives of steering you inside of their network and offering only options they have even though they are not the best one. Another scary thing is that some of them even may not want you to get better completely at all. That way they can keep you dependent on their services and products forever. It’s sad but it’s true.
Just like some pharmaceutical companies, some healthcare practitioners are like that, too.
The best Physicians out there will follow newest practice guidelines and recommend Physical Therapy first as a safe and efficient alternative for back pain. Is your Physician following current practice guidelines established by College of Physician Association? And if not, does he or she deserve your trust?
I want you to know…
That it’s important to me that you pursue your dreams and be the best person you can be—were designed and meant to be.
I want you to know that I can help remove the chains of pain that is stopping you—remove the obstacles that are holding you back from being productive, motivated and youthful.
I want you to know that you can trust me.
And when this has been accomplished and your health restored, it will be glorious, and you can thank me then.