Can you wait for back pain treatment.
This article will focus on the effects of patients waiting for back pain treatment and will touch briefly on treatment comparisons.
Detailed comparisons of treatments can be found at these pages:
- Epidural Steroid Injections vs Prolotherapy for back pain
- Spinal instability | Prolotherapy for Back Pain
The longer you wait to treat your back pain, the worse your situation becomes
Recent research from doctors at the University of Sydney published in the Journal of the Canadian Medical Association says the faster you get treatment for your back pain, the sooner you will get pain relief. That seems obvious.
Now they do not specify a specific treatment, only that in their examination of the medical literature, patients who got treatment sooner had a better chance for pain relief and that any treatment would be preferable to none. These treatments could include chiropractic, yoga, therapy, epidurals, etc.
Here is what the Australian team suggested:
“Patients who presented with acute or persistent low-back pain improved markedly in the first six weeks (of treatment). After that time, improvement slowed. Low to moderate levels of pain and disability were still present at one year.”(1)
Again, this is based on any treatment, improvement seen in the first six weeks then the level of improvement declines based on what type of treatments you get.
The point of this research again was to suggest that people get treatment because it will help them short-term. In our practice of course we utilize Comprehensive Prolotherapy with may include PRP Prolotherapy and Stem Cell Prolotherapy. These treatments have the goal of being long-term, more permanent solutions.
Spinal surgeons say the longer you wait for surgery, chances of success, already doubtful, will be even less
This was a warning issued by doctors writing in the medical journal Clinical spine surgery. Here the doctors noted that the success rates of surgical interventions for lumbar disorders vary significantly depending on multiple factors and, among them, the duration of symptoms.
What these doctors from Boulder Neurosurgical Associates were looking for was to see if there was a “cutoff” time when lumbar decompression and fusion surgery becomes less effective in the conditions with chronic nerve root compression symptomatology. Thus they analyze whether the duration of symptoms has any effect on clinical outcomes and primarily resolution of radicular pain symptoms due to degenerative disc disease and stenosis with spondylolisthesis in patients undergoing transforaminal lumbar interbody fusion (TLIF).
The results they achieved showed that the duration of symptoms was a significant predictor of better leg pain resolution, but not back pain resolution, or improvement in disability.
The patients with a shorter duration of symptoms had significantly better radicular symptom resolution compared with patients who waited at least 24 months or longer to undergo fusion.5
In the above study, the faster you went to surgery, the better the chance your radicular symptoms would resolve. But going to surgery faster or waiting did not impact relief from back pain or reduce problems of disability.
Minimally invasive Prolotherapy
This is the problem with acute and/or chronic back pain treatments, many treatments while providing relief 6 weeks after initiation do not provide long-term relief. It is then suggested that rushing to spinal surgery did not significantly improve symptoms more if you waited or not-waited to get the surgery. The problems of back surgery not providing relief or even making the patient situation worse is covered in our article Failed back surgery syndrome treatment options
- Typically patients with low to moderate levels of pain and disability still present at one year are good candidates for Prolotherapy.
While we believe Prolotherapy is an excellent long-term solution for back pain, Some studies suggest that painkillers are the best treatment, other research seems to think elsewise: “despite greater use of medications at greater chronic low back pain severity, current options remain less than optimal in providing analgesic efficacy.”2 That was written in 2011, for much more critical and current statements from the medical community of the place of painkillers in managing chronic pain.
Some think of physical therapy as the preferred treatment, however, others do not: University researchers in Portugal wrote: “There was a high perception of pain and disability after conventional physical therapy treatment, which suggests the need to modify the therapeutic approach to achieve more effective pain relief and function.”3
Some think Prolotherapy is the best treatment, such as the researchers in the medical journal International Musculoskeletal Medicine who explored the use of Prolotherapy in patients who had failed to respond to conservative approaches including spinal manipulation and physiotherapy. Utilizing Prolotherapy (3 injections over a 3 to 5 week period), they confirmed that 91% of respondents were better or not worse off after 12 months. 4
Not that everyone agrees with Prolotherapy either. But research in the Journal of Prolotherapy proves the effectiveness of this regenerative injection treatment. Our researchers at Caring Medical investigated the outcomes of patients undergoing dextrose Prolotherapy treatment for chronic low back pain.
We looked at 145 patients, who had been in pain an average of four years and ten months, and were treated quarterly with Prolotherapy.
- This included a subset of 55 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of 26 patients who were told by their doctor(s) that surgery was their only option.
Patients were contacted an average of 12 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms, and activities of daily living, before and after their last Prolotherapy treatment.
- In these 145 low backs, pain levels decreased from 5.6 to 2.7 after Prolotherapy;
- 89% experienced more than 50% pain relief with Prolotherapy;
- more than 80% showed improvements in walking and exercise ability, anxiety, depression and overall disability;
- 75% percent were able to completely stop taking pain medications.6
If you would like to discuss non-surgical options for back pain – talk to our specialists.
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2 Taylor-Stokes G, Lobosco S, Pike J, Sadosky AB, Ross E. Relationship between patient-reported chronic low back pain severity and medication resources. Clin Ther. 2011 Nov;33(11):1739-48. Epub 2011 Oct 15. [Pubmed] [Google Scholar]
3 Pinheiro J, Figueiredo P, Branco J, Ramos S, Ferreira L. Nonspecific chronic low back pain and function: a clinical study in a physical medicine and rehabilitation consultation. Acta Med Port. 2011 Dec;24 Suppl 2:287-92. [Pubmed] [Google Scholar]
5 Villavicencio AT, Nelson EL, Rajpal S, Burneikiene S. The Timing of Surgery and Symptom Resolution in Patients Undergoing Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disk Disease and Radiculopathy. Clinical spine surgery. 2016 May. [Pubmed] [Google Scholar]