Can you really get off the pain medications for your back and spine pain? How?

Ross A. Hauser, MD., Danielle R. Steilen-Matias, MMS, PA-C

Can you really get off the pain medications for your back and spine pain? How?

When someone comes into our office with back pain, they have a lot of fear. They have fear of surgery, they have a fear that they are taking too many medications, they have fear of disability, they have fear of motion and moving because that may cause them a lot of pain and make their back seize up. They will also tell us that we don’t understand how necessary the continued use of prescription medications is to manage their back pain.

This is not true, we do understand the strength of this person’s desire to remain on these medications. We also know that they have a strength of desire to get off off these medicines. We have been helping people with back pain for over 28 years. Life has brought these people a very demanding challenge, one of significant, life-altering back pain. Yet they have to manage.

Some of these people are construction workers or others who have very physically demanding jobs. To them, the only way they can work is by using pain medications. They are very fearful that if they do not take the medications, they will have too much pain and they cannot work. Some are people that have to sit all day and they have to alternate between painful sitting, painful standing, and very painful getting out of a chair.

We understand these challenges, however, we do see a different way to help these people. Instead of pain medications, we help restore pain-free function to the spine. In our clinics, we use regenerative medicine injections to strengthen the soft tissue attachments of the spine. This helps bring the vertebrae back into alignment, reduces pressure on nerves and discs, and reduces and in many cases eliminates pain on a long-term basis. Our treatment restores function. Since 1993, we have been practicing this functional regenerative medicine instead of pain management and prescription writing.

We do know that many people who are reading this article, are not the people are suffering from back pain themselves. Rather, many of the people reading this article are a spouse, a son, a daughter, or a loved one who is very concerned that their loved one is on these pain medications. We hope we can give you some good information to help your loved one.

Research: Functional medicine vs pain medicine, 2019


Moving away from pain management medicine as a primary treatment recommendation due to the limited effectiveness and the risk of adverse effects

In February 2019, in the journal Expert Review of Clinical Pharmacology (1) a team of doctors from Erasmus MC, University Medical Center, the University of Southern Denmark and the University of Sydney examined the standard of care in the pharmacological treatment of non-specific low back pain with recent studies used as the best available evidence on drug efficacy and common adverse effects.

What they found was that new research was universally moving away from pain management medicine as a primary treatment recommendation due to the limited effectiveness and the risk of adverse effects.

The learning points of this study:

At the beginning of this article, we said: “someone will tell us that we don’t understand how necessary their continued use of prescription medications is to manage their back pain.” This research team above said: “Patient education is important to make sure non-specific low back pain patients accept these changes.” Accepting a change to functional, repair medicine and away from pain management may be hard for some people. Unless you show good results and your functional treatment takes the person’s pain away.

In November 2018, Swiss researchers from the University of Zurich and the University Clinic for General Internal Medicine in Bern published their review of recommendations for patients with chronic low back pain. The learning points of their study, published in the journal Internist (2)  suggests:

The conclusion of this study cites: “The main goal of pain medications is to enable patients to stay active.” This is what we call functional medicine.

Why am I getting an antidepressant for my back pain? Because if the only other choice is an opioid, the anti-depressant is better

In November 2018, an international team of researchers led by Monash University in Australia published these findings in the Journal of the American Medical Association (3) (JAMA)

Here are the learning points of their research:

 

Function and pain management – what is the reality you can move off of pain medications?
Our published research on getting 75% of patients off their pain medications

Citing our own Caring Medical published research in the Journal of Prolotherapy (4) which we followed 145 patients who had suffered from back pain on average of nearly five years, we examined not only the physical aspect of Prolotherapy but the mental aspect of treatment as well.

If our study, mentioned above, was solely based on getting 75% of patients off their pain medications, that would be wildly successful in itself. But the fact that Prolotherapy was able to strengthen the patient’s spines and decrease overall disability and return these people to a normal lifestyle. That is not pain management, that is a pain cure.

If this article has helped you understand the role of pain management and functional medicine procedures and you would like to explore treatment options, get help and information from our specialists

References:

1 Schreijenberg M, Koes BW, Lin CW. Guideline recommendations on the pharmacological management of non-specific low back pain in primary care–is there a need to change?. Expert review of clinical pharmacology. 2019 Feb 1. [Google Scholar]
2 Wertli MM, Steurer J. Pain medications for acute and chronic low back pain. Der Internist. 2018 Aug. [Google Scholar]
3 Urquhart DM, Wluka AE, Van Tulder M, Heritier S, Forbes A, Fong C, Wang Y, Sim MR, Gibson SJ, Arnold C, Cicuttini FM. Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial. Jama internal medicine. 2018 Nov 1;178(11):1474-81. [Google Scholar]
4 Hauser RA, Hauser MA. Dextrose Prolotherapy for unresolved low back pain: a retrospective case series study. Journal of Prolotherapy. 2009;1:145-155. [JOP/CMRS]

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Fort Myers, FL 33908
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