Low Back Pain
Low back pain is one of the most common health problems we see in primary care. There are many different approaches to examination, evaluation, testing, and treatment. Below we'll talk about some of those treatments.
Steroid Injections for Back Pain Weaken Vertebrae
That's right-steroid injections in the back which were intended to 'reduce' inflammation in the discs of the back and help you heal actually cause more damage than they solve! According to a recent research article in the Journal of Bone and Joint Surgery (2013;95:961-964) found a significant number of LESI's (Lumbar Epidural Steroid Injections) administered to relieve back pain actually leads to greater bone fragility.
When pain runs from the back and then down a nerve into the leg, that pain is referred to as 'radiculopathy'. Radiculopathy often is severely disabling and feels like a person was being stabbed with a hot iron shoved deep into the back. the resulting direct pain and the shooting pain down the legs causes people to feel 'desperate' and as they say desperate people do desperate things.
Each successive injection of LESI steroids increased the risk of fracture by 21%! This is a massive increase in fracture risk-and from a single injection. People who have received multiple injections have had horrible incidents of multiple fractures. these fractures cause pain worse than the original pain or injury.
Knee Injections No Longer Recommended
A new treatment standard from the American Academy of Orthopedic Surgeons (as of July 2013) advised against the use of hyaluronic acid for osteoarthritis of the knee. New research of this treatment shows that the original presumption of benefit for this therapy were incorrect and the level of 'benefit' after reviewing several studies, shows the treatment fails to reach minimum thresholds of clinical improvement.
New FDA Guidelines: Tylenol-By Itself, Not That Safe Anymore
During 2013, the FDA has published new, safer guidelines regarding Tylenol (Acetomenophen) for use in the treatment of chronic pain. Previously, the FDA had limited the daily Tylenol dose to 4,000 miligrams: however, that dose has been found to cause too much liver damage.
Research identified the much safer dose to be 2,000 miligrams. As an 'intermediate' dosage downward, the FDA has decided to first lower the 'safe' dose to 3,000 miligrams. So, we now all enter the national discussion on pain management.
The 'safe' dose of 2,000 miligrams would allow for basically 2 doses of pain medication-which would, at best, provide 8 hours of mild pain relief. So, what's the plan for pain relief for the next 16 hours of pain?
Ibuprofen (Motrin, Advil) and Diclofenac (Voltaren) Highten Heart Attack Risk
New research shows that Ibuprofen, (Motrin, Advil) and Diclofenac (Voltaren) significantly increase the risk for heart attack! These same medications also significantly increase the risk for liver damage, kidney damage, and stomach ulcer.
So, here we go again: in the national debate on chronic pain management-especially chronic back pain, would you want to take multiple doses of medications which cause liver damage, kidney damage, and increase your risk for heart attack?
Shawn Elliott was a talented member of the San Antonio Spurs-that is until he took too much ibuprofen and caused life-threatening damage. The only reason he's not hooked up to a dialysis machine every-other day for 6 hours a day is because he has a very kind brother who gave him one of his kidneys to avoid 'living' on kidney dialysis.