How NOT to treat your low back pain and the side effects of prolonged medication usage

Ultra-Prevention Book Cover

 

I am currently reading a great book by Dr. Mark Hyman and Dr. Mark Liponis called Ultra-Prevention:  The 6-week plan that will make you healthy for life.  In this book, in the chapter of Do Drugs Cure Disease?, they used a great example of a patient with low back pain and how medical management can go wrong with the dependence on medications and when looking for a “quick fix”.  Here is the story……

 

 

Rudy, a 54 year old fireman who had worked his way up to captain before a chronic back problem put him on permanent disability.  Rudy had first noticed back problems in his thirties, when a few Tylenol a day were enough to keep him on the job.  Over the years, however his pain increased and he finally consulted his doctor, who diagnosed him with arthritis in his spine and began giving him prescription anti-inflammatory drugs and pain medication. Each new medicine would work for a few months, or even up to a year, but then the effect would wear off and Rudy would be immobilized with pain again.  This process escalated as he took stronger and stronger medications.  Three years ago Rudy was overcome by an omninous wave of weakness and he passed out.  His crew rushed him to a hospital, were he began passing large amounts of blood rectally; he was immediately given 2 blood transfusions and admitted to the intensive care unit, where the cause of his attack  was determined.  Rudy had a large ulcer in his stomach caused by the arthritis medicines he was taking for his back pain. His conditioned stabilized, Rudy spent a week in the hospital and took medications for another six weeks to heal the ulcer.  But in the meantime, he could no longer take the arthritis anti-inflammatory medications.

So the back pain grew, and his doctor responded by prescribing narcotic medications such as codeine.  Rudy soon became addicted to these stronger painkillers; his job performance also suffered as the narcotics made him feel foggy.  Rudy asked if there were any alternatives, so his doctor ordered and MRI scan of Rudy’s back to see if surgery might help the problem.  The scan showed considerable arthritis in the lower spine and areas where the nerves were being pinched by newly developed bone spurs; the doctor announced that Rudy had a condition known as spinal stenosis and referred him to a neurosurgeon for possible surgery.  After looking at the scan, the neurosurgeon told Rudy that surgery might help, but there was no guarantee that it would relieve his pain – and there was a small chance of paralysis from the surgery itself. “Are there any other options?” Rudy asked.  The neurosurgeon recommended Rudy see a pain management specialist for a cortisone injection in his back.  Although he was leery of taking cortisone injection in his back, Rudy saw it as his only option.  He took the cortisone shots and the pain specialist put him on a low dose of an oral cortisone called prednisone.  It felt like magic.  For the first time in over twenty years, Rudy had no pain in his back at all.  But like the other treatments, this didn’t last – within six months the pain returned.  So his doctor increased the dosage of prednisone, which helped a little, but now

Rudy noticed that he was gaining weight-within four months he had gained eighteen pounds, and almost all of it was right around the middle of his body. Even more alarming, Rudy’s blood pressure had risen.  Rudy’s doctor prescribed blood pressure medication, too.  And because Rudy’s cholesterol level had increased by eighty points, he started Rudy on Zocor to lower it.  Rudy, feeling like a walking pharmacy, decided enough was enough and scheduled the back surgery, which, according to his neurosurgeon, was successful.  But to Rudy’s surprise, while he was in the hospital he was diagnosed with diabetes and had to take insulin shots to keep his blood sugar under control.  His doctor explained that the steroids had caused him to become diabetic.  And since he had been on prednisone for so long prior to his hospital visit, his doctors now gave him doses of intravenous steroids during his surgery, which made his blood sugar rise even higher. Thankfully, his back pain was more bearable, although not completely gone.  But Rudy paid a high price for this relief.

He was now taking medications for diabetes, high blood pressure, high cholesterol, and ulcers, not to mention a small dose of steriods; moreover his doctor had put him on Prozac when he was discharged from the hospital. Rudy wondered if he had made the right decision about having surgery-he was no longer able to work and was placed on complete disability, making him feel even worse.  After all, he’d always been a fireman, and he was only fifty-four years old.  Rudy was feeling both hopeless and helpless about his situation until he arrives at Canyon Ranch. Rudy’s history told us most of the story, and a few blood and urine tests confirmed what we suspected as we backtracked the path of Rudy’s problems and re-created a dangerous but common chain of events.  Rudy’s back problem was never properly taken care of when he was thirty.  Rather than taking medications to cover up the symptoms, Rudy should have been on a restorative program ( ex. Physical Therapy) of stretching and strengthening to prevent his back from getting worse.  Instead, all those medications led to further problems; the arthritis pills gave him a bleeding ulcer; the steroids caused weight gain; diabetes, and high cholesterol; and the downward spiral led to depression. But there was hope.  These problems were neither permanent nor irreversible.  All of Rudy’s problems could be corrected with changes in diet, lifestyle, and exercise.

After his visit to Canyon Ranch, Rudy made adjustments to his diet, started an exercise program, started physical therapy, and started losing weight.  Eight weeks later he had lost over 25 lbs, his low back pain was resolved, he has reduced or was able to stop taking several medications, his blood pressure and cholesterol has decreased, and is back to feeling great!  They finish his story with this statement…..

Man with low back pain

 

Rudy’s story is not uncommon.  Every week I see people suffering from clear, curable, and unnecessary symptoms that are directly caused by medications prescribed  in the right dose for the right reason by a well-meaning doctor.  But when symptoms occur, doctors are more likely to diagnose a condition and prescribe a new medication than to examine the possibility that the new symptom was caused by one or more of their medications.  This is a perfect example of how medical management of low back pain has over and over again shows poor long term outcomes and a dependence on medication for the “quick fix” and cure.  But, not until you solve the cause of your low back pain and not treat the pain, is when you truly will resolve the pain and symptoms.  If you can relate to this story and are constantly dealing with low back pain, call today at 407-494-8835 and schedule your FREE CONSULTATION today with Pursuit Physical Therapy.

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