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Phillip Porter, MD
Phillip Porter, MD

Cindi Weisenberger, FNP
Cindi Weisenberger, FNP

 

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Chronic Spinal Pain: Are narcotics the answer?

Phillip Porter, MD
Neurosurgery & Spine Surgery
Wisconsin Brain & Spine Center
Altoona

Cindi Weisenberger, FNP
Neurosurgery & Spine Surgery
Wisconsin Brain & Spine Center
Altoona

In this country, the use of narcotic pain medication for non-cancer pain is increasing at a fast rate. The Food and Drug Administration noted there were almost twice as many narcotics prescribed for people in 2011 than in 2008. Many people are on narcotics for pain. For the spine, narcotic pain medication is most beneficial in the short term for those with new onset neck or back pain or for those who have recently had spine surgery. There are many alternatives to narcotic pain medication for use in those with chronic back pain that cannot be treated surgically. Chronic back pain is pain that lasts longer than 12 weeks.

Some people believe that if it hurts it has to be fixed; and narcotic medicines like Vicodin or oxycodone are supposed to make the pain go away. This is proving not to be the case in many circumstances. There is research that shows that people develop a tolerance to narcotics, and, even with an increase in the dose, their pain is no better controlled. Narcotics also have side effects such as decreased reaction time, drowsiness, impaired judgment and addiction. There is a role for narcotic pain medication in certain cases of back pain, but there are alternatives one can use to get relief of some painful symptoms.

Alternatives to treatment of chronic pain include things like:

  • Anti-inflammatory medications: Medications that can reduce swelling in the affected area.
  • Neurologic medication/anti-seizure medications: Medications that can alter the way one perceives pain.
  • Anti-depressants: Medications that can help one cope better with pain. They may elevate mood and dull pain signals. They may help with sleep.
  • Muscle relaxants: Medications that may help relax skeletal muscles to prevent spasm.
  • Physical Therapy including:
    • Massage
    • Ultrasound
    • Pool-therapy
    • Heat or ice therapy
    • Traction
    • Core strengthening exercises
    • Electrical muscle stimulation

  • Pain Clinic:
    • Injections that often contain steroid and numbing medication can target specific generators of pain like the joints or nerves in the back.
    • Radiofrequency ablation where an electrical current is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.
  • Complementary Alternative Medicine:
    • Chiropractic treatment—A more hands-on approach to spinal manipulation.
    • Acupuncture—Inserting fine needles into the body to stimulate these regions and improve energy flow with the goal of relieving pain.
  • Spinal Cord Stimulator: A pulse generator is implanted and sends electrical impulses to the spinal cord to override signals of pain.

Certainly, for a carefully selected few patients, narcotics are warranted for chronic neck or low back pain. In general, there are a number of alternatives to use instead of narcotic pain medication in the treatment of chronic pain. In addition to the categories addressed above, one should also maintain a healthy body weight, consume a nutritious diet, practice good posture, stop smoking and find effective ways to manage stress.

For more information, a helpful, in-depth website is
http://emedicine.medscape.com/article/310353-overview.

 

Dr. Porter – Wisconsin Brain & Spine Center
For information or to schedule an appointment:
715-832-1700  |  www.oakleafmedical.com
Dr. Porter sees patients in Altoona and Eau Claire.