If you suffer from regular back pain, it’s important to understand what treatment options are available for you. You might be avoiding telling your doctor about your back pain for fear of surgery, treatment side effects, or other concerns—but those fears might be based on myths.
“As a pain management doctor, I have a lot of patients that have many misconceptions about the treatment of back pain, which may be preventing them from getting proper care,” says Kaliq Chang, MD, pain specialist in New Jersey.
If you are experiencing back pain on the reg but are worried about starting treatment, here are four common myths you can safely ignore.
MYTH: You should worry about getting paralyzed from an epidural steroid injection.
Epidural steroid injections, or ESIs, are an anti-inflammatory medicine that’s delivered directly into the area surrounding the spinal cord. By inhibiting inflammation in the area, it can help treat acute back pain. (It’s not the same as epidural anesthesia used for childbirth.)
“I’ve performed thousands of these epidural steroid injections and I’ve not encountered anybody getting paralyzed,” says Dr. Chang. “These procedures are done very safely and with X-ray guidance, and it’s a very small chance that anything catastrophic like paralysis occurs.”
How small? One 2016 study at Stanford University found that incidences of major complications of ESIs (such as paralysis or stroke) occur less than 1 percent of the time. In fact, these complications are only mentioned in rare case reports and have not yet been detected in large medical studies of ESI safety.
MYTH: Epidural steroid injections don’t work; you’ll need surgery anyway.
The point of ESIs is inhibit inflammation that may be causing back pain. They are not necessarily intended to correct the underlying cause of back pain, such as a bulging disc. (Here are other common causes of back pain.)
Sometimes, the pain can be so severe that people are unable to make important lifestyle changes to treat back pain, such as low-impact exercise and physical therapy. “For most patients, [an ESI] is going to be enough to get them out of pain and on the road to recovery,” says Dr. Chang.
When an ESI doesn’t soothe the back pain, it doesn’t necessarily mean the injection itself “doesn’t work.” There are many types of back pain, and the persistent pain may indicate a more serious condition that may need alternative treatment methods, like surgery.
MYTH: You can get addicted to back pain medication.
It’s a valid concern, but not all pain medications cause addictions. Opioid medications *are* used to treat back pain, but only as a last resort, and not for extended periods of time, according to Dr. Chang. Before opioid medications, doctors will likely try treatments like nerve blocks and ESIs, which are not addictive.
“The goal of pain management doctors is to only use opioids if it’s completely necessary, and all other medications haven’t worked,” says Dr. Chang, “and also to properly discontinue their use once the acute setting has passed” (i.e. when the pain becomes chronic).
MYTH: Long-term back pain means you’re destined to need back surgery.
Chronic back pain can be alleviated with a variety of low-risk treatment methods, including lifestyle changes. “With a dedication to lifestyle changes and periodic treatments with therapy and possibly anti-inflammatory injections, most people are able to avoid getting surgery,” says Dr. Chang.