Don’t let these myths stop you from getting life-improving treatment.
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.
00:00:00,000 --> 00:00:02,589
00:00:02,589 --> 00:00:06,443
As a pain management doctor, I have a lot
of patients that have many misconceptions
00:00:06,443 --> 00:00:08,039
about the treatment of back pain,
00:00:08,039 --> 00:00:10,642
which may be preventing them
from getting proper care.
00:00:10,642 --> 00:00:17,021
00:00:17,021 --> 00:00:20,857
It's a myth that you should be worried
about getting paralyzed from an epidural
00:00:20,857 --> 00:00:21,897
00:00:21,897 --> 00:00:25,162
I have performed thousands of
these epidural steroid injections.
00:00:25,162 --> 00:00:28,927
And I have not encountered
anybody getting paralyzed.
00:00:28,927 --> 00:00:32,987
These procedures are done very safely and
with X-ray guidance, and
00:00:32,987 --> 00:00:38,104
there is a very small chance that anything
catastrophic related to paralysis occurs.
00:00:38,104 --> 00:00:41,129
It is a myth that epidural steroid
injections do not work at all and
00:00:41,129 --> 00:00:43,112
that you are going to need surgery anyway.
00:00:43,112 --> 00:00:46,670
The point of an epidural steroid
injection is to reduce the inflammation.
00:00:46,670 --> 00:00:51,063
And for most patients, that's gonna
be enough to get them out of pain and
00:00:51,063 --> 00:00:52,802
start the road to recovery.
00:00:52,802 --> 00:00:55,750
If several epidural injections don't work,
00:00:55,750 --> 00:00:59,991
it usually means that the patient
is probably requiring surgery.
00:00:59,991 --> 00:01:03,202
It's a myth that you'll get
addicted to back pain medication.
00:01:03,202 --> 00:01:06,961
Opioid medications, which are commonly
associated with addiction,
00:01:06,961 --> 00:01:08,848
are not the first line treatment.
00:01:08,848 --> 00:01:13,499
For the short periods after an acute back
pain episode, the medications are safe and
00:01:13,499 --> 00:01:14,230
00:01:14,230 --> 00:01:18,260
However, when pain lingers and
starts to last for several months,
00:01:18,260 --> 00:01:21,204
that's when they're no longer appropriate.
00:01:21,204 --> 00:01:25,678
The goal of pain management doctors
is to only use opioids if it's
00:01:25,678 --> 00:01:29,297
completely necessary, and
all other medications haven't worked.
00:01:29,297 --> 00:01:35,045
And also to properly discontinue their
use once the acute setting has passed.
00:01:35,045 --> 00:01:38,632
It's a myth that long-term back
pain is going to require surgery.
00:01:38,632 --> 00:01:39,548
Having chronic or
00:01:39,548 --> 00:01:43,585
recurring low back pain doesn't mean
you're destined to have back surgery.
00:01:43,585 --> 00:01:48,331
With a dedication to lifestyle changes and
periodic treatments with therapy and
00:01:48,331 --> 00:01:50,985
possibly anti-inflammatory injections,
00:01:50,985 --> 00:01:55,746
most people are able to avoid getting
surgery, but have a return to normal life.
00:01:55,746 --> 00:02:01,022
7 ways to treat chronic back pain without surgery. Baltimore, MD: Johns Hopkins Medicine. (Accessed on December 17, 2018 at https://www.hopkinsmedicine.org/health/articles-and-answers/ask-the-expert/treat-chronic-back-pain-no-surgery.)
Chamandi S. Nerve block in treating chronic pain and addiction due to opioid like drugs and pain killer. J Addict Res Ther. 2013;4(4):49.
Epidural injections for back pain. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on December 17, 2018 at https://medlineplus.gov/ency/article/007485.htm.)
Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015 Jan 5;350:g6380.
Samanta A. Is epidural injection of steroids effective for low back pain? BMJ. 2004 Jun 26;328(7455):1509-1510.
Schneider B, Zheng P, Mattie R, Kennedy DJ. Safety of epidural steroid injections. Expert Opin Drug Saf. 2016 Aug;15(8):1031-9.