Chronic back pain treatment: Myths and realities

Whether you state it or not, you probably have some goals for the outcome of the treatment of your chronic back pain.  Perhaps your goal is to get back to activities you enjoyed before.  In many cases, you want to return to work.  Or maybe you simply want the pain to be reduced to a more tolerable level.

You seek treatment that you hope will help you reach these goals.  You have high hopes. But you also know that you may experience the cycle of expectations that are not met.  That is, you have high hopes before the treatment, only to have them dashed when it doesn’t work as well as you expected…or at all.  So what can you expect from treatment for chronic back pain?  And how can you know what’s right for you?  The suggestions below can help you find out.

Get the big picture

The first thing to do when you are considering a back pain treatment is to get the big picture.  Treatment for chronic pain is usually:

  • A long-term commitment.
    The management of chronic pain is usually a long-term situation, just like having a chronic disease (like heart disease).  It’s likely that the best treatment will be a combination of things, rather than one ‘magic bullet.’
  • Delivered by multiple providers.
    True chronic pain management is a multidisciplinary effort.  You often need relationships with several health care providers, starting with your primary care provider.  Pain specialists can come from a number of specialties, including anesthesiology, neurology, physical medicine and rehabilitation, or psychiatry.  Other healthcare providers who are involved in treatment for back pain may include surgeons, physical and occupational therapists, massage therapists, providers of acupuncture, and psychologists.
  • Involving a number of options. 
    There are lots of treatments for chronic back pain.  Each healthcare provider may offer treatments that are specific to his/her specialty.  Some treatments have good scientific research and evidence behind them, and others may have little or no research-based evidence.  The important thing to do is make sure that your primary healthcare provider is aware of everything that’s going on, to help you along the journey.

Tips for navigating your treatment

You can be one step ahead of the game if you do the following:

  • Learn all you can about the types of treatments available.
    Ask your health care provider to explain what options are available to treat your back pain.  Be assertive and ask questions.  Read about different pain treatments on this website, painACTION.com.  Ask your provider whether there is research evidence the treatment helps people with chronic back pain.  Ask details about the length of treatment, what the provider expects to happen, and what procedures you will go through if you choose that treatment.
  • Be clear about your treatment goals.
    Tell your health care provider what you are hoping for and ask whether the treatment is likely to deliver.  Your health care provider can help you be more realistic about your goals.  Beware if anyone says the treatment is 100% effective or that you will be running a marathon in no time.  Rarely, if ever, is any treatment for a chronic pain condition 100% effective all of the time.
  • Develop patience if you don’t already have it.
    It can be hard to be patient when you want and need a treatment to work.  But, some treatments work better than others and some work better for one person than another.  Further, some treatments, like certain medications, may take time to work.  Try to think of your health care provider as your long-term partners, to help you be the best you possibly can.
  • Try to find a balance in the expectation cycle.
    As hard as it can be, try to monitor your expectations.  Try to be optimistic, but realistic, at the same time.  Although most treatments for chronic pain cannot make you pain free, many can offer pain reduction or better ways to cope with pain.
  • Find the right combination for you.
    It may take you and your health care providers some time to find the right combination of treatments to manage your pain.  Your combination will probably be different from that of others.  Try to be open-minded.  You may find that a treatment you would not have considered before offers you reduced pain, increased activity or better ways to handle your situation.

It’s sometimes hard to know what to expect from back pain treatment.  And because there are many ways to treat chronic pain, the system can be hard to navigate.  But knowing the big picture and being willing to learn will help you know what to expect from treatment so you can work toward your goals.

References

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (2005). Handout on health: back pain. Retrieved June 19, 2008, from http://www.niams.nih.gov

National Institute of Neurological Disorders and Stroke (2008). Chronic pain information page. Retrieved June 19, 2008, from http://www.ninds.nih.gov