HealthWatch: Back Pain Paradox


It’s been called the painkiller paradox: millions of Americans are suffering from chronic pain, especially back pain, and need medication to make it manageable. On the other hand, many say they’ve gotten hooked on those same drugs designed to help. Now researchers are looking at safer solutions that may help avoid the high toll of addiction. 
Thirty-eight-year-old Chrioni Lenertz has experienced a lot in her lifetime  from traveling the world as a merchant marine, to surviving stage 4 breast cancer. She overcame every challenge … until injuring her back in the gym.
“I’m a young person I’m an active person and so I want to still continue, especially being a cancer survivor,” said Lenertz.
But Lenertz didn’t want to take pain pills for her back and experts say for many people, there’s good reason. 
“Those people who tend to go down the path of utilizing opioids have a hard time kind of riding that ship and going in the other direction,” said William J. Hanney, DPT, PhD, ATC, CSCS, Associate Professor of Physical Therapy at the University of Central Florida.
Professor Albert Lui studies health informatics.  He looked at the numbers for 45,000 with acute low back pain and followed them for a year.   The patients who started physical therapy within three days of being evaluated had fewer ER visits, were less likely to seek out advanced imaging, and …
“They were ten to 15 percent less likely to use a pain medication over one year,” said Xinliang “Albert” Liu, PhD, Assistant Professor in the Department of Health Management and Informatics at the University of Central Florida.
Researchers also say immediate referral could lead to huge savings each year. 
“We can achieve a cost saving of seven billion dollars nationwide,” Liu told Ivanhoe
Lenertz saw her doctor and now manages her pain through yoga and exercise.
“And I can just enjoy things a little bit more and not be so rough on myself,” she said.
In addition to physical therapy, researchers nationwide are working to find non-opioid drug treatments. The FDA recently fast-tracked the drug tanezumab to treat chronic back pain.
Contributors to this news report include: Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Videographer; Dave Harrison, Editor.

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REPORT:    MB #4492

BACKGROUND: Back pain is one of the most common medical problems, affecting eight out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months. Most back pain goes away on its own, though it may take time. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than one or two days can make it worse. Treatment for back pain depends on what kind of pain you have, and what is causing it. It may include hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery.

OPIOIDS: The most common prescription drug in U.S. adults with chronic low back pain (LBP) are opioids, according to a population study based on the 2009 to 2010 National Health and Nutrition Examination Survey. Opioids in this population were found to be used long-term and in combination with other central nervous system-acting agents. The majority (76.9%) of individuals with chronic LBP taking opioids reported taking opioids for more than one year. Duration of prescription medication use was greater in participants with, rather than without chronic LBP for opioids, acetaminophen, NSAIDs, and muscle relaxants. Opioid medications were commonly taken with antidepressants, benzodiazepines, or hypnotics. In addition, the majority (94%) of participants with chronic LBP who used prescription opioids did not have a college education, and a greater percentage of women vs men with chronic LBP used nonsteroidal anti-inflammatory drugs and muscle relaxants.
NEW RESEARCH: A research team led by the University of Central Florida has evaluated how the use of physical therapy to treat acute low back pain ? and the timing of when treatment begins ? impact the use and costs of health care. Patients with immediate treatment, about 27 percent, were the least likely to have emergency room visits. Nearly 33 percent of patients who had no physical therapy used emergency room services. Patients with immediate treatment also were the least likely to fill a prescription for opioid medication (44 percent), followed by patients receiving no physical therapy (48 percent), patients receiving therapy 4-14 days later (54 percent) or 15-28 days later (61 percent).


Megan Pabian, PR 

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know~to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

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