According to a recent study by the Albert Einstein College of Medicine in New York, the standard emergency room practice for treating lower back pain may soon be changing. In the study, patients who came to the ER complaining of lower back pain that had begun in the last two weeks were given a combination of NSAIDs and opioids and/or muscle relaxants, which is the standard treatment for such cases (a control group received placebos). To the researchers’ surprise, the standard treatment of opioids and muscle relaxants was not shown to have any demonstrable effect on lower back pain.
For people currently experiencing lower back pain, this study has a few implications. It is common for people dealing with long-term chronic problems to feel that they are unable to get complete care or relief when visiting the emergency room. This makes sense: Emergency rooms are better suited to deal with life-threatening and/or acute illnesses or injuries that cannot wait. Still, there are situations where people experiencing lower back pain may feel that their situation is an emergency. For example, if a patient is experiencing such debilitating pain that they are unable to lie down to sleep or are unable to walk, they are likely to feel they can’t wait for a doctor’s appointment. Unfortunately, when it comes to these kinds of issues, there is generally not a quick-fix cure. The only option available to emergency room doctors is to try to manage the symptoms and make the problem more bearable until the patient is able to see a doctor.
Interestingly, while this research did not find an impact from opioids or muscle relaxants, the findings do suggest that NSAIDs can bring relief to sufferers of lower back pain. According to one of the doctors in the study, patients can experience up to a 50% reduction in pain from NSAIDs. This is helpful knowledge, because NSAIDs do not have the side effects or addictive potential of many opioid and muscle-relaxing drugs. Given that these were shown to be minimally effective in providing relief for acute lower back pain, these may be phased out as part of the standard emergency room protocol for these episodes.
What should you do if you are experiencing debilitating back pain and think you may need to go to the emergency room? If the pain has just begun as the result of an acute injury, or if you are experiencing accompanying symptoms like dizziness or a sudden loss of function, you should head to the hospital. But when this is not the case, the results of this study suggest that the ER is probably not your best option. If you have been experiencing strong back pain for more than a few days, it’s time to contact your general practitioner or head to a specialist. While the measures described in this study may help to alleviate the symptoms of back pain, they don’t get at the source of the problem. That takes an accurate diagnosis, which will help develop a treatment plan that will both relieve the symptoms and address the underlying cause of the pain. Sound like what you need? Call the Spine Institute Northwest at 206-496-0630 to set up a consultation with one of our physicians.
(CC BY 2.0) photo by MilitaryHealth