Today's headlines are full of news about the opioid epidemic in America. However, there are times when opioids really are the best choice – in treating severe cancer pain, for example. But if you need back surgery, there are non-opioid alternatives for both preoperative and postoperative treatment. Here's some basic information about alternatives to opioids, courtesy of Dr. Kelly Kiehm at Capital City Neurosurgery in Columbus, Ohio.
Opioids are not the only medication that can be used in the treatment of back pain or after back surgery. Non-steroidal anti-inflammatory drugs (NSAIDs) are also useful. Muscle relaxants help with muscle spasms, while a variety of medications such as gabapentin (brand name Neurontin) and pregabalin (brand name Lyrica) can help with pain that originates in the nerves. Injections of local anesthetics and cortisone are also used for muscle spasms and nerve pain.
Physical Therapy and Exercise
Weak or uneven muscles – muscles work in pairs and must be balanced – increase the risk of injury and don't support the spine properly. Poor posture or lifting techniques can also cause chronic pain and injury. Regular exercise helps keep you stronger and more flexible and promotes better sleep. Physical therapy can help stretch and strengthen your muscles, and correct posture problems.
Disciplines such as yoga and tai chi teach balance, increase flexibility and help you become more aware of how movement affects your pain levels. This is especially true after surgery, as the original condition may have been corrected, but you've probably spent years adapting your body movements because of the pain. You need to learn new ways of moving and how to relax.
A variety of traditional practices can be helpful for the individual who has had back surgery. Therapeutic massage, for example, especially in combination with aromatherapy, can be relaxing and will help to loosen tight muscles. Acupuncture and acupressure are very successful for some people. Traditional Chinese medicine practitioners use herbs instead of or in addition to conventional medications. Diet also plays a large role in traditional disciplines such as Ayurvedic medicine.
While many alternative therapies and bodywork are high touch, there's also a place for high tech in the treatment of back pain. Radiofrequency ablation short-circuits pain signals from individual nerves with an electric current created by radio waves. Transcutaneous electrical nerve stimulation (TENS) sends low-voltage electric stimulation through the skin to painful areas. Spinal cord stimulation is similar to a heart pacemaker. Tiny wires are implanted in the spinal canal, and the patient can adjust the device. A pain pump can deliver medications directly to the spinal cord, using much lower doses of medication and decreasing the risk of side effects.
If you need back surgery and are concerned about how to manage your pain afterward, please give us a call at Capital City Neurosurgery. We can assess your situation and make recommendations for a wide array of possible treatments. Please contact us for an appointment.