When it comes to pain management, says Dr. Osman A. Latif, less is more.
Dr. Latif, a pain management specialist at Watson Clinic who also practices at Lakeland Surgical & Diagnostic Center, says an important thing to remember about chronic pain is that given time, it nearly always resolves itself.
He cited a 2007 study from the New England Journal of Medicine regarding patients with severe sciatica. Some were given conservative treatment, and others underwent lumbar-disk surgery. Although the patients who underwent surgery reported relief more quickly, after a year, 95% of both groups said they felt like they had recovered.
“People with back pain sometimes panic and worry that they are going to be paralyzed or hurt forever, but that is just not so,” Dr. Latif says. “Oftentimes, when people say, ‘I threw my back out’ or ‘I woke up and the pain was so bad I couldn’t move,’ the source of the pain is muscle spasms. We recommend a moist heating pad and an over-the-counter cream like Aspercreme with lidocaine. They may want to try an over-the-counter anti-inflammatory, also.”
Also, he adds, you have to rest. “You have to let the spasm have time to calm down. People tend to overdo it. They lift and twist all the time and don’t even realize it sometimes. They need to just take it easy for a while.”
Dr. Latif sometimes gives cortisone shots at the surgery center to patients with back pain. “But even then, we encourage people to take it easy and let the cortisone do its job. It’s amazing how people continue to overdo it. They feel like they should be able to do something just because they’ve been doing it for the past 75 years. Sometimes, the best thing you can do is rest.”
Dr. Latif says the difficult part about pain management is that pain is so subjective. Unlike cholesterol levels, there is no blood test that can determine whether pain is subsiding. Doctors have to depend largely on a patient’s perceptions.
Pain management specialists deal mostly with chronic pain cases, and those often are associated with psychosocial issues, Dr. Latif says. “We need to have realistic expectations. It takes time to treat chronic pain. There isn’t a quick fix. It is very hard to provide relief in those situations.”