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Looking for drug-free alternatives to control chronic back pain

Sandene, Cynthia, RN

doi: 10.1097/01.NURSE.0000547722.92481.ba
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Fully aware of the risks of taking opioids, this retired RN vowed to manage her pain without them.

Cynthia Sandene is a retired RN.

The author has disclosed no financial relationships related to this article.

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MY LIFELONG NURSING CAREER ended at age 55 following surgery for a back injury that left me with chronic back pain. Before my surgery, I had seen and heard about many poor outcomes after back surgery. I knew I faced a long and challenging road to recovery. I was most worried about the dangers of taking opioid analgesics during my recovery and the potential for opioid addiction. According to the CDC, 91 Americans die each day from an opioid overdose.1 Opioid misuse sends approximately 1,000 people to the ED every day.1 Fully aware of the risks of opioids, I vowed to manage my pain without them.

I tried taking nonsteroidal anti-inflammatory drugs, many herbal supplements, and over-the-counter topical analgesics, but they didn't help much. I then tried physical, mental, and spiritual alternatives for pain relief, including yoga, physical therapy, and Tai Chi. The slow, gliding movements of Tai Chi helped improve my balance and stability.

I have also tried transcutaneous electrical nerve stimulation (TENS), a form of electrical stimulation commonly used for short-term pain relief. There is no conclusive evidence that TENS is effective in relieving chronic back pain, but it has helped with mine.2 A hot bath or heating pad is usually enough to relax my muscle spasms. There are plenty of other therapies that can help patients manage their pain so they can think about and do other things.

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Enjoying life

A healthy lifestyle is also important for managing chronic pain. I control my weight by eating healthy, walking, swimming, and participating in aquatic exercises. The water supports the spine and other joints through range-of-motion exercises. Proper techniques decrease the chances of overuse injuries.3 Exercise also helps control my stress, which triggers my pain. I lie down during the day to rest my back and try get enough sleep most nights.

Although traveling aggravates my back, it is worth the few days of recovery I now require after I return home. I have developed a few strategies to keep discomfort in check while away, including routinely finding a place to lie down between flights and ensuring that I pack light.

Living with pain is not easy. There are days when I feel depressed and have to cancel activities on short notice. I caution all nurses to always be mindful of their backs, especially during a patient emergency when you may not be focused on your own safety. Report any injury to your nurse manager, fill out an adverse event report according to facility policy, and make sure you have disability insurance.

After a back injury, seek the advice of a spinal specialist and get a baseline MRI. Most important, take time to heal and consider rethinking your career if you seem prone to spinal injuries.

I no longer take my life for granted. I volunteered as a staff RN at a free medical clinic in Lincoln, Neb., until it closed last May. Soon, I will start mentoring immigrants with green cards who attend CNA classes. I don't dwell on which things I can no longer do. I set goals that are not physical in nature. Some days are great and I take advantage of them, although I may pay for it later. I keep my ego in check and don't overextend myself.

I seek out emotional support from other chronic pain sufferers and support them when they are having a bad day. I put pillows under my knees or between my knees when I sleep. Taking part in any complementary therapy gives me the sense that I am taking back some control. I keep a sense of gratitude and fight back fear. When I am not hurting, I am just like everybody else with a few invisible restrictions. I try to have all the fun I can. I remember how much pain I was in before back surgery. Anything I experience in life moving forward is a wonderful bonus.

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REFERENCES

1. Morbidity and Mortality Weekly Report (MMWR). Increases in drug and opioid overdose deaths — United States, 2000-2014. Centers for Disease Control and Prevention. 2018. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm?s_cid=mm6450a3_w.
2. Resende L, Merriwether E, Rampazo ÉP, et al Meta-analysis of transcutaneous electrical nerve stimulation for relief of spinal pain. Eur J Pain. 2018;22(4):663–678.
3. Pollard H, Fernandez M. Spinal musculoskeletal injuries associated with swimming: a discussion of technique. Australas Chiropr Osteopathy. 2004;12(2):72–80.
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