Friday Q&A: Low Back Pain; Full Body MRIs; Sustainable Exercise; & OUCH My Ribs Hurt!

You ask the best questions!

It’s Friday Q&A time!

This week is all about skeletal health. (Next week is about eating!)

• Check out this week’s newsletter about osteoporosis—and how to turn injury into opportunity.

• Tune into this week’s solo podcast about caring for our skeleton like we do our cars—with three patient stories (including my own)!

The first question today (about low back pain) is free for everyone. The remaining questions (about full body MRIs, exercise routines, and when to get an X-ray) are for paid subscribers.

Don’t miss my recent Q&As on:

• Emotional Eating; Marijuana Overuse; When Screens are Too Much; & Bedtime Routine Hacks

• Correcting Internal Narratives: Weight; Alcohol & Social Anxiety; Unknown Family History; Hormones & Heart Disease; & “Keto” Dieting

• Risks After COVID; Booster Shots; New Vaccine Formulas; & COVID During Pregnancy

Click here to submit your questions (about anything) for future Q&A posts!

Photo by Arek Adeoye on Unsplash

Let’s dive in!

QUESTION #1

Other than opioids, what pain medication can be used for age-related lower back pain? Over the counter meds just don't do it. The doctor prescribed Tramadol, but I don't want to be on it long term. How do I get relief without playing with addiction possibilities?

-Diane from Missouri

Dear Diane,

You are not alone! I assess and treat low back pain all the time. There are several types of pain medications that may be used to treat lower back pain resulting from age and wear. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can be effective for reducing inflammation and pain. However, long-term use of NSAIDs can lead to stomach problems such as ulcers and bleeding.

Other options include muscle relaxants and Tramadol, the synthetic opioid analgesic medication you mentioned. However, these should only be used under the supervision of a healthcare professional, since they can be habit-forming and can cause significant side effects. Meds like Gabapentin and pregabalin are also options for treating chronic skeletal pain, and they are less likely to be habit-forming.

Better than relying solely on medications for pain, manual therapies (i.e., physical therapy, myofascial release, and massage) are usually more effective and sustainable treatment modalities. Correcting alignment and movement of the spine and pelvis and addressing any underlying structural issues gets at the root causes of pain. In addition, exercises and stretches can help to improve strength, flexibility, and posture, further reducing the risk of future back pain episodes.

For example, low back pain that is due to a herniated lumbar disk can abate with physical therapy directed toward strengthening weak core muscles. Arthritis-related low back pain can be mitigated with postural adjustments, improved footwear, and avoiding heavy lifting. Back pain that stems from stress is often ameliorated with mindfulness techniques and graded exercise.

Treating the root cause is the best way to obviate the need for heavier medications—and to get back to your regular life! 🏃‍♂️🏊🏾‍♂️🧘🏻‍♀️🚶🏿‍♂️

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QUESTION #2

Is there any utility to full body MRIs as a health screening tool? I have seen a lot of health and wellness influencers promote this but haven’t seen any evidence.

-Angelica