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Report: More Upstate NYers are Turning to Surgery, Opiates to Manage Back Pain

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It appears more Upstate New Yorkers are resorting to opiates and surgery to address back pain over simpler, more effective treatments.  There’s concern that could be leading to worse outcomes.

  People in pain are often desperate to seek relief.  But a report from Excellus Blue Cross Blue Shield finds that desperation might have unintended consequences.  It shows in 2013, almost half of patients treated for spine pain received a prescription to treat the pain within the first six weeks of diagnosis.  More than half of those patients received a prescription for an opiate.  Dr. Richard Lockwood is vice president and chief medical officer of Excellus in Central New York.  He says there’s been a shift in the medical community away from controlling back pain with narcotics. 

"Back pain is a common problem," said Lockwood.  "It's part of aging, very often.  It should be managed as a long-term chronic problem, not as a short-term fix.  So, these people do get addicted to narcotics."

Lockwood says in some cases, that can lead to buying other narcotics or even heroin on the street.  The Excellus report also found surgeries to treat back pain rose 10 percent from 2010 to 2013.    Lockwood says the problem starts when a doctor recommends an X-ray or MRI.

"These tests are frequently very abnormal, especially for those over age of 50 in everybody, whether you do or don't have pain," said Lockwood.  "If someone does have pain, gets an imaging study, it's abnormal, and might get referred to the surgeon.  Even though they'll recommend some conservative management, they can see abnormalities, and possibly suggest that surgery may be helpful."

When in fact, Lockwood says, light activity, physical therapy, a chiropractor, and over the counter medications should be tried first.  Studies show they might actually be more effective.  But he says it’s our nature to seek quick fixes.

"They believe a surgical procedure will give them a quick cure, and a permanent cure," said Lockwood.  " The problem is, very often, surgery doesn't give them a permanent cure, and the patient continues to have back pain problems, even after the surgery."

Lockwood says medical literature doesn’t support surgery for long-term outcomes, especially for chronic back pain.  He says that’s not to say surgery is not ever necessary, but it should be the last option. 

Scott Willis covers politics, local government, transportation, and arts and culture for WAER. He came to Syracuse from Detroit in 2001, where he began his career in radio as an intern and freelance reporter. Scott is honored and privileged to bring the day’s news and in-depth feature reporting to WAER’s dedicated and generous listeners. You can find him on twitter @swillisWAER and email him at srwillis@syr.edu.