Yoga Exercises For Back

I used to love my visits with a patient who told me stories about piloting planes during World War II. Creating an emotional connection with your doctor can help him understand you better.

Dollars and Sense

Being a patient in pain can be very hard on your wallet. Millions of chronic pain patients spend thousands of dollars a year on tests, treatments, medicines, and devices. And yet, if you analyze years of outcome data on interventional and surgical treatments for pain, you will be disappointed. For example, the relief offered by epidural steroid injections is usually short-lasting and ofen must be repeated over and over again. And back pain patients who have spinal surgery often end up with the same amount of pain as those who do not undergo the surgery. Today’s standard treatments for chronic pain—medications, procedures, and surgeries—are not only costly, but increase the risk of needing future treatment. And, surprisingly, they lack the evidence-based scientific support to demonstrate their long-term efficacy and value.

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Isn’t it time to regroup and shift all of this spending to alternatives that actually help heal the “pain brain” and offer better long-term results? It’s a sad state of affairs that such treatments are not covered by most types of insurance and require out-of-pocket payment. But it’s vitally important that you allocate time and money to treatments that will be transformational—that will help you build lasting and meaningful change, actively engage in life, and become more independent. Transformational treatments will probably cost you money, but eventually there will be an end to your cash outlay. Unlike standard pain treatment, they do not have to be repeated indefinitely to remain effective.

For example, let’s suppose you want to work on improving your aching back. One option is to see a pain management specialist who prescribes a state-of-the-art painkiller. You take the medication regularly and it seems to help, but only if you keep taking it. What is the end game? How long must you continue to see this doctor for medication refills? One year? Two? Maybe ten? Your out-ofpocket costs will vary depending upon your insurance coverage, but regardless of what you pay, you will still be chronically dependent on this medication and the doctor who prescribes it. This is not a transformational situation; it’s more like being a hamster on a wheel.

Now suppose you take a different direction and begin working on your back pain with a Pilates instructor. After a few months of weekly sessions, your core muscles have begun to support your back better and the tight muscles around your spine have eased up and become more flexible. Afer investing in a dozen or so Pilates sessions, your back pain is under better control. At this point, you know enough so you can do some of the exercises and stretches on your own; this means you can cut back on your paying sessions. Your body has changed and you feel good. Now this is a transformational treatment!

It’s frustrating that mindfulness-based stress reduction courses, tai chi classes, Pilates, art therapy, EMDR, and other modalities that make positive changes to the “pain brain” are rarely covered by insurance plans or Medicare. But what you’re spending on standard treatments may also be quite hefty. And how much benefit have you received? There may be expensive copays and deductibles for medicines that haven’t produced the desired results. You may have paid in part or in full for MRIs or other tests, yet they do nothing to quell your chronic pain. You’ve probably spent (or lost) plenty of money on things like a special bed, mattress, and/or pillow because you aren’t sleeping well; vitamins and other supplements for joint inflammation; time off of work due to pain; or having to go on disability. And what about the personal things you’ve given up? You can’t put a price tag on missing your child’s recital, not being able to join a friend for a jog in the park, or not being able to walk along the beach with a loved one.

Invest your time, money, and effort on treatments that can truly reduce your pain, restore function, help you regain control over your life, and infuse you with hope so you can continue moving forward. At the end of the day, what you will really be investing in is you—in your health, your well-being, and the life you want to lead.

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