Most People with Back Pain Do Not Require Surgery or Opioids

More upstate New Yorkers with back pain are undergoing surgery and taking prescription medication such as opiate painkillers even though noninvasive treatments, such as simple exercises and over-the-counter drugs usually work.


In their lifetimes, more than 80 percent of upstate New York adults will experience low back pain, nearly two-thirds will experience neck pain, and some will endure chronic suffering. Surgeries for the treatment of back pain among upstate New York adults saw a 10 percent rise in utilization from 2010 to 2013.

If you have proper posture, chances are you’ll have a healthy back.

According to Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation related to spine pain, most people with lower-back pain feel better in about a month, whether or not they have an imaging test. People who get an imaging test for their back pain do not get better faster. Sometimes they even feel worse than people who took over-the-counter pain medicine and followed simple steps, like walking, to help their pain.

But when back pain does come on, it can affect more than just your back. Seven in ten low back pain sufferers said it affects their daily lives. While many back pain cases don’t require an ER visit, an MRI, CT scan, X-ray, or surgery, you should see a doctor ASAP if your back pain includes:

  • Fever
  • Bladder control problems
  • Leg weakness or worsening pain
  • Numbness of your buttocks and legs
  • Unrelenting night pain or pain at rest
  • History of cancer, unexplained weight loss or significant trauma

Recommendations from Choosing Wisely include:

  • Uncomplicated spine pain patients should initially avoid imaging, due to the risks associated with radiation, and the likelihood that additional and unnecessary (costly) tests and procedures without improved outcomes will follow
  • MRI is not recommended in the first six weeks for patients with nonspecific acute low back pain.
  • Health care providers should rarely prescribe opiates for acute disabling low back pain and only after an evaluation and when other alternatives have been tried.

If you have low back pain, doctors advise staying active, limiting bed rest, using pillows between or beneath the knees when you sleep, applying heat for pain management, taking over-the-counter medications when needed, consulting your primary care provider or alternative non-surgical treatments provider (such as physical therapy and chiropractic care) if needed and remaining relaxed to avoid worsening pain.

Back pain is not a disease in search of a cure. It’s a part of life that needs to be managed.

For further reading:

  • Visit the A Healthier Upstate blog and check out the article: Backpack pain is a thing. What every parent needs to know.
  • Read the Health of America Report: America’s opioid epidemic and its effect on the nation’s commercially-insured population (June 29, 2017)
  • For more information, or to download resources about back pain, tests, and treatments, visit the Choosing Wisely website here and search “back pain.”