In part 1 yesterday, we talked about the opioid epidemic and how treating low back pain plays a major role in it. Today, let's look at how you can relieve back pain without opioids or surgery.How Do I Relieve Back Pain Without Opioids?If you want to avoid opioids and surgery for back pain, it’s imperative to make sure your daily physical habits and behaviors are in line and to seek out appropriate professional guidance from a qualified healthcare practitioner.First, it’s important to understand opioids and surgery aren’t inherently bad. There are certainly times where pain medication is needed and surgery is a must. However, current low back pain recommendations are based on treatments rather than prevention, and the inappropriately high use of imaging, rest, opioids, spinal injections, and surgery will not reduce back-related disability or its long-term consequences.There are many non-surgical back pain relief and back pain treatment options available, such as chiropractic, physical therapy, massage, acupuncture, and other alternative treatment methods.Non-invasive options can be great ways to treat back pain naturally. Although, it’s difficult to know which one will be right for you, without wasting time and money in the process.When searching for a qualified non-invasive healthcare practitioner, asking friends and family or performing a quick Internet search is typically the first move. Asking a trusted peer for a recommendation can be a great start but beware of posting on social media, “I have back pain, who should I see for treatment.” You’re opening a Pandora’s box of opinions.No matter where you decide to start, it’s critical to do your own research on qualified healthcare professionals. Once you pull the trigger to make that first appointment, the vetting doesn’t stop.What a quality healthcare professional will do:

• Completes a thorough examination, assessment, report of findings, and treatment options

• Maps out a clear and understandable plan of action of which you are in agreeance

• Clearly define risks, benefits and alternative options

• Refers out to another healthcare professional when necessary

• Engages in an “active care” approach with movement and exercise rather than “passive care” with treatments that are only done to you

• Holds you accountable for what's necessary to do to ensure successful results

• Provides meaningful feedback and self-help strategies to ensure you’re making strides and maintaining long-term results

• Forgo administering unnecessary and expensive tests, treatments, and procedures

• Updated on the latest peer-reviewed scientific literature

• Follows the guidelines the latest scientific evidence has to offer

What a sub-par healthcare professional will do:

• Spends minimal one-on-one time where you feel you’re not being listened to and your needs aren’t being met

• Recommends tests, treatments, and procedures when you don’t fully understand why

• Withholds risks versus benefits and not offering you the ability to choose alternative options

• Expects you to follow their recommendations because they're the expert, and pushes back when you ask thoughtful and concerned questions

• Sells you on long-term care plans with the option to pay a large sum of money up-front

• Instills fear about your condition by using phrases such as, “you have the spine of an 80-year-old” or “I’ve never seen a ____ this bad”

• Employs treatments and “quick-fixes” done to you, without any offering any homework or self-care strategies

• Utilizes expensive technology and machines with poor scientific backing you are told will “fix” you

• Is not up-to-date with current best practices or turns a blind eye because it doesn’t positively impact their pocketbook

• Tells you “you just need to keep getting treatment” when your condition is not improving

• Won’t refer out to another healthcare professional unless absolutely necessary

What Can I Do to Avoid Back Pain and Opioids?Did you know there are ways to prevent and manage your own back pain without costly procedures or treatments?The most common type of back pain, called mechanical back pain, is often the result of habitual postures, positions, and movements you subject yourself to on a daily basis. Rather than hope there’s a silver bullet or “magic pill” for instant back pain, it’s best to spend your time to understand then address how you use your body on a daily basis.

Man seated at an outdoor table working on a laptop; image by Alejandro Escamilla, via unsplash.com.

Here are three simple tips to help you avoid the costs associated with mechanical back pain.

1. Move your body and move more often! Technology is amazing and modern conveniences are, well, convenient, but it has caused us to become more sedentary than we’ve ever been in our ancestral history. We used to have to hunt for our food. Now, you can “1-click” a meal delivered to your door! Tips for moving more and feeling better:

   • Do not sustain one position, especially sitting, for more than 30 minutes at a time. Get up, stand up, take a walk -- just move even for a few seconds.

   • Try this postural reset.

   • Drink more water. Hydration is healthy and you’ll have to use the restroom more often which makes you get up and move!

   • Modify your workspace -- such as using a convertible or standing desk -- to promote more movement throughout the day.

1. When you have to sit, sit up straight! Sitting is not inherently bad but It’s been demonstrated in our culture our spines spend over 90% of the day in some sort of forward flexion, a.k.a., slouching. Slouching places prolonged stress on our joints, tendons, and ligaments causing them to become painful. For example, take your finger and bend it backward as far as you can. Now, pull it back a little more and hold it there. Okay, let go because it’s likely quite achy at this point! The bent-finger example is like what we’re doing to our spines causing back pain from sitting all day. Words of wisdom: There is not a perfect posture. Your next posture is your best posture. Get up and move more often.

2. Seek out guidance from a qualified healthcare professional (see above) as soon an episode of back pain becomes more than just pain. Most episodes of back pain will resolve on their own with time and moving your body within your current limits (avoid inactivity). However, if your back pain episode is limiting or preventing you from performing normal daily activities comfortably, it’s time to get help.

The worst thing you can do is ignore your back pain and try to mask it with medications and over-the-counter pain relievers. The longer you let a persistent or episodic back pain episode go, the more difficult it can become to successfully resolve conservatively. Do not neglect an issue before it’s too late where costly and invasive measures are a must.By taking control of your daily physical habits by employing the strategies discussed, you have the power to prevent chronic back pain occurring in the first place!Lastly, it’s important to note not all back pain is created equal. Back pain most commonly is the result of daily postural habits and lack of movement; however, it can be from something more serious. If you’ve tried to correct your back pain without success, it’s best to seek out professional guidance -- I can’t say it enough.