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Chronic Pain Management: Wider Range of Therapies Rely Less on Meds

Chronic pain is one of the most common reasons adults seek medical care and it is often linked to restrictions in mobility and daily activities. Up to 40 percent of U.S. adults live with some degree of chronic pain, according to the U.S. Centers for Disease Control and Prevention (CDC).

September marks National Pain Awareness Month, an observation to help bring attention to the wide range of treatments available to help chronic pain sufferers lead normal lives.

Chronic back pain is one of the most common conditions requiring some type of treatment. Eduardo Icaza, M.D., [1] a board-certified anesthesiologist and pain management specialist at Miami Neuroscience Institute [2], part of Baptist Health, explains why back pain is so common.

Common Causes of Chronic Pain


Eduardo Icaza, M.D., a board-certified anesthesiologist and pain management specialist at Miami Neuroscience Institute.

“Most Americans will at one point experience an episode of back pain that will most likely resolve with a few weeks with conservative care,” said Dr. Icaza. “There are several reasons back pain is very common. First, the spine has lots of moving parts, discs, and nerves and thus various areas where a narrowing or inflammation could develop.”

A sedentary lifestyle is another major factor, he said. “In our modern lives, we spend a lot of time sitting. We sit at the computer, in the car, on the sofa, or at the dinner table. Prolonged sitting without regular standing and exercise can weaken our core muscles.”  Strong core muscles that include abdominals, back, hip and pelvic muscles can help prevent back pain.

Additionally, people are living longer, said Dr. Icaza, and “as we age we tend to see more age-related degenerative changes develop.” Disease can be the underlying cause of chronic pain, including rheumatoid arthritis, osteoarthritis and fibromyalgia. Persistent pain may also be due to serious health issues such as cancer. Another cause of chronic pain may surprising to many: smoking.

“One of the most common causes of chronic pain is tobacco use,” Dr. Icaza said. “Many patients know the harmful effects of tobacco on the lungs and heart, but do not realize that regular tobacco use results in less blood flow to our spine, muscles and joints. Less blood flow over time results in worsening arthritis, joint degeneration and chronic pain. “

Any medical condition that causes inflammation can be related to chronic pain, he explains.  “Chronic back pain is rarely a direct cause of a life-threatening diagnosis like cancer or multiple sclerosis. Still, our goal is always to rule out the “scary” causes and find the location and cause.”   

Pain Management Treatments

There are many conservative methods of pain management, including some begin with healthier lifestyle choices.

“There are many different ways to manage, reduce, and relieve chronic pain,” said Dr. Icaza. “Regular stretching and exercise are important in maintaining mobility and muscle tone. Weight management can reduce the stress on the spine and joints — as well as decrease risks of diabetes and heart disease. Additionally, adequate sleep, stress management, and a healthy diet are key elements.”

Additionally, Dr. Icaza and his colleagues at Miami Neuroscience Institute utilize a range of treatments customized to every patient with chronic pain.

“We will often coordinate specialized physical therapy, massage, or acupuncture,” explains Dr. Icaza. “We prescribe various medications — including nerve pain medications, anti-inflammatories and muscle relaxers. We also can perform safe injections, nerve ablations, and minimally invasive treatments to directly target the source of the pain.”

What are the biggest misconceptions about pain management among patients? 

“Many people think pain management just means being prescribed addictive narcotic pills,” said Dr. Icaza. “At Miami Neuroscience Institute, we aim to find out where the source of the pain is coming from and develop a plan to reduce, relieve, or better manage it. Pain management as a whole is moving away from a reliance on addictive medications and toward utilizing safer and more effective treatments.”