Veterans with back pain have treatment options


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There’s a revolution in the treatment of back pain now that research shows that physical therapy, spinal manipulation and yoga can help as much as surgery or drugs—with far fewer risks. That advice is backed up by a new nationally representative Consumer Reports survey of 3,562 back-pain sufferers.

It found that more than 80 percent of those who had tried yoga or tai chi or had seen a massage therapist or chiropractor said it had helped them. Altogether, a higher percentage of people in our survey who saw a yoga or tai chi instructor, massage therapist, chiropractor, or physical therapist said the advice or treatment was helpful compared with those who said they saw a doctor.

Injured back as combat soldier in Vietnam

One of these individuals is Army Veteran Thomas Sells. Note that a typical week for Sells includes acupuncture, tai chi, yoga, and a couple of hours with a massage therapist and sometimes a chiropractor. You might think that the retired bank vice president and business manager in Southern California is simply enjoying a pampered spa lifestyle. But Sells gets most of those services through the Department of Veterans Affairs— all for his aching back.

Those VA programs are more necessity than luxury, says Sells, who first injured his back carrying heavy packs as a combat soldier in the Vietnam War.  “None of these therapies were available to me back then,” he explains. “Had I known then what I know now, I could have avoided decades of debilitating pain.”

It used to be that those treatments were considered fringe, but no more. Growing research shows that a combination of hands on therapies and other nondrug measures can be just as effective as more traditional forms of back care, including drugs and surgery. And they’re much safer.

“Tai chi helps with back pain in several ways,” says Benjamin Kligler, M.D., national director of the Integrative Health Coordinating Center at the Veteran’s Health Administration. “It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.”

Back pain strikes most of us at some point. It’s one of the main reasons people go to a doctor, accounting for more than 24 million visits each year in the U.S., according to the Centers for Disease Control and Prevention. More than one of four in our survey said that an episode of back pain “severely” interfered with their daily life.

But there’s good news. “Even though back pain can be severe at first, it almost always gets better,” says Kligler. But “what has been considered ‘conventional’ care, including prescribing opioid pain medication, can short-circuit healing,” he says.

I feel better now than I did as a much younger man.”

These drugs include opioids such as hydrocodone and oxycodone. As a young combat soldier, Sells says he turned to alcohol and illegal drugs to numb his back pain. “That took me down a dangerous road,” he recalls. “I became addicted.” With help from recovery programs, he says he has been clean and sober for 30 years. But even with his attempts to self-medicate, his low-back pain continued to worsen over time.

“It became so bad I could barely walk,” Sells says. “I consulted with surgeons but I worried about the risks, and given my history, I didn’t want to take opioids.” Instead, he looked for something safer, and came across a class at VA in tai chi, which combines slow, gentle movements with deep breathing and meditation.

Soon he noticed improvements, gradually adding more exercise and hands-on therapies, which he says manage his pain while keeping his “mind, body, and spirit strong.” And he’s become so good at tai chi that he now studies with a grand master. “It’s given me back my life,” Sells says.

Success stories like this, combined with new research, convinced the agency to make nondrug therapies a foundation of its pain treatment strategy. As a result, VA has cut overall opioid use by 25 percent since 2012, according to a March 2017 analysis published in JAMA Internal Medicine.

Thomas Sells says that a combination of approaches has worked for him. “I feel better now than I did as a much younger man,” he notes. “Mentally, physically, and spiritually, I’m in the best place in my life.”

Watch this 4-minute video from Consumer Reports and hear directly from Thomas Sells about his experience.


This article is a portion of the complete Consumer Reports story, republished with permission from Consumer Reports.

Editor’s note: The information on that page is not the work of VA doctors or VA programs and in no way represents an endorsement of that information and has been provided for your convenience and education. Illustration by Bryan Christie Design

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Bernard T. Czajkowski    

    Glad to see that yoga and tia chi are being add to help with pain especially back pain.

  2. Bruce haupt    

    Has the VA in Washington, DC any chiropractic care ?

    May I suggest Terrapin Chiropractic in College Park. Discount prices often available for vets who must pay cash. ASK.

    Bruce

    1. Nikki    

      Your process to get Chiropractic and Acupuncture is this:
      You have to get on the pain pills for several years and they have to be ineffective.
      You have to go to the Pain Psychologist
      This practitioner has to recommend Chiro and Acu
      You then have to see your primary for another evaluation and point out the notes and recommendations fro the Pain Psyc
      Then you have to be recommended by your primary care provider. IF they are willing to do that you will get denied.

      True facts – this is my case.

      1. Nikki    

        Oh yeah – I forgot the step where you have to get recommended for Physical therapy and they have to state in the notes that your PT is ineffective – then you go to the Pain Psych.

        I just was informed I have to have 3 PT visits now (REALLY???? – 3 visits? what is that going to do)

  3. Mike Randall    

    Too bad very few va hospitals offer any of this. I just got farmed out to pain management and meds. If i ask for PT it is denied.

  4. William morley    

    The disrespect regarding the memorial day flower is unacceptable and all these non vet non citizen doctors do we really know who they are and why they feel they have a right to so demonize a flower and drug that helped win wars and most people responsible and some gave life to have our freedoms stolen from the very people who gave their lives or sacrificed so much. Demonizing opioid means disrespect bad doctoring and blaming victims. Nobody from other countries should be allowed to come here dig I to v.a. system hire all their relatives then impose their own country values onto us…. bill morley bedford v.a. hospital housekeeping nights weekends watching all the foreigners shake down system…unreal. my back broken in half all I get is put downs from non citizen doctors and blaming my mind for pain saying oh ya yoga psychology gonna change broken back. No it means they got somebody to shame and blame and punish cause that’s their cou true value system but it ain’t supposed to be ours we are supposed to be free not enslaved to pain by foreign agents and interlopers.

  5. Mike D    

    Glad to see that Thomas Sells has the means to get help OUTSIDE the VA since at the end of his story the fine print says this is not a VA program and not available.
    If the VA can’t provide the Choice Program should. Oh that’s right the Choice Program doesn’t pay providers and the VA makes it hard to use anyway.
    I have a 58 mile trip to Cape Coral Fl for treatment when I can get treatment. Choice rules say 40 to qualify for Choice care. We have a facility for blood, piss test and see a DR in that range but NO other services. This means for single xray I have a 2 hour ride and 116 miles to go round trip. NOT a good thing for a spine patient. Oh yes I have been denied treatment at the Haley Spine Center and the Haley pain clinic. Records are changed and which is illegal and no repercussions to the VA employees that changed the record to cover their asses.
    Thanks for covering yourselves not Veterans

  6. David Riva    

    Does this mean that the va will provide outside massage therapy for service connected neck/back injuries. ?????

  7. Tim E Gammel    

    I went into the VA office here in Port St Lucie Florida I was tol about a program the VA has if you can’t work with your disability they would give you a 100 percent rating raising my monthly income now the person saw first question are you prepared to have your monthly income lower so I’m very hesitant to go for the larger income because he said my income could be lowered please tell me this is not true…..Tim Gammel

    1. Cliff Haczynski    

      The VA made a rating decision based on your circumstances at the time. If, during the course of a new evaluation it is found that you have improved, them a new rating decision can be made based on the new information.

      So, yes, it is possible that your percent-disabled rating could be changed, either raised or lowered.

  8. Marty Coyne    

    Having severe back pain times, go to either a massage therapist or chiropractor but gets expensive. I live in Garden City Mi. And go to VA in Ann Arbor is there anyone in my area that gives a vet a discount?

  9. Stan Riedel    

    Before, doctors labeled chiropractic doctors as quacks and anything but helpful. Now that congress has made it easy for doctors to shirk their duties and oath’s. Doctors have embraced chiropractic medicine as helpful. Anything to get out of helping even documented pain patients with medicine proven over the last 10 years to help me with documented health problems. Chiropractic doctors can’t help me and the VA doctors.won’t. Like many documented pain patients who are offered crap for pills to shut me up. I feel like a POW, ignored in America. .

    1. Stan Riedel    

      Instead of POW in America as I posted previously. A more accurate “label”, because doctors like to label would be POP’s, Prisoners of pain, ignored and still looked down on by the medical community. They provide the reason and documentation for the debilitating situation for why we will die a slow painful death with no help to offer, just more labels.

  10. Barry Bloom    

    I have back pain since Basic Training 1968 during a low crawl exercise. Since that incident, I have difficulty walking and walking distances. Doctors can not find anything wrong. They gave me exercise routines which helps a little. Some days my pain level is 2-3 and some days, I have severe pain 7-8 and reach for drugs, asprin or aleve. Unable to move. I was reevaluated, but nothing found. And that happened to be on a day that my pain level was an 8. In 2007, I was diagnosed with stage 4 cancer. My bladder and prostate were removed. Its been over 10 years and I’m still here. I continue to have back pain and continue to do light exercise. Have not worked since 2007. I have been 20 percent disabled since 1971. Need to get reevaluated. Living in Tampa Florida. Any suggestions.

  11. Jody Shane Kozlowski    

    I hate this site already. Just typed a half page and it was wiped out by CAPTCHA Code error. Crap!

  12. Rose McGuire    

    Massage Therapy is great, but expensive. The VA should hire a bunch of therapist. I need sixty minutes a week. It doesn’t matter, if it’s in one or two seasons.

  13. Paul W Hobbs    

    If the VA and Active Duty is recognizing chiropractors, why the hell isn’t Tricare/Tricare For Life doing the same? At least for 80% of the cost.!.

  14. Leon Suchorski    

    This is all bull crap. It is only the same old stuff under new names. I have been complaining about my back pain for years, and I do not mean 4 or 5. NO ONE AT VE HAS GIVEN ME A SATISFACTORY RESULT. I have had the bone breakers and all of the rest, and none of it gives me any relief.

  15. RAMON R TORRES    

    I HAVE BEEN IN CERVICAL AND LUMBAR PAIN FOR 16 YEARS, HAD TWO DISCETOMY’S AND A TOTAL DISC REPLACE AT L4/L5. I WANT TO GET OFF MY PAIN MEDICATIONS? PHYSICAL THERAPY MAKES THE PAIN WORST. IN THE STATE OF PENNSYVANIA THEIR ARE ONLY FOUR VA MEDICAL CENTERS. AND THEY OFFER LIMITED SPECIALTY CLINIC. MOST VETERAN HAVE TO USE THE VETERANS CHOICE PROGRAM TO RECIEVE
    SPECIALTY CARE. I HAVE TO TRAVEL 54 MILE TO GET TO THE WILKES-BARRE VA MEDICAL CENTER AND THE MEDICAL HAS LIMITED SPECIALTY CLINICS. I KNOW OF VETERANS HAVING TO TRAVEL 200 MILE TO GET MEDICAL CARE. THIS IS A DISGRACE TO OR VETERANS. WE NEED MORE VA MEDICAL CENTER IN PENNSYVANIA.

  16. Donald Hendriks    

    Though medical marijuana use has been legalized in my state, North Dakota, I’ve been told that a positive test result for cannabis on the required urinalysis will cause me to be denied my current pain medication Oxycodone. Is this true?

  17. Andrew McNamara    

    I’ve been denied twice for disability compensation ,basically because I had no idea what or how to file
    on the third try VA conviently lost my smr. this has been going on since 1987. my condition got worse and worser until now where I’m basically crippled all because of the navy’s negligence and falsified
    medical eval.I was #1 recruit in co 198 ,I was class “a” school leader and meritoriously promoted to E4
    after 8 months of service I’m a single dad of two boys 7&8 I also take care of my 89 yr.old mom ALL BY MYSELF!NOW I HAVE AND FILED OVERWHELMING EVIDENCE TO PROVE THE NAVY NEGLIGENCE!I LOVED THE NAVY THATS WHY I FLOURISHED THESE DOCTORS WHOS FRAUDULANT EVAL OF MY CONDITION CAN AND HOPEFULLY WILL BE ABLE TO PROVE IT.im at the appeal stage with a dro deciding the case any help from a fellow shipmate would be appreciated .

    1. bob    

      Yes marijuana legal at a state level is different than VA that’s federal

  18. js    

    The real fact is they should be sure about exactly what your back problem is before they send you to therapy or a chiropractor. They did not check my back, not one finger was laid on me by the PCP at the VA after I gave them a lengthy explanation about how bad my spine was over the last 30+ years. After a 4 level spinal fusion, it appears that this nerve damage to my leg is permanent, the nerve will never heal, and I will never run again.

    If they did it right from the start and did a simple Xray, my legs would be fine. The whole evaluation from start to finish should have taken 6 weeks to get me into surgery, not 6 months.

  19. Dan Hughes    

    I am scheduled for laser spine surgery next week, I have heard nothing best great results. I borrowed $14,000 to have
    this procedure, can I file a claim upon my return?

  20. Ray Gonzales    

    I am being seen by a VA Choice Pain Management Dr. I have been seeing this Dr since February. Injections and RFA treatmwnts for my Cervical herniations and Radiculopathy for 14 years. My last vist with PM they have requested secondary authorization for consult/ surgery to nuerosurgeon. VA did not reapond within 14 days and rwceived letter for no reply. I am now being told my primary care VA Dr has to request consult now. Such a joke on the VA choice and process for approval. VA outsourced me for care now want to get consult within VA.

  21. David Riva    

    OK now does the VA pay for massage therapy for neck and back region injuries or not that is the question

Comments are closed.