Did you hurt your lower back shovelling last winter?
Are you currently suffering from the common cold or seasonal allergies?
What about those restless nights that you lie awake tossing and turning without ever actually falling asleep?
Lower back pain, the common cold and insomnia affect many Nova Scotians. Each condition has its own recommended course of treatment and each treatment plan varies based on the patient’s own unique health profile, such as underlying health conditions and lifestyle.
But here’s the thing: Many tests and treatments that are prescribed for these conditions or sought after by patients suffering with these conditions are often unnecessary. That is, they do not provide benefit to the patient and could potentially cause harm.
Let’s take a closer look at each common health condition and what course of treatment is recommended.
Lower Back Pain
There’s nothing worse than the searing, persistent and unrelenting feeling of lower back pain.
It’s not long after an injury that you’re on your way to a doctor looking for answers.
If the pain doesn’t go away right away, you might want your doctor to get you an X-ray, CT scan or MRI to rule out anything serious.
There lies the problem.
Getting an X-ray, CT scan or MRI may seem like a good idea but back pain usually subsides in about a month. X-rays and CT scans expose patients to radiation which can increase cancer risk. The tests often reveal abnormalities that are unrelated to the pain but can prompt needless worry and lead to unnecessary follow-up tests and treatment. After all this exploratory testing, your back pain is usually still present and likely requires simple treatments like applying heat, mild activity and over-the-counter pain reliever.
One study found that back pain sufferers who had an MRI in the first month were eight times more likely to have surgery, but didn’t recover faster than those who didn’t have surgery.
Another study found that people who had imaging tests soon after reporting the problem fared no better and sometimes did worse than people who took simple steps like applying heat, being active and taking non-prescription pain reliever.
This isn’t to say that all lower back pain is minor. In some cases there might be nerve damage or signs of serious underlying conditions such as cancer or spinal infection. In those cases a closer look is in order.
But there are symptoms and flags that alert your doctor to prescribe additional image testing such as family history of cancer, unexplained weight loss, recent infection, loss of bowel or bladder control, abnormal reflexes, or loss of muscle power or feeling in the legs.
If none of these symptoms or flags are present, you probably don’t need an imaging test.
What you should do
Most people get over back pain in a few weeks.
- Stay active – resting in bed for more than a day or so can cause stiffness, weakness, and depression and slow your recovery.
- Apply heat – a heating pad, electric blanket, warm bath or shower relaxes muscles.
- Over-the-counter medicine – Over-the-counter pain relievers like Tylenol, Aleve or Advil can help.
- Lying on your side with a pillow between your knees or lying on your back with a few pillows under your knees can help you while you sleep.
- If symptoms don’t improve after a few days, consider seeing your doctor to ensure your pain doesn’t stem from a serious underlying health problem.
Seasonal Cold & Allergies
Are you dealing with a drippy or stuffy nose?
Are your allergies in full swing?
Symptoms of the common cold or seasonal allergies can make you feel miserable. Miserable enough to want to do just about anything to get rid of them.
Unfortunately, the best way to get over the cold or allergies is to simply get lots of rest and fluids, not antibiotics or over-the-counter remedies.
For example, Sinusitis is a common complication of colds, hay fever and other respiratory allergies. Symptoms include a stuffy nose with yellow, green or grey discharge and pain or pressure around the eyes, cheeks and forehead that gets worse when bending over.
Around 15 to 21% of all antibiotic prescriptions for adults in outpatient care are for Sinusitis.
However, almost all sinus infections are caused by viruses, not bacteria. Therefore, antibiotics don’t work. Also, most sinus infections clear on their own in a week.
So what’s the harm?
Antibiotics can be hard on your body. They can have unpleasant side effects such as stomach problems, dizziness or skin rashes. In rare cases, antibiotics can cause severe allergic reactions. The overuse of antibiotics also promotes the growth of resistant bacteria.
Antibiotics – in some cases – are necessary. If you have a fever over 38.6 degrees Celsius, extreme pain over your sinuses or signs of a skin infection you might need antibiotics. When these signs are present you should seek medical attention.
In the meantime, get lots of rest and fluids, use a humidifier, take a warm bath or shower and gargle with saltwater.
If you’re one of those people that count sheep from the moment you lay in bed until the moment your alarm rings in the morning, than you know how frustrating and unbearable insomnia can be.
When you run out of sheep to count, you might be tempted to take a pill to help you fall asleep. But sleeping pills are not usually the best solution – especially for older adults.
Studies show that on average, people who take sleeping drugs sleep only a little better and a little longer than those who don’t. The amount of sleep and quality of the sleep you get from sleeping pills does not outweigh the potential risk these drugs present to your health.
For seniors in particular, these drugs can cause confusion and memory problems, changes in balance that more than double the risk of falls and hip fractures. They can also increase the risk of car accidents.
Over-the-counter drugs can present unwanted side effects such as next-day drowsiness, confusion, constipation, dry mouth and difficulty urinating.
Sleeping pills should only be used as a last resort. They do have a place, but only if sleeping problems are affecting your quality of life and nothing else has helped. If this is the case, your doctor should monitor your pill usage carefully. You should use the lowest dose possible and be mindful of side effects.
What you should do
First, establish a bedtime routine. Go to bed and wake up at the same time every day. Exercise daily and avoid caffeine after 3:00 p.m. Limit your alcohol consumption and don’t eat before bed. A peaceful environment free from bright lights, pets and noise can be helpful. Also, try a cooler room temperature.
Reducing unnecessary tests and treatments
Choosing Wisely Canada is an initiative to improve communication between physicians and patients on what is the best course of care. It intends to help physicians and patients engage in conversations about the overuse of tests, treatments and procedures.
The initiative focuses on encouraging physicians, patients and other health care partners to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm. It supports physician efforts to help patients make smart and effective choices to ensure the right care is delivered at the right time.
The most important thing is that you talk to your doctor about what treatment is best for you.
Over to you! Do you talk to your doctor about what tests and treatments are right for you? Are you a partner in your own health care? How can your doctor help you make informed decisions about your care?
Leave us a comment and tell us what you think.
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