Painkillers and rest can make back pain worse, spine surgery expert reveals why

Health risks of painkillers: Multiple studies have confirmed that chronic opioid use before spine surgery have more far-reaching consequences: more infections, slower wound healing, longer stay in the hospital, and higher rates of repeat surgeries (Image: Pexels)

Back pain affects people of all ages and lifestyles. Most people’s instinctive response is to pop painkillers and rest until the discomfort comes to an end. Though it provides a brief respite, spine experts warn that you can end up doing more damage than good if you depend on these as long-term solutions.

Painkillers merely suppress the underlying cause and weaken the muscles that support the back and prolong recovery. A lot of patients just keep falling into the pattern where pain gets better, comes back even worse, causing them to go back on medication and become less active.

“Back pain is a monster, and it has afflicted millions around the world. Most people grab painkillers and collapse on the couch for some much-needed rest. But it is only a temporary break from the suffering, with medical evidence mounting that relying too heavily on pills, along with being on prolonged inactivity, can make spine conditions worse, not better,” Dr Arun Bhanot, Director, Spine Surgery, CK Birla Hospital, Gurugram, tells Moneycontrol.

The hidden trap of painkillers

The drugs that people mostly use for pain in the spine are opioids and NSAIDs. Many feel that NSAIDS treat inflammation and mild pain effectively. However, depending on them for prolonged use exposes you to some serious risks such as stomach ulcers, kidney damage, heart problems, and fluid retention.

Opioids, on the other hand, are powerful against severe pain but also boast a terrifying list of side effects: drowsiness, slowed breathing, dependency, and fogginess.

Multiple studies have confirmed that chronic opioid use before spine surgery have more far-reaching consequences: more infections, slower wound healing, longer stay in the hospital, and higher rates of repeat surgeries. It can even have a paradoxical effect of raising your pain sensitivity, thus slowing your recovery.

The main problem with painkillers is that they are only putting a plaster on symptoms; they actually do nothing to correct any mechanical, degenerative, or muscular problems in your spine. Because you have masked the pain without addressing poor movement, inflammation, or muscle weaknesses, you give yourself license to continue overusing your spine, leading to further damage, often unknowingly.

The problem with "just rest"

Today, doctors seriously question this old-school advice to just "rest and wait" for the pain to go away. The problem is, when you lie completely still or become inactive for long stretches of time, the very muscles that hold your spine up — your core and back muscles — start to weaken, leading to decreased stability and a greater risk of re-injury.

Inactivity will lead to muscle wasting, joint stiffness, and poor blood circulation, all factors that contribute to slower healing and keeping you disabled for a longer time. The spine, like the rest of your body, benefits from gentle movement and specific strengthening exercises that will stimulate the healing process of tissues and maintain flexibility.

Moreover, prolonged rest is bad for your mind as well. Often, these factors lead to anxiety and depression, which, as is known, make people feel their pain more acutely, thus standing in the way of recovery.

The modern, smarter way to heal now

Opt for early motion and physical therapy. Combine these with nondrug treatments such as heat, cold packs, acupuncture, and mindfulness techniques.

Active physical rehabilitation exercises are taught to restore core and back muscle strength, improve bad posture, and the range of motion in your spine. Early initialisation of physical activity within the comfort zone prevents loss of muscles and accelerates recovery.

“Knowledge of why active recovery is so important and why the long-term use of medication is risky makes them less afraid, less helpless, and less dependent on drugs and bed rest,” says the expert.