MSN, RN
After countless discussions with colleagues, I learned many of them have experienced both neck and back pain issues throughout their nursing careers. As we care for our patients, we put more and more stress on our bodies. Longer hours and increased patient loads (with more sick and critical patients) are taking a toll on us. Trying to stay ergonomically correct during our working hours is becoming harder with each shift.
Options for pain relief and discomfort include physical therapy (PT) sessions with a limited number of visits per week. However, does that really help? How many nurses have gained relief from PT?
Another option is medication, whether an anti-inflammatory medication or a muscle relaxant, which can cause drowsiness. Hardcore treatment would be narcotic drugs. Several of the nurses I spoke with seemed resistant to pain management treatments with epidural medications. Either they did not believe in epidurals, or tried them with little success. In that case, they looked to other options.
My experience with pain management began last year with numbness in the right buttock. Jokingly, I thought I was just sitting too much! As the numbness turned into pain, I knew it was time to follow-up.
The pain became unbearable. At that point, my husband took me to the Emergency Room (ER). A computed topography (CT) scan was done, but a Magnetic Resonance Imaging (MRI) was needed.
My experience in the ER was not pleasant, as back pain patients can sometimes be regarded as seeking medications. What comes to mind is the phrase “doctor shopping.” I was admitted for pain control and scheduled for an MRI in the morning. The diagnosis was two herniated discs, L1-L2, and L4-L5, which was the disc causing the pain.
I was given a referral to follow-up with a pain management specialist. My question to the specialist was why after all this time did this pain start. His response was that I had been working in nursing for 48 years, and it was the lifting, pulling, pushing, and moving patients that finally took its toll on my back. I made an appointment and was seen two days later. After the exam, he suggested epidural therapy for the pain. I will admit I was a little hesitant, as the only epidural I received was when I was in labor, and it lasted all of 15 minutes!
I was willing to give it a try. I received injections every two weeks. It was explained that on each visit two injections were lidocaine and the third was a steroid. When the numbing medicine wore off, the steroid would kick in.
Another diagnosis — sacroiliitis, or inflammation of the sacroiliac joint — was also made. This joint connects the sacrum and the ileum. Pain in the lower back is the initial symptom, which is what most nurses complain of due to the strain of lifting patients or just everyday stress and strain of the body while at work. Treatments include pain relievers, which may also cause stomach upset or liver problems. Alternating ice with heat can help as well.
Stretching exercises or other modalities in PT can also help but might not relieve the pain altogether. Corticosteroids and epidurals can be injected directly into the affected joint to relieve pain and inflammation. A last resort may be surgery, such as a joint fusion, when all other treatments have not worked. I was determined to not undergo surgery, after hearing too many horror stories.
For my back issues, the using epidurals as treatment was a success. I truly did not want to live on pain meds like narcotics. I was willing to try the alternative. In my case, I found it to be very helpful. I still hear nurses say they did not have success with epidurals. I would say to give it another try, perhaps with a different physician. It is important to fully understand the benefits and uses of epidural treatments to effectively manage pain.
So, the questions here are:
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