Jeff is a marine who has suffered multiple injuries to his back during combat. He has had two surgeries to fuse vertebrae in his neck, he’s had four herniated discs in his lower back, and he also has spinal stenosis, a disease that can lead to nerve compression. He has lost a lot of weight and is now down to 137 pounds. He’s worried that his only option for pain relief are opioids, and wants to know if Harry has any advice that can help him manage the pain brought on by these injuries.
Jeff, I’m sure you know you’re not alone. Post-combat pain is a massive problem for vets. Fortunately, the VA has been making a lot of progress toward creating treatment programs that deal with the whole person, not just the part of your body that’s hurting.
This approach is called integrated care, or patient-centered care. It means you have a team of people to help you, not just one doctor. Many vets have issues in multiple areas—job, relationships, mental health, substance abuse, nutrition. Pain is usually just one piece of a larger puzzle—and you’ve got to take care of those other pieces too.
Now, spinal pain can be a real challenge and it may take a fair amount of experimentation to find a solution that works for you. But there is definitely hope. These days many VA centers are much more open than they used to be to alternative pain treatments such as acupuncture, massage, and ways to use your mind to manage your pain. These may not be the whole solution, of course, but they can really help. There are other techniques to try, such as electrical stimulation and different types of surgery. Opioid medications may be helpful for short-term pain, but you’re right to be wary of using them on a long-term basis. For a few people, that may be the best solution, but it would be better to find ways to ease your pain without them.
You might contact Colonel Ken Galloway at the VA and the director of the pain center, Tracey Gaudet. This team specializes in patient-centered or integrated care, where the focus is on getting veterans off opiates like oxycodone, and on to healthier and more sustainable methods of pain management. There’s also a great book about pain management written by an Iraq vet named Derek McGinnis. It’s called “Exit Wounds” and it is a real goldmine of information.
Good luck Jeff, and thank you for your service!
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