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Talking Back 20_0650-Hazard.indb 1 2/4/21 11:41 AM 20_0650-Hazard.indb 2 2/4/21 11:41 AM Talking Back How to Overcome Chronic Back Pain and Rebuild Your Life Rowland G. Hazard, MD ROWMAN & LITTLEFIELD Lanham • Boulder • New York • London 20_0650-Hazard.indb 3 2/4/21 11:41 AM The ideas and strategies in this book are not meant to substitute for the care and guidance of a skilled and trusted personal physician. The author recommends that readers begin their recovery programs by reviewing their health and treatment plans for safety and guidance with their doctor. The author and publisher disclaim any liability for health outcomes generated by following the suggestions in this book. Published by Rowman & Littlefield An imprint of The Rowman & Littlefield Publishing Group, Inc. 4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706 www.rowman.com 6 Tinworth Street, London SE11 5AL, United Kingdom Copyright © 2021 by Rowland G. Hazard All figures were created by the author. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review. British Library Cataloguing in Publication Information Available Library of Congress Cataloging-in-Publication Data Names: Hazard, Rowland, 1949– author. Title: Talking back : how to overcome chronic back pain and rebuild your life / Rowland G. Hazard, MD. Description: Lanham : Rowman & Littlefield, [2021] | Includes index. | Summary: “Back pain afflicts more than 3 in 4 adults and costs Americans over $100 billion every year. While most people recover quickly, the disabilities suffered by people who don’t generate the vast majority of the costs and heartache. Talking Back offers people disabled by chronic back pain personal strategies for recovering active lives and wellness” — Provided by publisher. Identifiers: LCCN 2020047797 (print) | LCCN 2020047798 (ebook) | ISBN 9781538146651 (cloth) | ISBN 9781538146668 (ebook) Subjects: LCSH: Backache—Popular works. | Chronic diseases—Popular works. | Communication in medicine. Classification: LCC RD771.B217 H39 2021 (print) | LCC RD771.B217 (ebook) | DDC 617.5/64—dc23 LC record available at https://lccn.loc.gov/2020047797 LC ebook record available at https://lccn.loc.gov/2020047798 The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992. 20_0650-Hazard.indb 4 2/4/21 11:41 AM To Bobbie Lanahan 20_0650-Hazard.indb 5 2/4/21 11:41 AM 20_0650-Hazard.indb 6 2/4/21 11:41 AM Contents Preface ix 1 No One Knows Your Pain the Way That You Do 1 2 You Can’t Get What You Want ’til You Know What You Want 21 3 The Medical Office Visit 43 4 Drugs 63 5 Relaxation 85 6 Acute and Chronic Pain 105 7 Wellness 119 Epilogue 129 Appendix A 133 Appendix B 135 Suggested Readings 137 Index 139 About the Author 149 vii 20_0650-Hazard.indb 7 2/4/21 11:41 AM 20_0650-Hazard.indb 8 2/4/21 11:41 AM Preface L ike three out of four Americans, you have probably suffered through an attack of back pain. Surely, you know someone who has. Chances are 9 out of 10 that the episode resolved, with or without any treatment. If so, you don’t need to read this book. Talking Back is for the millions of “1 out of 10s” who, despite their best efforts to get rid of their pain, continue to suffer for months and even for many years. Worse than that, their pain disables them. They not only hurt every day; they also can’t do the most meaningful things in life. Work, play, and even essential daily activities are limited or impossible. Americans spend more than $100 billion every year on back pain. You have no doubt been touched in some way by the enormous and growing economic burden of health care. So, you might expect that tests and treatments for back pain account for the billions spent. You would be wrong. The vast majority of the money covers the costs of disability, not medical care. Rather than proposing novel interventions to cure back pain, Talking Back aims to help people disabled by chronic pain to get their lives back on track. The lessons you are about to learn are drawn from my conversations with small groups of more than 3,000 pain-disabled participants in rehabilitation centers known as functional restoration programs (FRPs). These programs were conducted at the University of Vermont between 1986 and 2000 and subsequently at the Dartmouth- Hitchcock Medical Center in New Hampshire from 2002 through my retirement in 2018. ix 20_0650-Hazard.indb 9 2/4/21 11:41 AM