Fighting Severe Back Pain with Alternative Therapies
Jan Kodish always led a full, active life. She used to clock 200 to 300 miles on her bicycle every week. She has a border collie-German shepherd mix—“80 pounds of personal protection,” she jokes—that demands daily walks.
But over the years, her activity level dropped as deep back pain set in and restricted her lifestyle. “I could not do simple tasks comfortably, like go to the grocery store,” says Ms. Kodish, 54, of Mayfield Heights, Ohio. “I couldn’t even lean on the cart to give me momentum to do my shopping. I just could not stand up. It got progressively worse.”
Ms. Kodish never experienced a car accident or injury. The pain was unexplainable—until her internal medicine doctor, J. Harry Isaacson, MD, referred her to the Center for Spine Health at Cleveland Clinic, where she was seen by medical spine specialist Tagreed Khalaf, MD.
“Ms. Kodish presented for an evaluation of low back and leg pain,” says Dr. Khalaf. “Prior to her evaluation, she was unsure of the cause of her symptoms and her function was significantly limited.”
After an appropriate evaluation and work-up, Dr. Khalaf diagnosed a triple pain. Ms. Kodish had lumbar stenosis (narrowing of the spine), osteoarthritis and a bulged disc all in the same spot.
Relief without Drugs
Though Ms. Kodish has worked the last 35 years as an administrative secretary at Cleveland Clinic Lerner Research Institute, she was unaware of the array of services available to her as a patient with severe back pain. Motivated to avoid medications and find alternative solutions for managing her pain, which she rated a 9 on a scale of 1 to 10, she was willing to try anything.
Dr. Khalaf first recommended physical therapy. When that alone did not provide relief, she prescribed cortisone shots to reduce inflammation caused by the bulged disc. At first, the injections eased Ms. Kodish’s pain—but not for long. Dr. Khalaf suggested trying acupuncture, the traditional Chinese medical practice of inserting and manipulating needles at various points.
“I was at the point where I would have done anything to relieve the pain, and I was desperate and hopeful that it would work,” Ms. Kodish says.
At first, she received acupuncture weekly in 15- to 20-minute sessions. Then, her treatments tapered to biweekly for a half-hour and, eventually, to a monthly regimen.
“I was put at ease by the doctor, who completely understood my arthritic pain and used charts to explain where they put the needles into different nerve points,” says Ms. Kodish, describing her first acupuncture experience with Daniel Mazanec, MD, Associate Director of the Center for Spine Health.
Ms. Kodish brought her own music and relaxed during the therapy, feeling comfortable and euphoric. “I slept well the next night and felt ongoing relief,” she says. “My pain level went down over the months from 9 to maybe a 3.”
Getting Back in the Game
Ms. Kodish wanted to pair acupuncture with physical therapy so she could get back to her active lifestyle. She enrolled in an eight-week pool therapy program through Cleveland Clinic’s Department of Physical Medicine and Rehabilitation and worked one-on-one with a therapist. She also entered a core strengthening program to improve her posture and better align her back.
“It’s not just one thing that’s helping—it’s everything,” she says. “It’s like building a house.”
So, with Dr. Khalaf’s consent, Ms. Kodish layered another treatment on her regimen: an anti-inflammatory diet. The plan eliminates foods such as sugars, dairy products and meats that trigger inflammation. “I’m probably the healthiest I’ve ever been,” Ms. Kodish says. “For someone with a strong history of a sweet tooth, I feel calmer.”
A New Lifestyle
Today, Ms. Kodish adheres to her diet, swims five days a week and revisits acupuncture therapy when her pain flares up. She often can predict the “bad days” when her osteoarthritis triggers discomfort because weather is usually the culprit. But now she knows how to work through that pain.
“Every step of the way, I was grateful to have people here who were kind and could guide me to bring the horrible pain down to a manageable level,” she says of her care at Cleveland Clinic.
Ms. Kodish is biking again, though not competitively and in moderation. Meanwhile, her dog, Sam, enjoys evening walks. Ms. Kodish has learned to pace herself, and lifestyle changes have enabled her to control the pain without medications—her ultimate goal.
“Ms. Kodish has done well with the variety of treatment options available. Her significant improvement is a reflection of her dedication, hard work and compliance with her home exercise program,” Dr. Khalaf says.
Ms. Kodish has encouraging advice for others suffering from chronic pain: “Keep trying. Do not give up. The answer is not always in a pill.”