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August 29, 2008  
BACK NEWS: Feature Story

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  • Treatments for Low Back Pain

    Treatments for Low Back Pain


    March 14, 2003

    (ARA) - Low back pain affects up to 80 percent of Americans at some time during their lives, and is one of the top 10 reasons for patient visits to emergency rooms, hospital outpatient departments and physicians’ offices. Back pain is so prevalent that productivity in the workplace suffers each year as a result -- 100 million workdays are lost annually to back pain related problems, and it accounts for 15 percent of sick leaves. Although many cases of low back pain are not serious and subside with adequate rest or stretching, severe low back pain can have significant consequences if left untreated.

    The lower back provides mobility and strength, and enables the body to turn, twist, bend, walk and lift. Proper functioning of the lower back is required for practically all of life’s daily activities. And for 85 percent of back pain sufferers, the primary site of injury and source of pain is the lower spine. That’s why low back pain can dramatically reduce flexibility, restrict physical movement, and decrease the quality of life in patients who do not seek treatment.

    Many different treatment options are available to patients who suffer from low back pain, depending on the severity of the pain and whether the spine or surrounding tissues have been damaged. The extent of the damage and/or origin of a patient’s low back pain can best be determined by an orthopedic surgeon or a spine specialist.

    The safest and most common treatment for acute low back pain, or pain with an immediate and abrupt onset, is acetaminophen, an over-the-counter pain reliever that is taken orally. For more intense or longer lasting pain, usually referred to as chronic pain, additional oral medications are generally prescribed, including non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants or opioids -- opium-derived narcotic drugs, such as codeine.

    Physicians often perform physical adjustments or use alternative therapies as a way to relieve persistent, lasting pain that cannot be alleviated by oral medications alone. These methods include manipulation (i.e., adjusting the vertebrae in the spine to align properly), traction applied to the spine, massage, biofeedback or acupuncture. Epidural steroid injections, or potent anti-inflammatory medications delivered into the spinal canal to reduce pain and inflammation, are also recommended to relieve pain that has not responded to oral medication or physical therapy alone. Oral pain relievers frequently supplement these treatments.

    If a physician detects a serious problem with the alignment of the spine or sees damage to the surrounding nerves due to a problematic disc in the vertebrae, surgical treatment options may be considered. A damaged disc, often referred to as a "degenerative" disc, can be incredibly painful if left untreated. Discs act as shock absorbers for the vertebrae in the spine; a disc is considered degenerative if it has hardened or deteriorated, and no longer provides cushion.

    Degenerative discs are common and are not, in themselves, the source of the back pain. In fact, by the age of 50, 85 percent of the population will show evidence of disc degeneration. Pain occurs, and surgery is required, when the vertebra presses on nearby nerves or begins to pinch against the spinal cord as a result of weakened or deteriorated discs. About 12 million Americans currently have some form of disc degeneration and of those, 10 percent are candidates for surgery.

    Teresa Hoffman, an Alabama financial assistant and mother of three, endured severe low back pain for more than five years before doctors were able to pinpoint the source of her extreme discomfort and treat it effectively. The pain began in her lower back, and over time increased to include the area across her hips and down both legs. The pain in her hips radiated around her tailbone, making it difficult for her to sit or stand comfortably. In order for her to sit for any length of time, she had to place inflatable swim rings, made for infants, on her chair or on the seat of her car.

    When the pain got progressively worse, she had trouble working for an entire day and found it difficult to perform activities that required any type of movement, such as walking or playing softball with her children. She was finally referred to a spine specialist, who diagnosed her with a ruptured disc, and recommended that she have spinal fusion surgery. The surgery removed the damaged disc that was the source of her problem and fused the surrounding vertebrae together. Teresa was in and out of the hospital in less than a week. Today, she is back to living a normal life -- working full time and able to spend time with her children, pain-free.

    Spinal fusion surgeries are the standard surgical treatment for patients who have degenerative discs. This procedure involves removing the damaged disc from the spine, and replacing it with a device filled with pieces of bone to induce the vertebrae to grow, or “fuse” together. Traditionally, the bone pieces are harvested from the patient’s hip, so the patient must undergo two separate surgeries. Harvesting the bone from the hip can be as painful as the back pain itself. In fact, for some patients, their hip continues to be painful long after their back has healed. Studies have shown that nearly one-third of patients experience hip pain up to two years following surgery.

    However, a new biological product recently became available that eliminates the need to collect bone from the patient’s hip. This product is a genetically engineered protein, called INFUSE Bone Graft, that induces bone growth at a specific place in the spine.

    People at risk for low back pain can greatly reduce their chances of aggravating or possibly injuring their spine by maintaining a healthy diet, getting regular exercise and not smoking. Before choosing any treatment, patients who suffer from low back pain should consult their doctor. Patients can obtain information on treatment options and find a spine specialist in their area by using the “physician finder” on www.back.com.

    Courtesy of ARA Content

    Related Conditions
    Back Pain
    Degenerative Disk Disease

    Last updated: 14-Mar-03

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