Lower Back Pain Treatment

Evolution of Chiropractic Medicine in Health Care

cmaynard — Thu, 19 Nov 2009 12:54:22 -0800

The scientific merit of spinal dysfunction and therapeutic benefits of spinal manipulation for neuromusculoskeletal conditions were challenged in the early days of chiropractic. Manipulation has been generally accepted for back pain, neck pain, sciatica, joint problems, sprains, strains, osteoarthritis, herniated discs and other musculoskeletal (MSK) conditions.

American Chiropractic History of Treatment for Back Pain and Neck Pain

cmaynard — Thu, 19 Nov 2009 11:53:12 -0800

Since its inception in 1895, chiropractic has provided treatment for patients with back pain, neck pain and headache.

The Latest Chiropractic Debate

cmaynard — Mon, 27 Jul 2009 08:57:17 -0700

July 30, 2009
by: Sylvia Marten

While [url:1621,type=|node|,content=|chiropractic treatment|] of the spine may have been considered unproven at one point in time, that opinion has been dispelled more recently as nearly 9 percent of Americans now seek chiropractic care each year, according to the National Center for Complementary and Alternative Medicine.

While chiropractic treatment has gained acceptance in the mainstream as a valid form of health care, there is now a growing debate among [url:1624,type=|node|,content=|chiropractors|], specifically as a result of those who claim that chiropractic offers holistic treatment for much more than [url:145,type=|term|,content=|back pain|] and other symptoms associated with the spine.

Since its inception, chiropractic has held as a central tenant that the anatomical relationship between the spine and nervous system is vital to a person’s health.

Traditionally, chiropractic care has been used to treat musculoskeletal conditions, specifically via non-surgical and drug-free means. Chiropractors have based their practice on the idea of manipulating the spine through a series of short-lever, arm thrusts with the goal of reducing subluxation (the altered position of the vertebra and subsequent loss of function as a result of the vertebra being mispositioned in comparison to the other vertebrae) and providing relief for:

Upper and lower back pain
[url:149,type=|term|,content=|Neck pain|]
[url:998,type=|node|,content=|Sciatica|]
Muscle strains
Arthritic pain
Other conditions of the spine.

The acceptance of [url:1620,type=|node|,content=|chiropractic manipulation|] has naturally coincided with strong evidence to its effectiveness in improving function and reducing symptoms of acute and chronic back pain.

With its evolution, chiropractic treatment has expanded and incorporated the use of massage, exercise programs and physical modalities like heat/ice therapy, electrical stimulation, ultrasound and X-ray to help diagnose and treat back pain.

A Holistic Approach to Chiropractic Care

More recently, some chiropractors have provided chiropractic care for not only back pain but acid reflux, digestive disorders, ear infections, asthma, allegories, colic and much more.

These chiropractors promote chiropractic treatment as holistic, using words like “hygiene” and “wellness,” noting how the spine is directly related to all conditions, and using the concept of “subluxation” as a basis of their arguments.

Such chiropractors say that they don’t want to pigeonhole chiropractic in terms of its treatment abilities but rather aim to provide patients with a more well-rounded understanding of its many applications.

Other chiropractors disagree, saying that there is not any evidence at this point to suggest that chiropractic care is an effective treatment for symptoms beyond back pain and opining that it should thus be primarily used for treatment of spinal conditions.

So just as chiropractic has become more integrated with other health care practices, the battle is not over as it continually seeks to define itself, this time as a holistic approach.

Source: Chicago Tribune

More Chiropractic Resources for Patients

The most recent debate on chiropractic care should not confuse or sway patients interested in exploring this treatment in more detail.

Learn more about chiropractic care by checking out the following resources:

[url:1636,type=|node|,content=|How to Select the Best Chiropractor|]
[url:1635,type=|node|,content=|How to Choose a Chiropractic Clinic|]
[url:1633,type=|node|,content=|What to Expect at the First Chiropractic Consultation|]
[url:15655,type=|node|,content=|Questions to Ask Your Chiropractor|]
[url:15656,type=|node|,content=|Chiropractic Treatment Program Guidelines|]
[url:1647,type=|node|,content=|Chiropractic Treatment of the Joints|]

Weight Training Effectively Relieves Back Pain, According to Study

cmaynard — Mon, 20 Jul 2009 07:35:12 -0700

July 21, 2009
by: Sylvia Marten

More specifically, a University of Alberta study promotes the progressive building of strength in not only the back but the chest, arms and legs to make it easier for patients to complete everyday activities and to build the body's resistance to future instances of [url:896,type=|node|,content=|lower back pain|].

During the course of the 16-week study, back pain patients started out slowly, working with low levels of weights and fewer repetitions. As the patients built up strength during the first three weeks, the amount of repetitions and weight increased, eventually reaching 75 percent to 83 percent of the maximum amount of weight.

Researchers noted that back pain and disability decreased as patient strength increased while doing bench presses for the chest, lateral pull-downs for the back, and leg presses.

Specifically, back pain decreased by:

28 percent in patients who exercised four days a week
18 percent in patients who exercised three times a week
14 percent in patients who exercised two times a week.

In relation, quality of life – defined in the study as the person’s physical and mental well-being—respectively rose by 28, 22 and 16 percent.

According to the study, these developments support strengthening exercises that loosen the joints as effective treatments for back pain and promote the importance of having strong chest, back and leg muscles when dealing with back pain.

Of course, it should be advised that any person experiencing back pain should not just dive into a series of [url:1183,type=|node|,content=|back exercises|] and other strengthening exercises.

Rather, it is important that patients speak with a trusted medical professional who can observe their symptoms, evaluate different courses of treatment, and then develop an exercise program for back pain.

Still, with that said, the University of Alberta study further validates the benefits that exercise may have on back pain, a notion that may still seem counterproductive or dangerous to patients worried that such activities will only exacerbate their back pain.

Source: University of Alberta; Courier-Journal

More on This Topic:

[url:2518,type=|term|,content=|Back Exercises for Back Pain|]
[url:1185,type=|node|,content=|Back Strengthening Exercises|]
[url:1130,type=|node|,content=|Back Exercises and Abdominal Exercise Recommendations|]
[url:1723,type=|node|,content=|Physical Therapy Benefits for Back Pain|]
[url:1187,type=|node|,content=|Exercise and Fitness to Help Your Back|]
[url:1246,type=|node|,content=|Sciatica Exercises for Sciatica Pain Relief|]

Pain Killers Scrutinized after Shocking Death of Michael Jackson

cmaynard — Wed, 01 Jul 2009 11:55:00 -0700

July 1, 2009
by: Sylvia Marten

It’s been nearly a week since pop singer Michael Jackson’s sudden death from cardiac arrest, and questions still remain as to what led to his death.

According to various news reports, Jackson was addicted to the narcotic pain killer Demerol for more than 20 years and also received daily doses of another pain killer, Oxycontin. According to an unnamed senior law enforcement official in an ABC News report, Los Angeles police were told that Jackson did in fact receive a Demerol injection an hour before his death.

A lawyer for Jackson’s physician, Dr. Conrad Murray, has said that his client did not prescribe Jackson with any of these pain killers, but many medical experts think that Demerol and possibly other drugs played a role in the death.

Whether this is true or not, Jackson’s death provides a sad but absolutely necessary forum to talk about pain killer addiction.

While pain killers like Vicodin, OxyContin, Norco and Hydrocodone are typically prescribed to treat pain, what is often forgotten or not known with patients is that pain killers cause changes in the brain’s chemistry that are not under their control.

More specifically, the brain increases the number of receptors in response to the specific pain killer, and its nerve cells stop functioning. Since the body is receiving opiate pain killers, it stops producing endorphins (the body’s natural pain killers). Consequential degeneration of the nerve cells often auses a physical dependency for these opiates.

What is also not known by many patients is that taking pain killers over a long period of time may actually increase a person’s sensitivity to pain, possibly causing them to up their doses, become addicted and put their health in serious danger.

An overdose of pain killers can lead to respiratory arrest (when breathing slows and stops). Low blood oxygen may then cause the heart to quiver and not circulate blood, and lead to cardiac arrest (when the heart stops circulating blood).

Pain killer addiction is a very real problem in the United States. It has been estimated that more than 4.7 million Americans (roughly 2% of the U.S. population) are dependent on prescription pain killers.

Learn more about pain killer addiction and treatment in the following resources:

[url:808,type=|node|,content=|Pain Medications|]
[url:6639,type=|node|,content=|How Pain Killers Sometimes Increase Chronic Pain|]
[url:1924,type=|node|,content=|Pain Killer Addiction Treatment|].

In related news, Jackson’s death comes at a time when the European Medicines Agency (EMEA) wants a specific pain killer off the market and the U.S. Food and Drug Administration (FDA) is considering major changes to the use of one pain reliever.

The EMEA has said that the pain killer dextropropoxyphene (known as propoxyphene in the United States) should be withdrawn from the European market because a “significant” number of patients have allegedly been overdosing and dying from it (although the EMEA did not provide a specific number of casualties, according to a Wall Street Journal story).

Propoxyphene (e.g. Darvocet) has been used in the United States to treat mild to moderate pain since the late 1950s. It is marketed today by many drug manufacturers, and the FDA is reportedly considering whether to withdraw this pain killer.

For back pain patients who use or are considering taking a pain medication, especially medications with addiction potential, it is essential to understand and carefully monitor the use of that medicine. Do the upfront research to understand the medication options for your particular type of back or neck pain, and work closely with your medical professional to watch for side effects and risks of dependency. Some medicines are safe for short term use, but become potential dangers when used longer than indicated or in combination with other drugs.

Update: The FDA announced on July 8 that it would not withdraw Darvocet, Darvon and other pain killers with propoxyphene from the market despite calls from one consumer group to remove them. The FDA added that it would require a boxed warning of propoxyphene overdose risks and force manufacturers to study the fatality rates from overdoses.

9 Quick Back Pain Tips for Airplane Rides

cmaynard — Fri, 26 Jun 2009 08:22:42 -0700

June 26, 2009
by: Sylvia Marten

Looking forward to that much-awaited summer vacation but worried about dealing with chronic lower back pain, especially on a long flight?

If so, follow these lower back pain management tips -- courtesy of Spine-health’s continuing series on dealing with [url:145,type=|term|,content=|back pain|] on summer vacation -- to make your trip as painless, comfortable and stress-free as possible.

Let’s get started with some things you can do prior to your flight.

Utilize Your Doctor

As Haglandc of the Spine-health forum wonderfully points out, your doctor is one of your best advocates when preparing for a vacation. Here’s why.

A doctor may be able to provide a letter about your [url:896,type=|node|,content=|lower back pain|] to the airline and flight crew, which may then make accommodations for your needs. In the case of one forum member, that meant getting upgraded to business class, allowed to lay on the floor and rest during long flights, provided with a bunch of blankets for cushions, and afforded the opportunity to get up and walk around when others remained in their seats.
A doctor may provide you with prescription drugs like narcotics or muscle relaxants to help make the plane ride easier on your lower back pain. If this is the case, be sure to keep all of your prescription drugs in their original bottles (for airport security reasons) and bring a doctor’s note with you that specifies the medications you are on and the medical necessity.

Contact the Airline

Generally speaking, it usually cannot hurt to contact the airline a couple of weeks prior to the flight and let them know of your back pain. In the case of one forum member, speaking with the airline prior to flight made boarding much easier.

With a letter provided by a physical therapist, this passenger was allowed to bring on his [url:1940,type=|node|,content=|Transcutaneous Electrical Nerve Stimulation|] (TENS) unit, a portable, pocket-sized device that blocks pain signals by sending electrical impulses to certain parts of the body, and go through security without have to take it off.

You may be surprised that the airline may be able to make accommodations for your back pain, especially when you give them a decent notice of your condition. As just a couple of examples, the airline may be able to:

Provide you with medical attention (if necessary) via wheelchair assistance and early boarding
Have airline personnel carry your luggage for you and/or lift it into the overhead bin for you
Accommodate you with special shuttles and elevator platforms for boarding
Allow non-medical assistants to accompany you through security and boarding.

Put More Thought into Scheduling Your Flight

Take into account how you can make your flight less stressful on your back rather than rushing to book tickets by:

Exploring the possibility of taking a flight when there will be less people on board and more room for you to lie down across seats.
Contacting the airline prior to scheduling a flight and let them know of your back pain. They may be able to provide you with more insight on when flights tend to be very crowded and much lighter.
Trying to limit the down time between in-flight connections or layovers, if applicable.

Now that you’ve done some work prior to your flight, here’s what you can do to curtail back pain during it.

Bring Over-the-Counter Pain Medication

Utilize over-the-counter pain medication like acetaminophen (e.g. Tylenol) or [url:1917,type=|node|,content=|NSAIDS|] ibuprofen (Advil, Motrin and Nuprin) or naproxen (Aleve), to provide back pain relief on your flight.

Take your pain medication one hour before your flight to give it time to get into your system.
Carry your pain medications together in a clear plastic bag and have them on you at all times, in case you need to resort to them during the flight.
Inform flight attendants that you are on medication. This way they can monitor you if necessary.

Provide Support to Your Back While in the Air

For lower back pain, providing support behind your lower back, often with a back roll or even a couple of pillows (which a flight attendant may be more than willing to give you), is a good way to prevent slouching that may lead to back pain and to keep your spine straight.

One forum member talked about how he brings a neck pillow on board to help with his [url:912,type=|node|,content=|neck pain|].
Back braces, tube-shaped pillows with microfibers inside and other materials providing support are common companions of passengers with back pain and can be purchased inexpensively at many stores.

Watch How You Are Sitting

Airplane rides can be a bit tight and uncomfortable at times, especially if you’re not in a luxury class.

If your legs are not positioned at a right angle when you sit in an airplane seat, ask for something (pillows, blankets) to prop up your feet and keep your knees at a right angle. Doing so keeps stress off the lower back.
If you have long legs, request an exit row or bulkhead seat, which generally has more leg room.

Get Up, Move & Stretch as much as possible

Staying stationary for prolonged periods of time stresses the spine and can make back pain much worse.

See if there is room at the back of plane to do some quick stretching, which can provide more flexibility to the back and ease stiffness. Just be sure not to get up and move when there are jerking movements.

Alternate between Heat and Ice

Stock up on inexpensive heating options like ThermaCare heat wraps or warm gel packs and apply them while in the air.
Bring an empty hot water bottle and ask the flight attendant to fill it up during your flight.
Carry a small gel pack on the plane and have the flight attendant store it in the fridge when you are not using it.
Have a Ziploc bag on hand and ask the attendant to fill it up with ice that you can apply to your back.

Of course, do not apply heat or ice directly to the skin and be sure to check in with the airline to see what items are acceptable to carry on.

Relax and Try to Get Some Rest

A long flight provides plenty of time to [url:1080,type=|node|,content=|relax|], with just some suggestions including:

Getting comfortable via a back or neck support, sitting properly or reclining your seat, and maybe even taking some pain medication prior to your flight
Breathing slowly (inhale deeply, count to five, exhale slowly and repeat 10 times) to relax your muscles and nerves
Listening to some soothing music on an iPod
Bringing a novel or some other reading materials that can stimulate your mind and divert your attention away from your back pain
Staring out at the clouds and scenery (if you have a window seat) and letting your mind drift
Thinking about your vacation destination and how long you’ve waited for this day.

Hopefully these tips will help and even spark some more ideas as you prepare to deal with your back pain on a vacation plane ride.

Thanks again to those forum members who provided ideas with how they’ve dealt with back pain on airplane rides in the past.

Feel free to provide us with any other tips that you feel may be helpful to others, and be sure to check in at the Spine-health blog for future tips on dealing with back pain during summer vacation.

Happy travels to you.

More On This Topic:

[url:6713,type=|node|,content=|5 Tips for Flying Back Pain Free|]
[url:22230,type=|node|,content=|Effective Tips for Curtailing Back Pain on Plane Rides|]
[url:22226,type=|node|,content=|Top 7 Back Pain Treatments for Summer Vacation Car Rides|]

Top 7 Back Pain Treatments for Summer Vacation Car Rides

cmaynard — Wed, 17 Jun 2009 08:06:30 -0700

June 17, 2009
by: Sylvia Marten

Well, it’s that wonderful time of year when school is letting out, the weather is getting beautiful and the days are much longer and brighter. For most people, the summer is an ideal time to get away from the grind of the 9-to-5 and take a vacation with family.

With money tighter and the economy what it is, more families vacationing this summer may decide to travel by car, which may not present the most ideal situation for people dealing with a history of lower back pain.

Still, [url:896,type=|node|,content=|lower back pain|] doesn’t have to throw a wrench in your summer travels. In fact, if you keep the following tips in mind, you may very well make your trip a comfortable one.

In the first installment of Spine-health’s summer series of tips for limiting back pain on vacation, we examine how you can “have the back” of your back during that long car ride to the destination of your dreams.

1. Cover Your Bases by Getting Comfortable Immediately.

Whether you’re going to be driving or sitting in a car on your vacation trip, chances are you’ll be in the vehicle for extended periods, likely hours at a time. While this may sound extremely basic, make sure you’re comfortable from the get go.

Unfortunately, not all cars include built-in lumbar support or other ergonomic features. With that said, here are some tips for making your car more ergonomically-friendly for your back.

If your car seat provides little back support, roll up a towel, pillow or back support and place it between your lower back and seat for some more support. There are many different types of cushions and pillows (including but not limited to ones for sciatica, the [url:149,type=|term|,content=|neck|], lumbar spine, bottom and full body) that you can also purchase to alleviate your back pain.
Don’t sit on your wallet, cell phone or anything else that may throw your spine out of whack.
Reduce reaching (which places more stress on the lumbar spine, neck, shoulder and wrists) by sitting as close to the steering wheel as possible without compromising your safety.
Sit up straight with your knees slightly higher than your hips, and keep your chin pulled in.
Since staying still is bad for your back, don’t just pick a position and stay in it. Rather, adjust your seat and make slight adjustments to your position every 15-20 minutes.
Perhaps you’ll be renting a car for your vacation. If so, seek a car that provides lumbar support, is high enough for you to see past other vehicles without having to cringe your back and neck, and allows an easy way to get in and out without having to do much bending.

2. Bring a Small Cooler & Stack an Ice Pack.

Chances are you’ll already be bringing a small cooler with little snacks and beverages for yourself or the kids as you begin your vacation trek in the family car, so you might as well store a small ice pack in there as well.

[url:1664,type=|node|,content=|Applying ice|] to where you’re experiencing back pain – most often for no more than 20 minutes – is typically a good way to curtail any pain.

As most back pain is accompanied by inflammation, ice therapy can slow back swelling, numb sore tissues, slow the nerve impulses in the affected area, and decrease tissue damage.

Just remember that you should never apply ice directly to the back, but should rather keep it in a towel or another protective barrier to avoid ice burn.

3. Alternate Ice with Heat Therapy via These Inexpensive Means.

Alternating ice and heat is often an effective way to combat back pain, so be sure to bring something that can provide some warmth to your back.

Since lower back pain typically develops from strains and over-exertions that place tension in the muscles and soft tissues around the lower spine, hence leading to a lack of proper circulation and the transmission of pain signals to the brain, [url:1662,type=|node|,content=|heat therapy|] may reduce such signal calling and decrease stiffness by stretching the soft tissues around the spine.

Here are just a few options for how you can “light a fire” under your back during your summer vacation car ride.

Right before you leave, fill up a hot water bottle that you can place on your back. Be sure to refill your water bottle when you make bathroom breaks at rest stops.
While you’re preparing for your vacation by buying new clothes and snacks, be on the lookout for a heating pad with a car adapter that can simply plug into your vehicle’s cigarette lighter.
If you have leather seats with heating power, turn this function on for a few minutes at a time.
Gear up with other less expensive heating options, like warm gel packs and heat wraps. As an example, something like a ThermaCare heat wrap can be used to deliver low level heat to your back for several hours.

As you can see, there are plenty of affordable ways to provide heat therapy to your lower back pain. Just remember, that like ice packs, you should never apply heat directly to your skin.

4. Make Rest Stops So Much More – Utilize the Open Space for Back Exercises.

While this may seem counterintuitive, exercise is often a good treatment for lower back pain. Specifically, active [url:1183,type=|node|,content=|back exercises|] keep discs, muscles, ligaments and joints healthy by distributing nutrients into the disc space and soft tissues in the back.

Now if you have been to one rest stop, you’ve likely been to them all. In addition to providing lovely facilities to use the rest room and being stocked full of vending machines where you can get some of the oldest coffee in the world, rest areas are typically known for having plenty of flowing, green space.

After taking care of business at the rest stop, be sure to utilize its open space by making it a point to do some back exercises, including stretching and working on your hamstrings (FYI: you should stretch your hamstrings twice a day when dealing with low back pain).

Even walking around a bit is a good way to stretch out the muscles.

Here are just some [url:1246,type=|node|,content=|lower back pain exercises|] that may work for you (with that said, a physical therapist or spine professional can provide you with more back exercises).

If you have done back exercises in the past to curtail lower back pain, you’ll want to keep your routine, even when going on vacation, which is all about breaking routines.

Make it a point to spend a couple of minutes doing back exercises at a rest stop before getting back on the road with the Joads, and be sure to get to a stop every couple of hours.

5. Make Good Use of the Back Seat (if available).

If your back pain is proving unbearable and the back seat is available, use it to lie down and rest.

Simply lie down in the back seat (obviously when the car is parked and not moving) with your knees slightly bent. Put a blanket on the seat and rest a pillow under your head.

In simple terms, try to get as comfortable as possible and adjust your positioning when necessary.

6. Substitute Your Pain Medications with Tylenol, Ibuprofen or Naproxen.

Taking your pain medications is not advisable when driving. With that in mind, you can always alternate with over-the-counter pain relievers like Tylenol, ibuprofen (Advil, Motrin and Nuprin) or naproxen (Aleve).

These [url:1917,type=|node|, content=|NSAIDs or non-steroidal anti-inflammatory drugs|] are often effective in limiting inflammation associated with back pain and typically don't produce the gastrointestinal side effects of aspirin.

7. Sit Back, Relax and Rest.

There’s a reason why passenger seats recline. And there’s usually no better time to catch up on some sleep than during a long car ride.

If your lower back pain is nagging, taking a nap may be an effective way to limit the pain.

While sleeping in a car may be difficult for some people, most people are able to adapt and find a good way to nap and get some much needed refreshment and back pain relief.

Here are some general tips for doing so.

Recline the passenger seat in a position that is most comfortable to you.
Depending on how you feel and what you prefer, you may want to use a comfortable pillow to rest your head on and a back brace to support your back.
Throw on a pair of headphones, simply stare out the window at the wonderful scenery passing by, and drift off into your own place of contentment.

Well, hopefully you find these tips helpful as you treat back pain during your summer vacation car ride.

If you have any tips that you would like to add, feel free to let us know in the “Comments” section.

With that said, be on the lookout for next week’s tip on dealing with back pain on plane rides to your summer vacation hot spot.

Latest SPORT Data Supports Back Surgery for Degenerative Spondylolisthesis

cmaynard — Thu, 11 Jun 2009 12:36:10 -0700

June 11, 2009
by: Sylvia Marten

Spine-Health has blogged in the past about the Spine Patient Outcomes Research Trial (SPORT), including one study concluding that [url:6608,type=|node|,content=|back surgery was better for patients with degenerative spondylolisthesis|].

Well, SPORT just recently released the latest data on this study. Its verdict? The newest data supported this earlier conclusion, finding that back pain relief was more prevalent four years later for those patients who voluntarily had lumbar laminectomy surgery as opposed to those who voluntarily passed on this surgery.

Here’s a quick summary of these latest SPORT findings:

Identical Approach, Longer-Elapsed Time Frame, More Crossover, Similar Results.

To recap, there were two cohorts in this study: 304 patients in a randomized cohort (meaning that they were randomly chosen either to have or not have laminectomy surgery to treat their [url:6000,type=|node|,content=|spondylolisthesis|] and [url:152,type=|term|,content=|spinal stenosis|]) and 303 patients in an observational cohort (meaning that these patients voluntarily chose to have or not have this surgery).

It should be known that 66 percent of those patients who were randomly chosen to have surgery did so within four years and that 97 percent of those patients who chose surgery also had a laminectomy in that time period.

More telling were the latest findings that 54 percent of those people who were randomized not to have surgery ended up having surgery within four years and that 33 percent of those who voluntarily passed on surgery eventually had it. For more than a half and approximately a third of these specific patients, not having surgery apparently wasn’t as beneficial in terms of providing back pain relief.

Adding more intrigue to this study were the responses of those patients who voluntarily had surgery for their back pain. This group of patients reported improvements of 15.3 points for bodily pain and 18.9 points for physical function, and decreases of 14.3 points on the Oswestry Disability Index, signifying that gains experienced two years after back surgery were still maintained four years later.

At the end of the day, these latest findings confirm how laminectomy surgery may have wonderful results for people dealing with spondylolisthesis. Still, one must not rush to assume that surgery is always better than not having surgery when addressing spondylolisthesis associated with spinal stenosis. It should be noted that non-surgical treatments may adequately alleviate back pain for others, as very well may have been the case for the 70 percent of the observational patients who initially passed on and still did not have surgery four years later.

As each patient’s case is unique in itself, it ultimately comes down to the patient and his or her doctor examining their options and making a decision that they are most comfortable with and feel is the best course of action at the time.

Source: The Journal of Bone and Joint Surgery

More on This Topic:

[url:144,type=|term|]

[url:6000,type=|node|]

[url:1056,type=|node|]

[url:152,type=|term|]

[url:1581,type=|node|]

[url:18465,type=|node|]

Lyrica (Pregabalin)

Greg — Thu, 17 Apr 2008 07:46:59 -0700

Brand name: Lyrica (generic: pregabalin)

Overall comments
Lyrica (pronounced LEER-i-kah) is an anti-convulsant (seizure) medicine and considered by many to be a pain relief medication. It is indicated for treatment of four specific conditions, and though it is not indicated or FDA approved for use to treat pain, it is prescribed (off label) by doctors to treat certain types of chronic pain.

Chiropractic Treatments for Back Pain

spine-health — Wed, 12 Dec 2007 00:07:08 -0800

Chiropractic is a health care profession dedicated to the non-surgical treatment of disorders of the nervous system and/or musculoskeletal system, generally through chiropractors maintaining a unique focus on spinal manipulation and treatment of surrounding structures.

Massage Therapy for Lower Back Pain

spine-health — Tue, 11 Dec 2007 23:07:35 -0800

More Low Back Pain Info:

Low Back Pain Causes

Low Back Pain Symptoms and Treatments

Low Back Pain Info

Mattresses for Back Pain

“Oh, my back still hurts,” Jim groaned as he sat on the bed and bent over to pick up his shoe.

Lower Back Pain Symptoms and Treatment Options

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

Sciatic Nerve Anatomy

cmaynard — Thu, 25 Jun 2009 06:45:01 -0700

The sciatic nerve is the largest and longest single nerve in the human body, about as big around as a thumb at its largest point. The nerve originates in the lower spine as nerve roots exit the spinal cord (through the bones in the spine), and extends all the way down the back of the leg to the toes.

McKenzie Method Assessment

Ben Parr — Mon, 16 Mar 2009 12:02:48 -0700

When a patient’s pain symptoms can be made better or worse by adopting various, differentiated active positions, it is said that a patient has a directional preference of movement for treatment. The identification of a directional preference through mechanical means is the hallmark of the McKenzie Method (which is often referred to Mechanical Diagnosis and Therapy or MDT).

McKenzie Therapy Classifications

Ben Parr — Mon, 16 Mar 2009 12:01:24 -0700

The Mechanical Diagnosis and Therapy system has three broad treatment classifications: postural, dysfunction and derangement syndromes. Each classification treats a distinct underlying cause of disablement. There are also sub-classifications in each group.

Treatment Options for Chronic Sciatica and Lower Back Pain

Ben Parr — Mon, 09 Mar 2009 11:01:55 -0700

A physician answers patient questions about conservative treatments for chronic back pain and sciatica.

Lower Back Pain after Discectomy Surgery

Ben Parr — Thu, 26 Feb 2009 15:18:15 -0800

A physician answers patient questions about persistent lower back pain after a discectomy.

Question: What's the next step after discectomy surgery?

My 19-year-old son had a discectomy surgery a while ago due to a disk herniation at L4-L5. He still has lower back pain, but no leg pain any more. Now we have no diagnosis.

Spine Specialists and Exercise for a Bulging Disc

Ben Parr — Mon, 16 Feb 2009 13:58:17 -0800

A physician answers patient questions about contacting a spine specialist and incorporating exercise to keep discs from bulging.

Question: How To Keep Discs From Bulging?

I have had debilitating lower back pain for two years. My MRI indicates I have bulging discs. My doctor recommended exercise, but that has not helped. What are some alternatives to keep my discs from bulging?

Surgical Implant or VAX-D for Degenerative Disc Disease Treatment?

Ben Parr — Fri, 13 Feb 2009 12:43:56 -0800

A physician answers patient questions about disc replacement and VAX-D treatments for degenerative disc disease.

Cortisone and Hamstring Stretching for Degenerative Disc Disease

Ben Parr — Fri, 13 Feb 2009 12:43:45 -0800

A physician answers patient questions about hamstring stretching and cortisone shots for degenerative disc disease.

Question: Are there options beyond cortisone and surgery for degenerative disc disease?

I am 30 years old and I started suffering lower back pains about a year ago. Around six months ago, my doctor sent me for x-rays and told me I had degenerative spinal disorder. He put me on pain killers (when needed) and 800mg of ibuprofen three times daily.

History of Cold Laser Therapy

Ben Parr — Thu, 12 Feb 2009 14:19:14 -0800

Cold Laser Therapy has been used in clinical practice all around the world for over four decades. In 1916, Albert Einstein conceived the theory of Light Amplification through Stimulated Emission of Radiation or LASER. In 1967, Professor Andre Mester began using low power lasers in medicine. Dr. Mester is recognized by many as the grandfather of laser therapy.

F.D.A Recognition of Cold Laser Therapy

The F.D.A classifies medical lasers into three categories:

Treatment for Back Pain Flare-Up

spine-health — Thu, 24 Jan 2008 12:02:40 -0800

Dr. Andrew Cole discusses his experience with treatments for low back pain, including proper methods for controlling inflammation, strength training, fitness, and cold and heat therapy, and medications.

Percutaneous Neuromodulation Therapy (PNT)

spine-health — Mon, 17 Dec 2007 08:55:42 -0800

(Research Article)

Percutaneous neuromodulation therapy (PNT™) is a new, non-surgical treatment that is based on the premise that electrical stimulation applied to the deep tissues in the back can help provide relief for certain types of lower back pain.

The treatment has recently received FDA clearance for treatment of lower back pain. It is minimally invasive and performed in the doctor’s office.

Physical Therapy for Low Back Pain Relief

spine-health — Wed, 12 Dec 2007 00:18:36 -0800

Physical therapy for the low back

Patients suffering from most types of low back pain are often referred for physical therapy for four weeks as an initial conservative treatment option before considering other more aggressive treatments, including back surgery. The goals of physical therapy are to decrease back pain, increase function and teach the patient a maintenance program to prevent future back problems.

Guidelines for Recovering from Low Back Pain

spine-health — Wed, 12 Dec 2007 00:18:36 -0800

More Low Back Pain Info:

Low Back Pain Causes

Low Back Pain Treatment

Coccydynia Introduction

Mattresses for Low Back Pain

In addition to stretching, strengthening and aerobic exercises, there are several lifestyle guidelines that can help in the healing and rehabilitation process.

Specific Low Back Pain Exercises

spine-health — Wed, 12 Dec 2007 00:18:36 -0800

More Physical Therapy Info

Exercise Ball Therapy

Physical Therapy Benefits

Rehabilitation and Exercise

Core Strength Exercises

Most physical therapy programs that are designed to treat low back pain and some radicular pain (pain radiating down the leg) will include a combination of the following types of exercise:

Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Heat Wrap Therapy Can Reduce Post-Exercise Low Back Pain

spine-health — Wed, 12 Dec 2007 00:08:51 -0800

Low back pain after exercise

Benefits of Heat Therapy for Lower Back Pain

spine-health — Wed, 12 Dec 2007 00:08:50 -0800

While the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.

In addition, heat therapy for lower back pain - in the form of heating pads, heat wraps, hot baths, warm gel packs, etc. - is both inexpensive and easy to do.

Post-Operative Care

spine-health — Wed, 12 Dec 2007 00:07:11 -0800

More Chiropractic Info

Chiropractic Back Treatment

Spine Decompression

Selecting a Chiropractor

Chiropractic Manipulation

Chiropractic Care for Low Back Pain

spine-health — Wed, 12 Dec 2007 00:07:11 -0800

Steven G. Yeomans, DC

Low Back Pain Relief Using a Pneumatic Vest (Research Article)

spine-health — Tue, 11 Dec 2007 23:57:44 -0800

Low back pain relief

Most people with an acute episode of low back pain or leg pain find significant pain relief within a few weeks, but for some, the pain and inability to tolerate upright, weight bearing postures persists or recurs based on activity. As many as 62% of people who have experienced an acute low back pain incident have persistent pain episodes at 1 to 2 years after onset (1). Many who have returned to normal activities suffer relapses when they do certain activities of daily living (2).

Research Results for the Orthotrac Pneumatic Vest

spine-health — Tue, 11 Dec 2007 23:57:44 -0800

Preliminary research indicates that for appropriate patients, significant functional improvement can be expected with use of this device.

The following research results are currently available:

Pneumatic Vest - A New Lower Back Pain Treatment Option

spine-health — Tue, 11 Dec 2007 23:57:44 -0800

A general review of medical literature shows that patients with moderate or minor lower back pain symptoms often respond well to conservative back care, while patients with severe, acute lower back pain occasionally require a surgical intervention rather than non-surgical treatments.

Choosing the Best Mattress for Lower Back Pain

spine-health — Tue, 11 Dec 2007 23:10:14 -0800

More Mattress/Sleep Info:

Sleep Problems

Best Mattress for Low Back Pain

spine-health — Tue, 11 Dec 2007 23:10:14 -0800

More Mattress/Sleep Info:

Massage Therapy Considerations for Lower Back Pain

spine-health — Tue, 11 Dec 2007 23:07:35 -0800

The muscle spasm should relax in response to the pressure applied by the massage therapist. If the muscle does not relax in response to the pressure, there is usually inflammation present. Massage is not the best treatment option for inflamed muscles, and patients should consult their doctor for treatment for the inflammation.

McKenzie Therapy for Mechanical Low Back Pain

spine-health — Tue, 11 Dec 2007 23:04:47 -0800

Of the many frustrations back pain patients face, the lack of a standardized or uniform treatment approach is high on the list. Especially for those patients with longer-lasting symptoms of sub-acute pain (lasting between six and twelve weeks) or longer than twelve weeks (chronic back pain), treatment approaches are very inconsistent.

Lumbar Stabilization as Exercise for Lower Back Pain

spine-health — Tue, 11 Dec 2007 23:04:46 -0800

Lumbar stabilization is an active form of exercise used in physical therapy. It is designed to strengthen muscles to support the spine and help prevent lower back pain. Through a regimen of exercises, and with the initial help of an experienced physical therapist, the patient is trained to find and maintain her/his “neutral spine” position. The back muscles are then exercised to teach the spine how to stay in this position.

Strengthening Exercise Program for Low Back Pain Relief

spine-health — Tue, 11 Dec 2007 23:04:45 -0800

The next few exercises are examples of some basic stabilization exercises that aid in low back pain relief. Having strong midline support is critical to decreasing the stresses placed upon the lumbar spine (lower back) and pelvis. It should be noted, however, that often muscles that appear to be weak may actually be inhibited by an antagonist muscle (muscle on the opposite side of the joint) or by faulty lumbar facet joint mechanics.

Back Braces

spine-health — Tue, 11 Dec 2007 21:54:09 -0800

Motion of the lumbar (lower) spine can delay healing in fractures or in post-operative fusions. Limiting the motion of the spine enhances the healing process for bone in both conditions, and will also usually decrease the patient’s low back pain and discomfort.

Two types of back braces are commonly used to limit the motion in the spine:

Rigid braces
Corset braces (elastic braces)
read more

Playing Golf with Low Back Pain

spine-health — Tue, 11 Dec 2007 21:50:16 -0800

For the millions of people who have chronic, long-standing low back pain, golf can still be an enjoyable sport. However, a regular routine of stretching and low-impact exercise is critical to maintain the ability to play golf.

Treating Low Back Pain and Back Injury from Golf

spine-health — Tue, 11 Dec 2007 21:50:16 -0800

Most acute low back injuries that occur during a game of golf will get better over a couple of days to weeks. The most common injuries from golf include:

Muscle strains: typically occurs with rough or forceful golf swings or a sudden shift during the downswing
Muscle and tendon attachment: generally occurs due to excessive use, accidents or swing abnormalities while playing golf
Disc injuries: can occur from swinging abnormalities (note that this is usually due to a pre-existing disc lesion that is aggravated by golf)
read more

Back Care for Lower Back Pain

spine-health — Tue, 11 Dec 2007 21:50:16 -0800

Since most episodes of lower back pain are self-limited, it is often advisable for patients to employ back care on their own early in the course of low back pain.

Back Care First Aid

In most cases, do-it-yourself back care for low back pain should center on a combination of:

A short course of rest, limited to one to two days
read more

Preventing Low Back Pain from Golf

spine-health — Tue, 11 Dec 2007 21:50:16 -0800

As with so many health conditions, a little effort to prevent back injury and low back pain goes a long way. Four key areas of prevention for the sport of golf include: warm-up, swing, bio-mechanics, and carrying the golf bag.

Axial Back Pain: Most Common Low Back Pain

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

Axial low back pain can vary widely. It can be a sharp or dull pain, it can be felt constantly or intermittently, and the pain can range from mild to severe. The most common type of axial back pain is "mechanical” and is characterized as:

Conservative Treatments for Coccydynia

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

Treatments for coccydynia are usually conservative and local. The first line of treatment typically includes:

Non-steroidal anti-inflammatory drugs NSAIDs. NSAIDs (such as ibuprofen, naproxen, COX-2 inhibitors) help reduce the inflammation that can cause pain.
A donut-shaped pillow to help take pressure off the coccyx when sitting

Patience is also very important, since it often takes many weeks, or even months, for the pain to subside.

Low Back Pain with Referred Pain

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

This type of low back pain can vary widely with regards to severity and quality. It tends to be achy, dull and migratory (moves around). It tends to come and go and often varies in intensity. It can result from the identical injury or problem that causes simple axial back pain and is often no more serious.

Surgical Treatments for Coccydynia

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

For people who have persistent pain that is not alleviated or well-controlled with conservative treatment of coccydynia, surgical removal of the coccyx (coccygectomy) is an option.

This surgery is rarely performed, and the procedure is not even included in most spine surgery textbooks. It is, however, a relatively simple operation.

Treatment Options for Sacroiliac Joint Dysfunction

spine-health — Tue, 11 Dec 2007 21:30:17 -0800

Treatment for sacroiliac joint dysfunction is usually conservative (non-surgical) and focuses on trying to restore normal motion in the joint.

Typical treatments for sacroiliac joint dysfunction include: