Low Back Pain: Many Options for Relief

| October 1, 2012 | 0 Comments | 43 views
Low Back Pain: Many Options for Relief

Oct. 1, 2007 -- People who suffer low back pain have high odds of findingrelief without surgery, an expert panel says.

The panel, made up of experts from the American Pain Society and theAmerican College of Physicians, has released guidelines for the diagnosis andtreatment of low back pain.

The guidelines cover what doctors call "nonspecific low back pain"-- that is, back pain not due to aspecific condition such as cancer, a slipped disk, a compressed nerve, or afracture.

If you have this kind of bad pain, there's good news, says panelist RogerChou, MD, associate professor of medicine at Oregon Health & ScienceUniversity in Portland. Chou is director of the clinical guidelines developmentprogram of the American Pain Society.

"There are lots of options out there that have pretty good evidence theywork," Chou tells WebMD. "There is no one perfect treatment foreverybody. If you are interested in spinal manipulation and acupuncture, theevidence is just as good as for medications."

Once upon a time, doctors told people with low back pain to stay in bed forthree days -- perhaps with a board under their mattress. That very bad adviceactually made back pain worse, Chou says.

"We don't want people lying in bed," he says. "Get out. Try anormal range of activities, but back off if your back hurts. But you won't hurtyour back by doing regular stuff, and it may actually keep your backconditioned and strong."

Doctors also used to give routine X-rays to patients complaining of low backpain. That, according to the expert panel, also is wrong. X-rays areindicated only when a doctor has reason to suspect an underlying condition thatcould be confirmed by imaging studies.

Back Pain Relief Menu

Most people with low back pain have an acute pain episode. But up to a thirdof patients report persistent pain of at least moderate intensity -- chroniclow back pain.

The panel found evidence that different patients can get relief from a widevariety of treatments. These treatments include:

Cognitive-behavioral psychotherapy Exercise therapy Spinal manipulation from a chiropractor, osteopath, or physicaltherapist Intensive interdisciplinary rehabilitation (physical, vocational, andbehavioral therapies provided by multiple providers with different clinicalbackgrounds) Acupuncture Massage therapy Yoga Progressive relaxation

"Patients and doctors need to talk," Chou says. "Don't use stuffnot backed up by evidence. Don't fall for stuff just because it's touted on theInternet or whatever."

Scott D. Boden, MD, professor of orthopaedic surgery and director of theEmory University orthopaedics and spine center, says the panel's adviceconfirms what back specialists have been saying for years.

"These programs have been around for 15 to 20 years," Boden tellsWebMD. "Some studies show they have a benefit, some not. A lot of this hasto do with the psychological makeup of patients."

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