People Who Suffer from Low Back Pain have High Odds of finding Relief Without Surgery
A recent panel consisting of experts from the American College of Physicians and the American Pain Society, has released guidelines for the diagnosis and treatment of low back pain. The study concluded that low back pain sufferers have high odds of finding relief without surgery.
The study covered what physicians call "nonspecific low back pain," meaning back pain that is not related to any specific condition. The guidelines indicated that non-surgical relief from a variety of conditions other than cancer, fracture, compressed nerve or slipped disc, can be effective in relieving pain.
Panel member Roger Chou, MD, associate professor of medicine at Oregon Health & Science University in Portland recently stated, "If you have this kind of bad pain there's good news." Chou told WebMD, "There are lots of options out there that have pretty good evidence they work. There is no one perfect treatment for everybody. If you are interested in spinal manipulations or acupuncture," Chou continued, "the evidence is just as good as for medications."
Chou continued his comments by stating "Once upon a time, doctors told people with low back pain to stay in bed for three days, perhaps with a board under their mattress. That was very bad advice as it actually made the back pain worse. We don't want people lying in bed. Get out, Try a normal range of activities but back off if your back hurts. You won't hurt your back by doing regular stuff and, it may actually keep your back conditioned and strong."
Another mistake of those days gone by was that physicians routinely used x-rays to diagnose low back pain in their patients. According to the expert panel was the wrong thing to do. The panel stated that X-rays should only be used when a physician has reason to suspect an underlying condition that could be confirmed by imaging studies.
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People with low back pain are among the most common victims of acute pain episodes. Persistent pain of at least moderate intensity, that is to day chronic back pain, are found in up to one-third of all low back pain patients.
Another finding of the panel was that there are a wide variety of relief available to low back pain sufferers. Included in this list of treatments are:
Cognitive-behavioral psychotherapy, exercise therapy, spinal manipulation from a chiropractor, osteopath, physical therapist, intensive interdisciplinary rehabilitation (physical, vocational and behavioral therapies provided by multiple providers with different backgrounds), acupuncture, massage therapy, yoga energy medicine and progressive relaxation.
According to Chou, "Patients and doctors need to talk. Don't use stuff not backed up by evidence. Don't fall for stuff just because it's touted on the Internet or whatever."
"These programs have been around for 15 to 20 years," says Scott D. Boden, MD, professor of orthopedic surgery and director of the Emory University orthopedics and spine center. "The panels advice confirms what back specialists have been saying for years. Some studies show they have a benefit, some not. A lot of this has to do with the psychological makeup of patients."
Boden added one more possible cure to Chou's list: time.
"Fortunately for most patients, it is just a short period of time where back pain is absolutely debilitating," Boden stated. "For some, the most important thing is just the education that they are to falling apart, so they can stop searching for the cure and go on and live their lives."
Important to note is that both Boden and Chou have stressed that surgery is not the answer for most patients. According to a recent issue of Consumer Reports, back surgery was listed as the number one most overused medical treatment.
"Since surgery doesn't offer a large advantage in most patients, the message is that most people will be able to get better without surgery," Chou said. "Iff you avoid it, you are going to be better off."
However, Boden suggested that patients tend to settle on a treatment plan that helps. He also warned that some people may never be totally cured of back pain.
"Unfortunately, while looking for a cure patients can run into surgery that would be moderately risky with a small chance of success," Borden stated. "Or they could end up with something that is not necessarily dangerous, but equally ineffective. There are a lot of new things that sound good, but the real back pain options really haven't changed that much in decades."
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