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About Cottage Grove sentinel. (Cottage Grove, Or.) 1909-current | View Entire Issue (July 20, 2016)
Back Pain Consumer How to UNDERSTAND BACK PAIN Most Americans will experience significant back pain at some point during their lives. Back pain is the second most com- mon reason for people to seek med- ical attention. It is the second most common neurological ailment, sec- ondary only to headache. Back pain hurts America. There are many causes of back pain. Most are not serious; however, some forms can herald sinister possi- bilities. SERIOUS CONCERNS: • Tumors can result in back pain either by compressing nerves or destroying bone and surrounding tissue. Tumors can be benign or malignant. • Infections involving the spine cause serious pain. They can occur in asso- ciation with diabetes and obesity. Such infections generally require, at minimum, weeks of careful expertly guided antibiotic therapy. Some cases will require surgery. • Fractures can either occur as a result of trauma or even spontaneously in the elderly and osteoporotic. • Cauda equina syndrome refers to a condition wherein the lower lumbar and sacral nerves are severely com- pressed. This can result in severe pain, weakness, and trouble control- ling bowels and urine. • Nerve pain, often referred to as "sci- atica", is a condition wherein some type of structural change causes pres- sure upon one or more of the nerve roots that supplies the muscles and sensation to the legs. A variety of degenerative conditions may result in this type of pain including degenerat- ed discs, cysts or other "wear and tear" conditions. Muscle and ligaments are common causes of back pain. Often referred to as back strain or back sprain, this accounts for the most common cause of minor back pain in America. Bones are a more unusual cause of back pain. Usually in the context of 14 HOW TO GUIDE fractures, but also associated with the muscular and ligamentous strain of abnormal curvatures (scoliosis, kyphosis, lordosis, etc.), bone-related problems can cause pain. Severe injuries can result in fractures as can minor injuries later in life, particular- ly in the elderly and osteoporotic. TREATMENT OPTIONS: Every American should develop their own back brace – made of strong muscle and ligament. Decondition- ing is a common theme in the orches- tration of recurring back pain, often harmonized with overweight, smok- ing and general lack of exercise. Creating a sound muscular back brace does not require signing up for boot camp or joining a local exercise group. Simple lifestyle changes such as taking short, frequent walks throughout the day and losing weight will almost always make significant differences. The old adage of bedrest, especial- ly for more than a couple days, may actually be far more harmful than ben- eficial. Many other fads in the treat- ment of back pain have come and gone over the past decades. Gentle strengthening, weight loss and stop- ping smoking are the absolute requirements of treating almost any back pain. Physical Therapy and Chiropractic can also play important roles in treat- ing back pain. Oral medications are also common- ly used to help patients get through acute, and sometimes chronic, back pain. Over-the-counter pain relievers are often used. More powerful med- ications, requiring a prescription, can be used — however, care should be exercised to avoid prolonged use, if possible. These medications include both pain modulating medications as well as steroids that can reduce the inflam- mation and/or irritation of affected nerves. Strong medications can also be delivered directly to compressed nerves or to nerves responsible for long-term pain. This can be done with single injection or can even be accomplished continuously with externally located or surgically implanted pumps. Single injection is often useful if pain is severe and there is a reasonable hope that the pain may resolve with time. These injections can also be useful diagnostically. Continuous pumps are generally used to treat severe pain associated with cancer. A significant advantage of delivering medications directly to the nerves is that side effects are marked- ly lessened. Medications that can be delivered include pain medication and steroids that reduce the inflamma- tion and irritation on individual nerves. Surgery should be reserved for sit- uations wherein there is not a reason- able chance that the pain will resolve with more conservative measures. Generally, a trial of conservative ther- apy should be attempted. Neurosurgeons, trained in the eval- uation and treatment of severe pain caused by compromised nerves, can assist with the evaluation and treatment of severe pain. Neurosurgeons can also recommend additional non-surgical measures or counsel regarding what options should be contemplated if surgery is considered. If you have back pain and/or pain, numbness, tingling or weakness that seems to radiate down your arms or legs, you should seek an evaluation by a medical professional trained in diag- nosing and treating pain associated with the spine and nerves. For more information under- standing back pain, contact Neurospine of Aberdeen, Dr. Charles Miller and Dr. Jay J. Schindler (605) 225-1133.
