New Guidelines for Low Back Pain Treatment

I would like to thank Dr. Mark Borigini for his insight and information on  "new treaments for lower back pain".

I recently was at the neurologist office that I go to often. When I explained to her that I had been having pain in the lower back again. I was telling her that I get paranoid when the pain becomes very intense. 

A few years back, when the pain was getting too much for me, I visited with the GP doctor I had at that time. She explained that there was nothing more she could do in helping me. I had been to therapy two other times when I had rough spells and on pain meds many times. My doc refered me to a specialist who prescribed meds, injections, and more therapy. I saw him on two different occassions. The last visit was they may have to open me up. When I did my follow up I said that I was getting much better because my neurologist made a very firm suggestion on not getting surgery.

So, you can see why your post is very important to many.

Greatfully,

Marlene S.       

Dr. Borigini

Thank you for the additional information and keeping us up to date on what is going on in the US for lower back pain.

The sharepost pretty much confirms what my own doctors have been telling me, with both of them opposed to me trying surgery.

You did not mention Radio Frequency Oblation in your article and would like to know what the current opinions are on this treatment for Lumbar pain.  If I could find an article to read I would certainly appreciate it.

Thank you

Betty

Finally, they're agreeing with my back!

My spinal cord stimulator for lower back pain has been working wonderfully.  Okay, it's only been three months, but I'm now walking for 15-20 minutes instead of THREE or FOUR.  (Anyone considering this for lower back pain that does NOT radiate down the legs, go for the ANS brand device with the new paddle leads!  They are AWESOME!)

I HAD BACK SURGERY IN THE 1980'S LAMINECTOMY L4 & L5, AT THAT TIME I WAS AN ACTIVE DUTY ARMY OFFICER WHO WERE IN A SPECIAL FORCE TEAM,SINCE I HAD THE SURGERY I HAVENT BEEN THE ACTIVE PERSON THAT I WAS BEFORE THE SURGERY, MY LIFE CHANGE FROM BAD TO WORST.THE PAIN ON MY LOWER BACK HAVE NEVERGONE AWAY IT HAVE BEEN GETTING WORST AND HAVE AFFECTED BOTH MY LEG'S THAT I CANT WALK FOR MORE THAN FIVE MINUTES, I DONT RECOMENT NO ONE TO HAVE BACK SURGERY,TRY ALL TREAMENT BEFORE SURGERY.

The debate about effective treatment for low back pain will continue for many years, I believe.  It is my opinion that there are at least two critical reasons why; problems in the spine can be difficult to diagnose and the subject of pain, its causes, and its treatments are not covered fully in medical schools.

I have lived with chronic pain in my low back and legs for over 40 years now and between 1970 and 1994 I had 3 laminectomies and an anterior/posterior spinal fusion that included using rods and screws to stabilize my spine. Since the mid 60s, however I have had just about every pain medication prescribed for me, as well as experienced almost every alternative treatment, including steroid injections and epidurals, physical therapy, traction, massage therapy, biofeedback, spinal manipulation under anesthesia, which I learned later was considered very dangerous and the hospital stopped allowing the practice.  I wore a body cast for several months in my senior year of high school and a TENS unit, (transelectrical nerve stimulator is what I believe

TENS stands for) and many other invasive and non-invasive treatments.

Finally, in 1999, after being diagnosed with Multiple Sclerosis as well as having the problems with my back, which I would label 'failed back syndrome,' my neurologist had a pain management specialist join his practice.  After only a few short months of attempting some of the treatments I had already had this doctor told me about the Medtronics Intrathecal Pump.  In January 2000 I had a pump implanted in my abdomen and since then it delivers morphine, bipivicaine and baclafen to my central nervous system through a catheter to the spine.  For the first time since I was a young girl I was living with pain that was manageable. I cannot say it was gone altogether and there are still some days that I have to  supplement the pump with an oral pain medication, but these are few.  For the most part the last seven years I have lived with a totally acceptable level of painm and much fewer side effects than I had taking these drugs orally.

There is a wide variety of specialties from which medical students can select their field of concentration, and pain may be covered in their education, however it will most likely be limited to pain in relation to the specialty they have chosen.  One way to address this issue is to require all hospital residents to take a specially designed course in pain, specifically chronic pain.  It doesn't take long for a chronic pain patient to know if their medical professionals, doctors, nurses and/or therapists, have a firm understanding of how pain works and the impact it has on the patient's life.

Thank  you for your posting on this issue.  We need to have more discussions about pain and the need for a better understanding of how to treat it.  The National Pain Policy Act was introduced to Congress this year and among other things it calls for federal funding for research on pain, a national conference on the treatment of pain, and increased education for medical doctors on the subject of pain.  We would all benefit  from this becoming law, of course implementation is another issue.

Thank you for this opportunity.

Denise Coleman

I too am a chronic back pain sufferer. I have some stenosis and ruptured disc sith a annular tear.  I tried every treatment that the pain clinic could offer from facet blocks and injections to the unit that they implant in your back that works like a pacemaker.  My neorosurgeon went in and put what looks like lag bolts around the L-4 L-5 and S1 region this was the best thing that ever happened.  for the first time in years i litterally could feel blood flowing in my feet and they didnt hurt.  The pain in my legs was gone.  If I had to do it all over I would do it again in a heartbeat and would also reccomend that anyone that has tried every thing else give the surgery a try.  I feel so much better.   

connie