Last month, the American Pain Society added to its recommendations to health care providers regarding the diagnosis and treatment of low back pain .
In addition, the Society decided to discuss openly procedures that could be risky to sufferers of low back pain, including recommendations on surgery and other invasive therapies.
Unfortunately, there is not a significant body of good evidence to justify unquestioningly embracing these new recommendations. It is difficult to find well-done clinical studies which support the use of a number of the more invasive treatments used for chronic low back pain.
The initial set of guidelines for the management of chronic low back pain were published in "Annals of Internal Medicine" last October. However, these recommendations dealt more with the initial evaluation of a low back pain patient, and included thoughts on what type of x-rays to order in addition to more conservative treatments such as massage/manipulation and exerci...
One of the most common problems seen in a primary care medical practice is low back pain. It accounts for more discomfort, lost work and productivity, and frustration for many patients than any other malady. Some think it is the price we, as humans, pay for walking upright. The lower back is a complex structure made of bone, muscles, connective tissue and nerves that, along with our legs, hold us erect, allow us to bend, run, twist, catch a football, or just lay down and rest. However, once a problem arises, the complexity of its structure makes pain in the lower back difficult to diagnose and treat. The lower back consists of a spinal column from the lumbar region of the mid-back down to the tail bone or coccyx. The spinal column consists of 5 lumbar vertebrae which are cylindrical bony structures with a ring like component behind the cylinder also made of bone. In between the vertebrae are disc shaped cushions filled with a gelatinous central core known as the nucleus pulposis
Damage to the spinal cord, an information superhighway that originates in the brain, is a very devastating injury that can lead to paralysis. Most people have heard of traumatic spinal cord injuries because the sudden tragedies grab headlines from time to time. But, few people have heard of spinal stenosis, a narrowing of the tube which shelters the spinal cord called the spinal canal (See Spine Anatomy 101 ). As the space tightens like a noose, this slow strangulation of the nerves in the spine can disrupt anyone’s life. Sara turned 68 years old last month. She has enjoyed good health and has been an avid golfer. But, lately she has noticed an aching pain in her legs that occurs when she is walking or standing. This new problem has really slowed her golf game down and has made it difficult for her to even do her own grocery shopping. The only way she can make it up and down the aisles is by leaning on the shopping cart because that eases her pain. Frustrated, she calls to ...
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