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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...
Many would argue that back pain is inevitable and for some it becomes a sudden reality. Bending over to pick up a piece of paper, moving furniture, or reaching for something in the car's back seat; one of these scenarios may sound familiar to you. At home or at work, you need to know what to do when a sudden attack of back pain occurs. Fortunately, most back pain will get better naturally. But in order to improve your chances of recovery and to save yourself a trip to your doctor's office, you need to learn some first aid for back pain.
Those of you familiar with life-saving first aid remember the ABC's (Airway, Breathing, and Circulation). Let's apply the ABC's to your back; "A" for arrest the offending activity, "B" for balance the pressure, "C" for control the inflammation. With the ABC's for sudden back pain, you can quickly recover from a sudden back pain attack.
Let's go back to the scenarios: bending, lifting, and twisting (the BLT's). All of these activiti...
If I had an episode of lower back pain, am I always going to be more likely to have lower back pain in the future?
It is true that once you have an episode of lower back pain or shooting leg pain, you are probably more likely to have it in the future - if you do nothing. But you are not going to "do nothing."
I see a lot of patients with lower back pain and shooting leg pain. Once we work together to resolve the pain, a very common question and concern that is raised is whether the pain is likely to return. A typical example is the following: Mr. X comes in with lower back pain that shoots into the right leg all the way to the foot. MRI reveals a herniated disc at L5-S1 level. After an injection, the pain is 90% better. Next, Mr. X starts physical therapy. Six we...
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