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...
My Garden, and Oh My Aching Back
My gardening hobby was taken away from me at the age of 29. SCHREEEECH! Wait a minute, I don't think so. Getting my hands dirty, watching my plants thrive, and smelling my roses; I cannot give this up. No way! When my back says no , I find another way. I have learned to adapt my gardening habits to suit my physical abilities because giving up a pleasurable activity is not an ideal option. Being smarter than my problem is the best option. Here are some ways that I have continued to enjoy my garden.
1. Staging Projects
I used to prune all 25 of my roses in one day. Those days are gone, baby, gone. Now, I stage such big projects over the course of multiple days. On the first day, I might prune five rose bushes; the second day maybe three bushes and so on. By spreading the task out over time, I allow my back to recover. I do not let my back get too overwhelmed. This concept can apply to any chore. Everything gets done eventually. Pacin...
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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