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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
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...
If you walk into any drug store, mega-box store or sporting goods store, you’ll be sure to find a variety of lumbar supports, back braces and alike. Because these devices are readily accessible, many users grab one off the self before seeking professional advice. That’s not necessarily a good idea because back braces offer a mixed bag of benefits and risks.
Now, strapping on an elastic lumbar support is tempting as a means to relieve pain and keep on going. And for the most part, these medical devices can help to accomplish that goal. The wrap-around support mimics the internal support that supposed to be provided by the abdominal muscles. Because many people have weak core muscles , the extra bracing does help sometimes. It’s probably most helpful in someone with disc degeneration as opposed to someone with lumbar stenosis . And it’s probably most helpful in average-weight individuals that don’t carry a lot of belly fat. Even if you don’t get ...
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