We've Got Your Back

Struggling with back pain? Here are many ways to find relief
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Back pain affects some 80 percent of Americans. In fact, it’s second only to the common cold as a leading cause of doctor visits, and back-related healthcare costs rival those of cancer, arthritis or diabetes. Whether acute (two days to three weeks) or chronic (more than three weeks), back pain can range from a dull discomfort to a burning sensation to a sharp, sudden ache. It can come on suddenly—simply from lifting a heavy laundry basket or twisting the wrong way—or it can develop slowly, perhaps from age-related changes in the spine. Regardless of how it happens, it hurts. Luckily, you don’t have to live with the pain. “The body is a remarkable thing,” says Alfred Gigante, D.C., founder of The Back Pain Center LLC in Waldwick. “Press the right button for the right diagnosis and in most cases the body will respond.”

TYPES OF BACK PAIN— AND CAUSES

Discovering the root cause of your back pain is the key to pain management, explains Thomas P. Ragukonis, M.D., a board-certified anesthesiologist and director of Bergen Pain Management in Paramus. Here’s a look at some of the most common forms this problem takes: Mechanical back pain. This type affects the back’s mechanics—the bones, ligaments, discs, joints, nerves or meninges. It can be caused by a sudden fall, strenuous activity, bad posture or even excessive belly weight. Sprains or strains. An estimated 85 percent of lower back pain cases in the U.S. are the result of a sprained/strained muscle or ligament. Some common culprits: a fall, a car accident, repeated lifting of a heavy object, an awkward twist or sudden movement.

Sciatica. Characterized by pain that radiates along the path of the sciatic nerve (which branches from your lower back through your hips and buttocks and down each leg), sciatica often occurs when a herniated disc or a bone spur on the spine compresses part of the nerve.

Aging of the spine. Discs, those spongy cushions between the rings of spinal vertebrae, are made mostly of water. As you age, they tend to get drier and less able to absorb the impact of heavy lifting, falling, sitting, slouching and exercising.

Arthritis. Several kinds of arthritis, including osteoarthritis (OA), rheumatoid arthritis, ankylosing spondylitis and spinal stenosis (a narrowing of the spinal column that puts pressure on the spinal cord and nerves) can cause back pain. The most common type, however, is OA. This degenerative wear and tear of the spinal joints affects 15 percent of American adults, mostly among those over age 45.

Osteoporosis. This bone-thinning condition can make the vertebrae of the spine more susceptible to fractures, so that even something as simple as moving furniture can cause injury and pain.

Obesity. Excess body weight can mean increased strain and back pain for many people. In fact, according to the National Institutes of Health, obesity is associated with various musculoskeletal disorders, including OA and impairment of the spine.

TREATMENT OPTIONS

“Today there are wonderful discoveries that bring relief and help patients return to normal lifestyles,” says Dr. Gigante. From tried-and-true treatments to alternative approaches to new advances, the trick is working with your healthcare provider to find one that’s right for you. “There’s no one-size-fits-all treatment,” says Richard D. Santucci, D.C., of Bergen Family Chiropractic Center in Hackensack. “You are an individual and the last thing you want is the same treatment as the person before you.”

The mild procedure: Used most often to treat lumbar spinal stenosis (narrowing of the spinal column that occurs as a result of wear and tear), this is one of the more recent advances in back pain treatment. Using special surgical instruments, surgeons are able to remove the bone or tissue causing pressure on the nerves, without cutting into the muscles, bones and ligaments. The procedure takes about an hour, in an outpatient setting, and patients are often allowed to go home the next day. “As a result of new technology, you can fix certain things in the spine without open surgery—in a surgical center where patients can go home after the procedure,” says David Gamburg, M.D., director of injection therapy and pain management at Montvale Health Associates.

Endoscopic facet rhizotomy: A new and minimally invasive spine surgery, this procedure allows surgeons to use a tiny scope to locate—and permanently destroy—pain-conveying nerves in the facet joint, located on the sides of the back and involved in most movement of the spine. “It takes less than an hour and the patient is basically cured,” explains Dr. Gamburg, who specializes in this procedure. Hot or cold applications: Heat and ice, especially when used alternately, have been found to relax the muscles and decrease muscle inflammation. The Cleveland Clinic recommends applying heat for 20 minutes and then ice for 20 minutes, and then repeating this pattern two to three times per day.

Exercise: Though it’s not recommended for acute back pain, exercise has been found to ease chronic pain and prevent further injuries. And according to the American Academy of Physical Medicine and Rehabilitation, resting can actually worsen back pain. Gentle stretching and yoga have been both study-proven to improve flexibility and relieve tight, stressed muscles.

Medications: Over-the-counter pain relievers such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are frequently used to treat mild to moderate back pain. If the pain is severe, your doctor may also prescribe a muscle relaxant or a narcotic (codeine or hydrocodone).

Physical therapy: This is often the first course of treatment for back pain. The goal is to increase strength, flexibility and function through a variety of treatments, including heat, ultrasound, electrical stimulation, muscle-release techniques and at-home exercises. Injections: If oral medications and other nonsurgical treatments fail to alleviate the pain, doctors may recommend injections containing a steroid medication or anesthetic for pain relief.

Chiropractic treatment: Nearly 22 million Americans visit chiropractors each year—and of these, 35 percent are seeking to ease back pain. A chiropractor often works to restore mobility and realign the spine. Therapy generally takes several visits to be effective.

Behavioral modification: Because back pain can stem from everyday habits—smoking, inactivity, poor posture and irregular sleep—relief may come from adopting healthier behavior.

Spinal decompression: A type of motorized traction, spinal decompression works by gently stretching the spine in order to take the pressure off the spinal discs.

Surgery: Although it’s often a last resort, certain types of back surgeries can help to relieve pressure on the spine: discectomy, laminectomy, fusion, vertebroplasty and disc replacement.

Laser therapy: Cold laser therapy or low-level laser therapy utilizes wavelengths of light to interact with tissue in order to eliminate pain and swelling, reduce spasms and increase functionality.

Acupuncture: This ancient form of alternative medicine, which involves placing very thin needles in strategic positions in the body, has been found more effective than anti-inflammatory drugs, exercise or physical therapy in reducing low back pain among osteoarthritis patients. Acupuncture appears to reduce inflammation and stimulate the body’s natural opiate production.

Biofeedback: This alternative therapy uses electrical sensors to help you use your mind to control bodily functions, such as muscle tension, that are known to cause back pain.

Massage: Massage has been found to reduce levels of the stress hormone cortisol, which is associated with pain. It may also decrease levels of a hormone that constricts blood vessels and raises blood pressure, both of which can boost pain.

 

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