Illustration: (c) Anne Asher 2007 Licensed to About.com

Back pain is ubiquitous. Lots of new treatments and tests have emerged in recent years to try to address it. A 2009 study led by Richard Deyo, MD, PhD, and notable patient advocate specializing in spinal treatments, found that Medicare payments for spinal epidurals, spine MRIs, opioid pain management, and spinal fusions have shot up significantly since 1994. This is most likely a combination of more procedures done and an increase in cost for those services.

So how well did the recipients of the treatments and tests do? Deyo says there are not a lot of follow up studies, but the ones that have been done suggest that back pain is actually increasing. For example, he reports that the US Medical Expediture Panel Survey found several factors that usually go with back pain (like limitations in what you're able to do and your mental health) actually rose between the years of 1997 and 2005.

One might think that with the increase in costs and use of new spine treatments, the people on the receiving end would feel better for the experience.

Do You Really Need All That Treatment for Your Back Pain? originally appeared on About.com Back & Neck Pain on Monday, March 8th, 2010 at 15:37:23.

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If you have chronic or subacute low back pain, what do you do to cope with it?

A recent study from England looked at 700 people with back pain lasting longer than about a week (subacute and chronic back pain patients). They gave approximately half of the patients an assessment and advice on what to do, or "standard treatment". The other half received cognitive behavior therapy. CBT is a short term therapy that helps people identify the things that trigger their pain, and to take actionable steps to manage them.

The researchers found that after a year, not only did the CBT help reduce the peoples' pain, but it did so at a low cost.

About.com's Depression Guide, Nancy Schimelpfening, has a great intro article on cognitive behavior therapy.

_{Source:
Lamb, S.E. et al. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, Early Online Publication, 26 February 2010}

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A Low Cost Way to Cope with Back Pain originally appeared on About.com Back & Neck Pain on Monday, March 1st, 2010 at 15:03:15.

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Photo: (c) Alvimann

The recent tragedy at the Winter Olympics site in Vancouver has me thinking a lot about the risk-taking I do (and refuse to do). Wearing a helmet, for example, can reduce the risk of a serious neck or head injury. So I wear one, along with my seatbelt, even when I don't feel like it. How about you? How do you keep your neck safe? Share your precautions (or confessions).

Here are some more ways to prevent a broken neck.

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Preventing Broken Neck originally appeared on About.com Back & Neck Pain on Sunday, February 21st, 2010 at 10:17:47.

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Falling is a leading cause of neck fracture in senior citizens and the elderly. Falls can have devastating consequences, so prevention is the best medicine. The Daily Spine has a few tips on ways to prevent falls in elderly people.

More from The Daily Spine:

| You Don't Have to Throw Your Back Out | Aspirin for Back Pain | Morning Spine Stretches |

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Elderly People Can Prevent Falls originally appeared on About.com Back & Neck Pain on Monday, February 15th, 2010 at 09:00:05.

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Photo: (c) kingvald

About 90% of kids wear backpacks. Have you ever wondered what this does to your child's spine?

A new study, published in the Jan 1 issues of Spine found that heavy backpacks can damage children's spinal discs, increase spinal curvature and cause back strain (and pain).

According to press materials, the study took MRIs of kids wearing different backpacks weighing up to 26 pounds. The researchers added 10, 20 and 30 percent of the childrens body weight with backpack weight and measured spinal changes.

Most of the time, backpacks range between 10 and 22 percent of a child's weight.

As the backpacks got heavier, the childrens intervertebral discs became more compressed. Wearing back packs also increased abnormal side to side curves, beginning at 18 pounds. At 26 pounds, kids needed to adjust their posture to accommodate the pack.

Unfortunately, the negative effects of wearing a heavy backpack may carry over into adulthood. Children with back pain are at a greater risk for back pain during adulthood. This post has a few tips for how to minimize the pain.

_Source:

_{Press Release. Heavy Backpacks Affect Children's Spines. Newswise. Jan 27 10.}

| Tips for Wearing Backpacks | Back Pain | Scoliosis |

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Backpacks and Back Pain - Is Your Child at Risk? originally appeared on About.com Back & Neck Pain on Monday, February 8th, 2010 at 11:08:16.

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Photo: (c) Adam Ciesielski

When you go to your family physician for relentless back and leg pain, you may get a referral to a spine surgeon. But are you sure you and your doctors are on the same page about what to expect from back surgery? A new study may shed some light.

The study presented scenarios to both family docs and spine surgeons and asked at what point surgery would be the treatment of choice. I found it interesting that the spine surgeons were the most conservative bunch. They said that if the patient has more leg pain than back pain, that's when they would consider surgery. This is most likely because leg pain usually means a nerve root is affected.

In contrast to surgeons' preferences, patients and family doctors had a higher preference for surgery. When patients have neurological symptoms, and/or impaired walking and lots of pain, the family physician tend to prefer surgery. The researchers suggest that family doctors may not have a grasp on which factors contribute to good outcomes in back surgery.

_Source:

_{Press Release. Surgeons Less Likely than Family Doctors to Prefer Back Surgery. Newswise. Jan 28 10.}

| Types of Spine Doctors | Back Pain | Back Surgery |

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Back Surgery - Align Your Expectations with Your Doctors' originally appeared on About.com Back & Neck Pain on Monday, February 1st, 2010 at 23:10:24.

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Recently the American Academy of Neurosurgeons reviewed medical studies on TENS, which is a small device you wear to mask the pain. It is a mild form of neurostimulation. The AAN found that TENS is not really effective for back pain, and they recommend against it for this purpose.

TENS is a conservative treatment. Spinal cord stimulation is an invasive pain management therapy that does pretty much the same thing but with a lot more intensity. You might think of spinal cord stimulation as the industrial strength version of TENS. The main differences are that spinal cord stimulators have to be surgically implanted, and the impulses they deliver are much more powerful and flexible than those of TENS. Of course SCS is not for everyone. If you think it might be for you, check with your doctor or pain management specialist.

Although currently there are few studies on how spinal cord stimulation addresses chronic back pain, it is a promising therapy. There will likely be more studies done in the future.

| Neurostimulation | Back Pain | Neuromodulation |

_Source:

Richard M. Dubinsky MD, MPH, FAAN and Janis Miyasaki MD, MEd, FAAN. Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2009, doi:10.1212/WNL.0b013e3181c918fc.

Therapies to Mask the Pain Signals originally appeared on About.com Back & Neck Pain on Monday, January 25th, 2010 at 14:35:56.

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Photo: (c)Handout Getty Images

The New York Times estimates that the death toll in Haiti will reach between 100,000 and 200,000. Much of the attention paid to this devasted country is rightly focused on the death count, as well as the lack of basic supplies and the overwhelming medical needs of the victims and their families. But little has been said about the needs of those who sustained spinal injuries. An earthquake such as this one makes it virtually impossible to treat an injury safely and in a timely way. For example, moving someone who has a spinal cord injury, even if for their own safety, can increase the chances of paralysis or death. Also, getting the appropriate treatment as soon after the injury is a critical key to getting well again.

If the 7.9 magnitude quake in May 2008 in China is any indication, over 50% of victims may experience nerve injury and subsequent disability. There will likely be a large portion who have spinal injuries in more than one area of their back, and nearly all injuries to the neck will result in a spinal cord injury. Spinal cord injuries usually result in permanent paralysis.

<sub>Sources:

Reuters. Haiti Says 200, 000 May Be Dead, Violence Looms. Jan 15 10. http://www.nytimes.com/reuters/2010/01/15/world/international-uk-quake-haiti.html


Chen R, Song Y, Kong Q, Zhou C, Liu L. Analysis of 78 patients with spinal injuries in the 2008 Sichuan, China, earthquake. Orthopedics. 2009 May;32(5):322.</sub>

New York Times. Sichuan Earthquake. May 09. http://topics.nytimes.com/topics/news/science/topics/earthquakes/sichuan_province_china/index.html

| Spinal Cord Injury | Back Pain | What to Do in Case Of a Neck Emergency |

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Spine Injuries in Earthquakes originally appeared on About.com Back & Neck Pain on Monday, January 18th, 2010 at 12:23:29.

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Illustration: (c)Anne Asher 2007 Licensed to About.com

Most of the time, back pain is muscle or posture related, which means, it's likely that it is not serious enough to warrant the attention of a medical doctor. But what about those times when at-home therapies, holistic therapies or a visit to the chiropractor doesn't address the pain?

When you go for that initial appointment with either your primary care physician or a specialist, the first order of business is to get a diagnosis. "A successful treatment is based on a sound diagnosis," says Dr. Jack Stern, neurosurgeon and pain management specialist in White Plains, New York. "You need to know what's wrong before you can determine the best way to fix it."

When the doctor diagnoses you, she is looking to correlate the results of your exam and any diagnostic tests with the signs and symptoms you present. So, it's important to communicate well with your doctor.

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Getting a Diagnosis originally appeared on About.com Back & Neck Pain on Tuesday, January 12th, 2010 at 21:19:44.

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Photo: ladyheart

Another day, another snowstorm, it seems. If you are headed out to clear the stuff, the American Academy of Orthopaedic Surgeons has a few back saving tips for you:

• Warm up your muscles before doing the heavy work. About 10 minutes of a light aerobic activity such as walking will do. Stiff muscles that work hard are more prone to injury.
• Don't be a hero or heroine. This means go slow enough so that you can get all the work done with ease. Stay hydrated and take breaks when you get winded.
• Use a shovel that fits you. It should be comfortable height-wise and width-wise. It shouldn't be too heavy, either. Keep a fair amount of space between your hands in order to increase lifting leverage.
• Use your legs, not your spine, meaning, for one thing, don't bend over at the waist when lifting. This illustrated guide to digging in the garden goes over the biomechanics for shoveling. (The snow is missing from the pictures, that's all.)
• If you can push the snow out of the way instead of lifting it, then do so.
• Try to scoop a lot of little loads instead of fewer big ones. Definitely don't try to get all the way down to the bottom of a deep snow all at once.
• When you dump the snow, Turn your whole body by taking a few steps rather than twist your spine. Studies show that twisting the spine when carrying a load can lead to a disc injury.

| How to Shovel Safely | Back Pain | Back Strain |

Your Back Safe Shoveling Technique originally appeared on About.com Back & Neck Pain on Thursday, January 7th, 2010 at 19:33:55.

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