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Back Pain Health Center

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Low Back Pain Shouldn't Sideline You

Explore the common but under treated and misunderstood issues that accompany chronic back pain in our Back Pain Series. Part 1 explains the latest treatments that could relieve that aching back.

First Things First continued...

Your best bet is to seek treatment from a "comprehensive program that specializes in pain with a wide range of services available so that treatment is determined by what you need -- not by what's available," he says.

"If you have back pain that lasts six weeks or more, seeing a specialist is a reasonable thing to do and the main reason is to make sure it's not a more serious condition that presents as back pain such as infection, tumor, fracture, or aortic aneurysm," says Scott D. Boden, MD, an orthopaedic surgeon and director of The Emory Orthopaedics and Spine Center in Atlanta.

Medication Milieu

For mild to moderate symptoms, over-the-counter painkillers such as acetaminophen, aspirin, or ibuprofen can help along with heat or cold applied to the back. Massage, acupuncture, and chiropractic treatment may also play a role for some people. Adjusting or modifying your activities may help; light activity may actually speed recovery.

Not for David. He has tried just about every medication and every alternative treatment for back pain, and nothing really did the trick for long. The new thinking is that "chronic back pain may be chemical and that's why some of the older treatments don't work," Saper explains. "There may be a chemical basis for sustaining the pain."

That said, there may be a role for treatments such as the tumor necrosis factor-alpha (TNF-alpha) blockers used to treat joint inflammation caused by rheumatoid arthritis. These medications, also known as biological response modifiers, neutralize specific chemicals that are key players in the inflammatory process.

The antidepressant Cymbalta (duloxetine) has been approved for chronic back pain as well. It's a serotonin-norepinephrine reuptake inhibitor, or SNRI, that was first approved by the FDA in 2004.

Richard D. Guyer, MD, spine surgeon at the Texas Back Institute in Plano, says different types of drugs like seizure medications including Topamax and Neurontin may also help relieve pain. "They are not for everybody, but they may have a role for people with previous spinal surgery and chronic leg or arm pain," he says.

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