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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.

No Pain, No Gain? continued...


Just as David K. crawled to class, "people become experts at protecting their back and learn to do activities without using it to protect it, but you pay a price -- you essentially lose a lot of functional ability with the part of body that you are trying to protect," he says. "Your back is becoming more fragile [but] aggressive physical strengthening can increase the capacity of your back and you typically will have a very significant decrease in pain," he explains.


"A key part is putting people in positions and using special equipment that does not allow them to cheat and forces them to move a body part that they don't feel like moving -- their back," he says. This is for people with chronic back pain, not acute injuries, he stresses.


"Our goal is to make sure they are better a year from now, five years from now, and 10 years from now, and the only way to do that is to aggressively strengthen the back and show them how to maintain it," he says.


"If you read this article and say, 'this makes sense to me,' look around your community and call some places and say, 'I am looking for a fitness approach to back pain," he suggests.


Guyer says, "People that get into active strengthening exercises really do the best because they also get a release of endorphins to control the pain," he says. Endorphins are considered the body's own "feel-good" or "pain-killing" chemicals and are known to be released with exercise.

The Changing Face of Spinal Surgery

Only a small percentage of patients with back pain are candidates for surgery, but for these patients, advances in techniques have made recovery a much easier road, says Boden of The Emory Orthopaedics and Spine Center.


Fifty years ago, a spine fusion meant a two-week hospital stay, a body cast or brace for months, and a minimum of six months away from normal activities. A spinal fusion is performed by fusing the vertebrae together with bone grafts to eliminate motion between two adjacent vertebrae where motion is causing lower back pain.


Today, minimally invasively techniques allow for smaller incisions, less blood loss, and faster recovery time, Boden says. Some spine fusion techniques can be done on an outpatient basis.


Fifty years from now, Boden predicts that disc replacement will be an alternative to spinal fusion. Moreover, gene therapy will be able to prevent or reverse disc degeneration, and genetic research will help discover genetic sources of back pain, he says.


"Gene therapy for disc regeneration may be more than five years off, but less than 20," he predicts.

Reviewed on July 14, 2004

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