The Truth About Back Surgery
So What Does Help? continued...
Over-the-counter anti-inflammatories like naproxen (Aleve) and ibuprofen
(Advil, Motrin) can reduce pain. In an extensive set of treatment guidelines
issued by the American College of Physicians (ACP) and the American Pain
Society (APS) in 2007, these meds were found to offer "moderate" benefit. While
that may not sound encouraging, prescription painkillers also came in as
Your goal is to stretch and strengthen back muscles, which can bring
significant relief as you ease tightening and spasms. The same ACP/APS set of
guidelines found that exercise therapy and yoga, with its emphasis on
stretching and body control, are the best workouts for back-pain sufferers. But
don't "stretch through" or "push beyond" anything truly painful. A physical
therapist can show you how to exercise safely and for the most benefit.
Some people swear by chiropractic treatments; others are skeptical. And the
scientific evidence is just as mixed. A 2004 review of 39 randomized,
controlled studies published by the Cochrane Collaboration found that "spinal
manipulation was more effective in reducing pain and improving ability to
perform everyday activities than sham therapy." But, the researchers concluded,
"it was no more or less effective than medication for pain, physical therapy,
exercises, back school, or the care given by a general practitioner" for
patients with acute or chronic lower-back pain. If the pain's in your neck,
think twice about chiropractic; it's rare, but neck manipulations can trigger a
Many women are familiar with epidurals, having experienced the shots'
pain-numbing relief during childbirth. For backs, injections generally contain
an anesthetic (like procaine), as well as a steroid (like cortisone) to calm
inflammation. Epidurals can't cure back problems, but they may buy you some
pain-free time while the disc has a chance to heal and shrink. Relief tends to
be modest and short-lived (three months at most).
In a recent, well-designed study of 638 patients with chronic back pain, those
who received acupuncture (10 treatments over seven weeks) improved considerably
more than a group receiving continued "usual care" (no special treatments —
just medications, physical therapy, or whatever they'd been doing). Even after
a year, the acupuncture group was significantly better off. But here's a
surprise: Simulated acupuncture (stimulation of acupuncture points with a
toothpick in the traditional needle-guide tube) turned out to be as effective
as the real thing. Researchers speculate that stimulation of acupuncture points
without breaking the skin — or a placebo effect — provided the relief.