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    Heat Treatment Soothes Chronic Back Pain

    WebMD Health News
    Reviewed by Gary D. Vogin, MD

    May 1, 2002 -- A high-tech treatment that heats the spine from the inside may provide lasting relief for some people with chronic back pain that hasn't responded to conventional treatments. A new study shows the procedure, called intradiscal electrothermal therapy (IDET), can reduce pain and improve functioning for up to 2 years.

    The study appears in the May 1 issue of the journal Spine.

    The treatment isn't right for everyone with chronic back pain, though. Only about 5% of patients referred to the study for chronic low-back pain were good candidates for the procedure. Researchers say the ideal candidates all had "unremitting, persistent" disc-related low-back pain that did not improve after treatment with medications, physical therapy, exercise, and steroid injection.

    IDET involves placing a miniature catheter with a heating element into the center of the damaged or degenerated disc that is causing the pain. The heat toughens and seals the disc and destroys any abnormal nerve endings that might be causing pain. It is performed using local anesthesia and does not require hospitalization.

    Study authors Jeffery A. Saal, MD, and Joel S. Saal, MD, of the SOAR Physiatry Medical Group in Menlo Park, Calif., performed the procedure in 58 patients and tracked their progress over two years. Within six months after IDET, the patients had a significant reduction in pain and increase in physical function, including improvement in the ability to sit upright for longer periods of time.

    After two years, the patients continued to show more improvement in both pain and physical functioning scores. Pain scores had dropped to an average of about 3.4 on a 1-to-10 scale from an average of 6.6 before treatment. Sitting time also increased to 85 minutes from 33 minutes at the start of the study.

    Researchers say the patients also reported improvement in various aspects of their life, such as emotional and mental health, after IDET.

    In an editorial that accompanies the study, Timothy S. Carey, MD, of the University of North Carolina calls the long-term results "reassuring." But Carey says there are still many unanswered questions about IDET and says more research is needed on the procedure that compares it directly with other treatments.

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