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    Understanding Back Pain -- Diagnosis and Treatment

    What Are the Treatments for Back Pain? continued...

    In cases of persistent pain from extreme nerve damage, rhizotomy -- surgically severing a nerve -- may be necessary to stop transmission of pain to the brain. Rhizotomy can correct the symptoms caused by friction between the surfaces in a spinal joint, but it doesn't address other problems, such as herniated discs.

    Chiropractors have a role in the treatment of back pain. The U.S. Agency for Healthcare Research and Quality recognizes spinal manipulation by chiropractors and osteopaths as effective for acute low-back pain. Its effectiveness for treating chronic back pain is less well-established. Some researchers suggest that early chiropractic adjustments for acute back pain may prevent chronic problems from developing. Other doctors warn against some chiropractic manipulations, particularly those that involve rapid twisting of the neck.

    Osteopathic treatment is likely to combine drug therapy with spinal manipulation or traction that may be followed by physical therapy and exercise.

    Research has shown that acupuncture may bring relief for many chronic back pain sufferers. There doesn’t seem to be any difference, however, between the relief brought on by acupuncture as opposed to simulated acupuncture. More research is needed to find out why both techniques are effective. Acupuncture can be used alone or as part of a comprehensive treatment plan that includes medications and other therapies.

    If you consult a psychotherapist for cognitive behavioral therapy (CBT), your treatment may include stress management, behavioral adaptation, education, and relaxation techniques. CBT can often lessen the intensity of back pain, change perceptions about levels of pain and disability, and even lift depression. The NIH considers CBT useful for relieving low back pain, citing studies that show CBT to be superior to routine care and placebo. Other comprehensive behavioral programs have shown similar success, with participants able to lessen the amount of medication they needed while improving their outlook and pain-related behavior.

    If lower back pain is related to muscle tension or spasm, biofeedback may be effective for lessening pain intensity, decreasing drug use, and improving quality of life. Biofeedback may help you train your muscles to respond better to stress or movement.

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