Treating Lower Back Pain

By: Dawn Black - [health]
Posted 06/14/04

Annapolis, MD March, 2004- It has been reported that 70-85% of all people have back pain sometime in their lifetime, and about 5-10% of those develop a chronic condition. Management of low back pain remains a difficult challenge. Back pain is ranked second as the most frequent location of pain and a reason for a visit to the doctors. It is the mostcommon ailment of the working-age adult, affecting millions of people each year in the U.S. and weighing an economic burden on our health care system of up to $100 billion. Treatment of low back pain is the most expensive healthcare cost in the U.S. Back pain is also the number one cause of permanent disability for Americans under the age of forty-five.

Back pain can be categororized in two phases: acute pain and chronic pain. Back pain is considered acute during the first six weeks. Most LBP will disappear within six weeks regardless of intervention. Back pain continuing beyond six weeks, is considered to be chronic. - April 1, 2004 -- Frequently recurring LBP is also considered to be chronic. It has also been referred to as LBP that lasts beyond the expected healing process. Chronic low back pain can interfere with sleeping, walking, sitting, exercising, and driving. Many people suffer from LBP as a result of an increasingly inactive lifestyle. Chronic low back pain is often preventable. Most symptoms occur because poor habits have developed over a long period of time.

Exercise has been recommended as part of the treatment of chronic low back pain for decades. It is recommended that patients with LBP becomes as physically fit as possible using exercises such as aerobics and cardiovascular fitness, flexibility and muscle strengthening.

Intensive exercises reduce pain and improve muscle function. However, maintaining and adhering to the exercise program that is required for a long term care is difficult.

The human spinal column is an extraordinary mechanism, providing the stability we use to stand upright and the flexibility needed for active movement. An isolated human spine can only withstand five pounds of pressure before it buckles. This shows the importance of soft tissues (muscles, ligaments, and tendons) that surround the spine and allow it to perform the normal physiological movements. Most injuries occur when some outside force exceeds an individual's structural capacity. Most low back pain occurs during an unguarded moment when an individual reacts suddenly by turning, twisting, stooping, or bending in an unusual manner. Chronic low back pain can interfere with sleeping, walking, sitting and driving. Many people suffer from LBP as a result of an increasingly inactive lifestyle. It is often preventable. Most symptoms occur because poor habits have developed over a long period of time.

The natural reaction to pain is to adjust movements that cause the pain. Pain leads to disuse, leading to muscular atrophy and atrophy leads to weakness, allowing recurrent injury. The continuous cycle is referred to as chronic deconditioning, which should be avoided at the onset.

A variety of medication types are used to treat low back pain. Acetaminophen, such as Tylenol, is the most commonly prescribed medication for mild to moderate LBP. NSAIDs (non-steroidal anti-inflammatory drugs), such as Advil, Motrin, or Naprosyn, are helpful in reducing both pain and swelling. Muscle relaxants, such as Flexeril or Soma, are used to depress muscle spasms. Opioid pain relievers, such as codeine or oxycodone, are very effective in treating LBP and have shown to be more effective for pain than other types of medication. Corticosteroid injections can be used for short-term relief, but should not be used more than twice yearly. Tricyclic anti-depressants, such as Elavil or Tofranil, are used when mood is affected by LBP. Low doses also act as pain relievers.

Other treatments include: Comprehensive rehabilitation programs, such as ''back schools,'' or pain center programs, help those with LBP to learn behaviors and therapies to manage the pain. Manipulation therapies, including chiropractic, can help reduce pain and increase motility. Surgery is rarely used for chronic low back pain, and typically only when spinal disks or other tissues become damaged. Acupuncture has not conclusively been proven (nor disproven) to help with LBP.

Not all treatments work for all people; new treatments are continually sought. New medications are tested in research studies called clinical trials for their safety and effectiveness before being available for prescription. Participation in these clinical research trials provides opportunities for patients to aid in the development of new treatments and new ways to deliver treatments for their condition.

A medication delivered via a new transdermal patch technology is now being evaluated nationwide to treat chronic low back pain. The patch has an adhesive that attaches to your skin. The goal of this research study is to evaluate the safety and effectiveness of the patch for the treatment of low back pain (LBP).

Potential study volunteers ages 18 and older must have moderate to severe chronic low back pain for at least three months, as confirmed by radiographic (x-ray) evidence, and must be taking strong prescription pain medication for their low back pain. Qualified participants will receive study-related exams, lab tests, and study medication. Potential study volunteers can call 1?877-5-ATTACH (1-877-528-8224) for additional information.

Patients in 49 cities nationwide can volunteer for this clinical trial and be referred to a participating physician in their area. For more information and pre-screening, potential study volunteers can call Clinical Research Associates at 1-877-5-ATTACH.

Potential study participants must have moderate to severe chronic low back pain for at least three months, as confirmed by radiographic (x-ray) evidence, and must be taking strong prescription pain medication for LBP. Qualified participants will receive study-related exams, lab tests, and study medication. Potential study volunteers can call 1?877-5-ATTACH (1-877-528-8224) for additional information.

Available for Interviews
Please contact Community Outreach Network at 1-800-664-5099 to arrange an interview. There are 55 participating physicians in the US. Doctors participating as investigators in the study have experience with treating low back pain and/or clinical research.

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