Print Article for : Chronic Back Pain Management

[C672]Chronic Back Pain Management

by Mahsa Khalilifar, Mah

An article from HealthDay News featured on MedlinePlus.com, A service of the U.S. National Library of Medicine and the National Institutes of Health, reports a study which found a correlation between chronic pain and the brain.

The study found researchers in Chicago from Northwestern University's Feinberg School of Medicine using devices to track the pain symptoms with the brain's activity. According to the article, the researchers ?used functional MRI to scan brain activity in people with chronic low back pain while they tracked a moving bar on a computer screen.? They conducted the same procedure with another group of people; these subjects were known as the control group since they had no documented pain.

The study found that people with a lack of pain, had rather balanced brain functions. People who had chronic pain had a brain that showed a variety of emotional symptoms. Since the front region of the brain with the people who had chronic pain seemed to be on overdrive, the region can result in wearing out the brain neurons, according to Dante Chialvo, the study's author; in turn, such findings show that there can be permanent damage done to the brain.

Chialvo, an associate research professor of psychology, also says that chronic pain patients deal with pain constantly -- 24 hours a day. The professor was quoted saying that, ?that permanent perception of pain in your brain makes these areas in your brain continuously active. This continuous dysfunction in the equilibrium of the brain can change the wiring forever and could hurt the brain."

Chronic back pain is usually said to be diagnosed after three months of pain, but can take months to heal. This form of low back pain can cause people to be uncomfortable, and such pain can make it hard for people to get up in the morning and be productive at work. The pain indirectly and directly hurts the individual with pain.

?Approximately 80% of Americans experience [low back pain] during their lifetime. An estimated 15-20% develop protracted pain, and approximately 2-8% have chronic pain. Every year, 3-4% of the population is temporarily disabled, and 1% of the working-age population is disabled totally and permanently because of [low back pain],? according to eMedicine.com, an extension of WebMD.com.

?[Low Back Pain] is second only to the common cold as a cause of lost work time; it is the fifth most frequent cause for hospitalization and the third most common reason to undergo a surgical procedure. Productivity losses from chronic low back pain approach $28 billion annually in the United States,? eMedicine online reports.

The numbers are staggering, as people with pain in the low back are becoming more disabled due to the pain. Becoming depressed, getting anxious, and having a low self-esteem view can result from chronic back pain.

So what can you do if you fear that you may have chronic back pain? Seeing a specialist for your pain is the first step. Once your pain is diagnosed the route to recovery may be a long one, but can happen at a faster pace when discovered at an early stage. Contact your local chiropractor for more information.

On The Net

http://www.nlm.nih.gov/medlineplus/news/fullstory_60971.html

http://www.emedicine.com/neuro/topic516.htm

The treatment of lower back pain is one of the most frustrating challenges a doctor can undertake. It is a specialty filled with misinformation, alternative views and unfortunately old outdated theories. The other problem with the specialty of treating back pain is that it is open to a wide variety of health care providers both main stream and alternative. Therefore a person suffering doesn't know where to turn.

In operating a multidisciplinary back and neck pain clinic I have had the privilege to work with a myriad of specialties including medical doctors, chiropractors, physical therapists and naturopaths and one thing is certain initially everyone has their own ideas based on what they where taught and also on their own experiences. It really is a shame because the medical literature does have many valid and promising studies published on effective treatments for low back pain.

The natural history of low back pain appears to be one of the main reasons this life altering condition hasn't been dealt with properly. For example if pain is the primary indicator used it appears that most episodes of back pain go away within 6-10 weeks. This has been the bench mark for many first time sufferers and those routinely treated in medical clinics around the world. The problem with this form of measurement is that pain in and of itself is not a valid indicator of underlying function of the spine.

A study I think best describes this is one that was published in the prestigious journal SPINE in this study first time back pain sufferers where allocated to two groups one that received traditional medical management including medication and rest and the other a specific spinal rehabilitation program focusing on the deep spinal muscles. Prior to separating the groups however, they performed diagnostic ultrasound studies on the deep muscles of the lower back and saw a 30% decrease in size of the deep spinal muscles on the side of pain.

After 10 weeks everyone recovered fully which would seem to indicate that both treatments were equally successful. The ultrasounds were repeated and only the exercise group recovered the size of the deep spinal muscles. Both groups were no longer experiencing pain however. The biggest difference came when these researchers followed up at one and three year intervals. What they found was quite remarkable, at one year a full 84% of the medically managed group had another episode equal to or worse then the previous episode and at three years 73% of the 84% had another one, compared to 33% of the rehabilitation group.

What this study so clearly indicates is that even though the pain may be gone the functional changes secondary to back pain are still present and contribute to further episodes and disability. This is a powerful example of the need for specific early management using function and not pain as an indicator of response to care. At the Arizona Back Institute every patient goes through a rehabilitation process focusing on restoration of normal spinal strength for the appropriate age and weight matched categories. This ensures the highest probability of a long term recovery. If you have suffered from a recent episode my advice is find a clinic that focuses on function and not just on pain. In a later article I will explain why treatments like epidurals and surgery rarely give the patient the best opportunity at recovery. I will also give you some very effective non-surgical options that are safer and focus on a long term solution.

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Both Mahsa Khalilifar & Randall Pruitt, DC, DACNB, DAAPM, MUAC are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Mahsa Khalilifar has sinced written about articles on various topics from Backpain. Mahsa Khalilifar is a freelance writer for in Irvine, CA. She received her bachelor's degree in communications with an empha. Mahsa Khalilifar's top article generates over 5400 views. to your Favourites.

Randall Pruitt, DC, DACNB, DAAPM, MUAC has sinced written about articles on various topics from Backpain, Backpain. Dr. Randall Pruitt is the president and founder of the Arizona Back Insitute a multidisciplinary back pain clinic specializing in non-surgical treatments. He can be reached at 480-503-3344 or. Randall Pruitt, DC, DACNB, DAAPM, MUAC's top article generates over 12100 views. to your Favourites.