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Eighty percent of Americans suffer from back pain at some point in their lives. Americans spend $50 billion each year on low back pain and it is the most common cause of job-related disability and a leading contributor to missed work. Bottom line, back pain is more wide spread than the common cold. Most people are misinformed about both the causes of their pain and the treatments available to solve their problems. The more you know about how your back works and the reasons why it hurts, the easier it will be for your physician to correctlydiagnose and treat your back pain. Keep in mind these 3 things: 1) Correctly diagnose your problem Know how your back works and why it hurts. Positively identify the type of pain that is ruining your life by understanding back mechanics. 2) Become an educated consumer Know which treatments are currently available, safe, and recommended to helpback pain. 3) Combine the diagnosis with treatment As many of my patients have learned, it's important to try different things. Each patient responds differently to treatments, exercises and medicines. If your case is one where self-treatment does not improve your overall well-being, you can work with your doctor to achieve a more pain-free life. |
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 Back pain will ruin any day, and it has certainly ruined a few of mine. That's why I have written Heal Your Back, not only because I've been treating my patients for back pain, but, because my own pain has given me the kinds of insights that helped me develop my basic back pain relief and ABC prevention plan. Heal Your Back is a complete program for understanding the causes of low back pain, the ways to prevent it, and the treatments to eliminate it. While other books recommend a specific type of treatment, Heal Your Back includes exercises and nutrition advice as well as information on chiropractic therapy, acupuncture, medicines, and surgery. This self-care program will help put you back in control of your back pain. |
Dr. B’s Q&A
Answers to Common Questions
about Back Pain
Q: Aren't stiffness and aches in the morning just part of growing older?
As we grow older, we may have a little stiffness or backache in the morning, but this should not last more than 15 to 30 minutes. Stiffness lasting for hours may a sign of a more serious illness, such as an inflammatory arthritis of the spine. Symptoms such as these should be evaluated by a doctor.
Q: What symptoms signal the need to see my doctor?
Consider the following “red flags”:
1) Fever or weight loss
2) Increased pain when lying flat in bed
3) Prolonged morning stiffness lasting for hours
4) Bone pain over the spine
5) Back pain associated with eating or menstrual cycle.
These danger signs are associated with medical illnesses that should be evaluated by your doctor.
Q: I hurt my back this past weekend working on chores around the house. I took ibuprofen (Advil) for the past two days and don’t feel much better. Should I call my doctor?
Most episodes of back pain will improve or disappear within a week or so. Two days may seem like an eternity but is not a long time in the usual course of a back problem. Simple analgesics like Advil are usually adequate to take care of a simple back problem. If the pain gets worse, or if the dose of Advil you need to control the pain is much higher than the recommended dose on the box label, contact your doctor.
Q: If one of my parents has back pain, am I prone to experience it, too?
Some forms of back pain are genetic. That means that your parents can pass on certain physical characteristics, which make you prone to developing certain back problems. Inflammatory arthritis of the spine is most commonly associated with a genetic factor, HLA-B27. This genetic marker predisposes individuals who come in contact with something in the environment to develop arthritis. There is also evidence that the chances of developing disc degeneration runs in families.
Q: Can stress cause back pain? What can I do to alleviate it?
Stress does not cause back pain. It makes it worse if you have it. The neck is a particular place where stress can cause muscles to tense and fatigue. The fatigue causes the muscle to ache. Recognizing that stress is making the problem worse helps alleviate it. Topical therapies like local heat can make the problem better. Get up, move around, and stretch. Staying in one place makes matters worse.
Medications & Treatments
Q: I have chronic lower back pain. For years, I have been taking a prescription medicine – one of the non-steroidal, anti-inflammatory drugs. How long can I safely take medicine like this?
Non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, if taken as prescribed by your doctor or according to the label found on the box of over-the-counter medicines, can be taken for years without developing any side effects. I have patients with rheumatoid arthritis who have been taking one of these “aspirin-like” medicines for a decade or more. People who are taking these medicines on a regular basis need to be followed by a physician to be sure that no side effects appear over time.
Q: I've heard there may be safety problems with Tylenol (acetaminophen) if I take too much of it or take it too often. Is this true?
The top dose of acetaminophen over a 24-hour period is 4000mg. That amount equals 8 extra-strength Tylenol tablets. The major side effect of acetaminophen is damage to the liver. People who take the maximum dose of the drug and drink alcohol are at risk of developing severe liver damage.
Q: My doctor has suggested I see a chiropractor. What can I expect a chiropractor to do to help me?
Chiropractors are health professionals that work with patients with back problems. They use a variety of techniques, including manipulation, to make the spine move better. Some people find the therapy from a chiropractor very helpful in improving motion and decreasing pain. Ask your doctor to recommend a physical therapist or a chiropractor who has experience taking care of your particular problem.
Q: I have been seeing my general doctor for years for my health care. Since I have increasing back pain, I would like to ask for a referral to a specialist. I don’t want to hurt my doctor’s feelings by going to another doctor. I know my insurance will cover a specialist only if my primary care doctor asks for the referral. What’s the best way to approach this?
I always feel that open, honest communication is important. If your back pain is getting worse, an evaluation by a specialist is a good choice. Any information that your primary care physician has already obtained can be of great help in your evaluation. Collect that information prior to your visit to the specialist. Take it with you so that the specialist does not need to repeat tests that have already been done. Be sure that your specialist sends a report about your visit to your primary care doctor.
Nutrition & Exercise
Q: I’ve heard some herbal remedies are good for bone and joint health. Can you tell me any I should try?
The combination of herbal remedies most often prescribed for bone and joint problems is glucosamine and chondroitin. These supplements are commonly used for problems with the knees and hips. These supplements have not been demonstrated to be helpful for problems in the spine. Just think about how different the structure of the spine and knees and hips are. They are made up of different types of cartilage. The cartilage in the spine does not respond as well as that in the hips and knees. Herbal remedies that help pain may be of some benefit. If you are going to experiment with herbal remedies and you are already taking a prescription or over-the-counter drug, you should consult your doctor, as the combination of herbal remedies and some other medicines can cause extreme, irreparable harm. Use caution when considering a combination of remedies.
Q: My doctor has told me I need to walk about one mile, three times a week. Won't exercise hurt me if I already don’t feel well?
Start off slow, with a distance or duration of exercise that is completed without any discomfort. Build up your distance or duration slowly over time increasing a small amount each time as long as you do not have pain. The hope is that before too long you will be able to walk one mile, 3 times a week and enjoy it.
