The Real Short Story on Long-Standing Back Pain

Long standing, or chronic back pain, originating from the neck, thorax, or lower back, is a widespread problem for many people. Chronic back pain is defined as pain lasting greater than 3 months duration. Back pain does not discriminate and affects people of all ages, from both genders, multiple ethnicities, and a variety of socio-economic backgrounds. It may strike patients without regard to their daily activity level or vocation. By age 80, the majority of us, about 84 percent, will be able to recall one or multiple episodes of severe back pain. You might say that back pain is a common denominator that unites us as humans.

The majority of back pain episodes experienced by patients are not dangerous, and resolve within several days to weeks. Only about 10-15 percent of back pain sufferers progress to the chronic state. These people account for the majority of spine related health care costs in the U.S., which costs over 50 billion dollars each year. Those with chronic back pain may unnecessarily suffer from lost wages, loss of vocation, loss of activity tolerance, loss of normal function, and stress on interpersonal relationships.

The medical community itself has encountered this problem for several decades, and is continually challenged with finding a viable solution that provides a win-win situation for these patients. Many patients experience a limited or poor response to the commonly prescribed treatment regimens of passive physical therapy and anti-inflammatory medications. A large number of patients progress to narcotics and other sedating medications, reporting no significant benefit or improvement in their symptoms.

Fortunately, there is hope. For over two decades, researchers and clinicians at Harvard Medical School, including neurobiologists, spine physicians, and physical therapists, have tapped into the underlying neurobiological and psychosocial factors that prolong the symptoms of back pain. One of the solutions to back pain management problems is available and treated at the AllSpine Surgery Center, which is located in Stockbridge, Fayetteville, Newnan and Riverdale Georgia.

Founded on advances in neuroscience, as well as on the symptomatic and functional improvements of thou- sands of patients, the most effective clinical outcomes in treating chronic back pain have been achieved through the avoidance of long-term use of narcotic medications, and through the use of high-intensity, structured exercise or physical therapy. These scientific studies show that persistent use of narcotics may prolong painful episodes by impairing the ability of one’s nervous system to adapt to regular wear and-tear (degeneration) of the spine. Intense, structured, physical therapy for the spine desensitizes the hyper- sensitized painful nervous system, a condition called central sensitization. Spine injections are also effective in minimizing severe pain episodes. Each of these strategies appear to have a major impact on how the nervous system reports pain to the brain.

These methods may be a paradigm shift for both practitioners and patients, as they may seem counter-intuitive. Utilizing these methods, however, I have seen hundreds, if not thousands, of patients who have successfully discontinued narcotic medications, returned to work and other activities, and have regained a more robust life.

The majority of people over the age of 30 will have degeneration of the spine on MRI, which may or may not be related to their back pain. It is important that patients presenting with back pain be evaluated by a spine physician, who will accurately distinguish patients who are surgical candidates from those who may benefit from conservative treatments, avoidance of narcotics, spine injections, and other intervention treatments.

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