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April 11, 2021  
BACK NEWS: Feature Story

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  • Treating Low Back Pain

    Treating Low Back Pain: Physical Therapy Versus Surgical Treatment

    August 06, 2003

    By Julia Yuo for Back1

    Low back pain can impose several inconveniences on the daily activities of your life. Left untreated, chronic low back pain can even deprive you of sleep. How do you treat low back pain? Non-invasive procedures and treatments are steadily increasing in popularity among the orthopedic community.

    It is estimated that over 80% of American workers from ages 30 to 50 suffer from back pain, causing reduced activity during their most productive years. When weighing the benefits and limitations of surgery versus physical therapy, you’ll be surprised to see an increasing trend toward non-invasive treatments for low back pain.

    Dr. Jerome McAndrews, spokesperson for the American Chiropractic Association estimates that there are 45,000 unnecessary lower back operations completed each year. According to the American Academy of Orthopedic Surgeons (AAOS), most low back pain can be effectively treated without running the risks and inconveniences involved with surgery.

    Although back pain is extremely uncomfortable and painful, surgery does not always offer a quick fix or cure. In fact, back surgery can even worsen your condition, especially if the pain is isolated to just the back.

    However, in the case of nerve damage that causes compressive pain, surgery is sometimes the necessary route of action. Compressive pain occurs when nerve roots leaving the spine are irritated or pinched, often times a result of a herniated disk When these nerves are pinched, numbness, and even loss of reflex control in the lower legs are common symptoms. In the case of the cauda equina syndrome, a disk herniation can be so severe that sudden pressure on the nerves at high levels can cause involuntary bowel and bladder movements. Patients experiencing loss of bladder and bowel control should immediately contact their orthopedic physician.

    When persistent back pain coupled with pain, numbness, or weakness in the thigh, leg, or buttocks does not respond to non-operative treatment, patients may be referred to an orthopedic surgeon for evaluation.

    A discussion of your medical history, physical examination, and diagnostic tests using x-rays, MRIs (Magnetic Resonance Imaging), CAT (Computer Assisted Tomography) Scans, or myelograms may be part of your visit to an orthopedic surgeon. After a thorough examination and discussion about your back condition with your surgeon, and after all non-operative measures have been taken, surgical treatment as a last resort should be considered.

    Physical therapy and pain medication, however, are always recommended as the initial treatment. A physical therapist is an expert in the treatment of musculoskeletal and neuromuscular conditions that impede on your everyday activities. Your physical therapist can prescribe certain exercises to condition and strengthen the back to relieve pain and prevent injury. A large part of a physical therapist’s treatment focuses on preventing re-injury through strengthening. Treatment includes hot and cold packs, massages, and manipulation. Your physical therapist will also teach you exercises to condition and relax the muscles in your back to restore range of motion. Furthermore, good posture and lifting techniques are important habits to learn from your therapist.

    While bed rest may be prescribed along with some modifications to your daily activities, the AAOS has recognized that light activity can speed healing and recovery to low back pain. Additionally, weight loss if you are overweight, and quitting smoking may be recommended in accelerating the healing process.

    Last updated: 06-Aug-03


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