The Management Of Chronic Back Pain

By Stephen Campbell


One of the commonest causes of hospital visits in Blue Bell, PA is back pain. This symptom is also associated with absenteeism from work and reduced productivity. The incidence is particularly high in persons who are in their sixth and seventh decade of life. There are slightly more cases among women than men. There are many different causes including trauma, tumors, degenerative conditions and infections among others. Chronic back pain exhibits different symptomatic patterns depending on the cause.

Regardless of the exact cause, the discomfort results from a problem affecting spinal column components. These include the bony structures (mainly vertebral bodies) the inter-vertebral disc, ligaments and muscles. The reason as to why the incidence of this problem increases with age is the fact that some of these structures undergo degenerative changes and can no longer function properly. Osteoarthritis is a well-known degenerative bone condition that affects many large joints including those in the spine.

If the cause is a tumor, it is important to determine whether the tumor in question originated from the spine or is a metastasis from another organ. The main types that originates from bone is multiple myeloma. In general, majority of cases that involve tumors are due to metastases. Examples include tumors originating from organs such as the kidneys, the prostate, the thyroid and the breast. If person with any of these tumors has back discomfort then metastasis should be suspected.

Symptoms that are caused by slippage of the inter-vertebral disc usually starts as a sharp pain that progresses over time and remains constant if intervention does not take place. Blunt trauma to the back or a heavy lifting event are usually the predisposing factors. The symptoms characteristically affect one side of the body and are worse on movement. Depending on the level at which the slippage occurred either the lower or the upper limbs may be affected.

To establish the diagnosis, the doctor will take a history of your condition then conduct a physical examination. A number of blood tests and radiological images may be needed depending on the nature of the illness. If an infection is suspected, for example, a septic screen will be done. In general, radiological images provide the most vital information. They include X-ray images, CT scans, MRI, CT scans and radionuclide scans among others.

There are a number of treatment options that exist. These are classified into pharmaceutical agents, physical therapies and surgical intervention. Analgesic drugs are chosen depending on the severity of symptoms. In cases of mild symptoms, aspirin, acetaminophen, ibuprofen and other non-steroidal anti-inflammatory drugs are typically used. Stronger drugs such as steroids and opioids are reserved for the severe cases.

Physical therapies are most effective for conditions that affect joints and muscles. Examples of commonly used therapies include massage, heat and cold treatments, physical exercises and electrical stimulation among others. One of the mechanisms involved in these treatments is strengthening of muscles. Patients usually exhibit different responses depending on the nature of their illness.

Surgery may also be used but as a last resort. The two main types of surgical operations that may be performed are spinal fusion and decompression. Fusion is used when dealing with a destructive process while decompression is required in case of space occupying lesions.




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