Friday, March 11, 2016

The Management Of Chronic Back Pain

By Stephen Campbell


Back pain is one of the commonest causes of clinic visits and hospitalizations in Blue Bell, PA. The incidence is highest in the sixth and seventh decades of life with a slightly higher proportion of women being affected. The underlying causes are widely varied. They include, among others, trauma, infections, tumors as well as degenerative changes within spinal components. The pattern of symptoms in chronic back pain is likely to vary slightly depending on the part of the back that is affected and the cause.

In general the discomfort originates from the spinal components. These include the body skeleton (vertebral bodies), the muscles, ligaments, and the inter-vertebral disc. The incidence appears to increase with age because of degenerative changes that affect these structures. Osteoarthritis is one of the most common condition under the degenerative conditions category. It is the result of wear and tear at the inter-vertebral joints.

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.

When you visit your doctor, they will want a detailed history from you so as to figure out what the most likely diagnosis is. They will also take you through a physical examinations with a particular emphasis of the back. The next step is to undergo a series of tests (blood tests as well as radiological images) depending on the pattern of symptoms. A CT scan, an X-ray image and a radionuclide scan are among those that provide the most useful information.

There are different types of treatments that exist. They are broadly classified into drugs, surgery and physical therapy. Drugs are used to help minimize the discomfort, inflammation or to clear infections. For mild discomfort, simple non-steroidal anti-inflammatory drugs, NSAIDs such as naproxen, acetaminophen and aspirin can be used. More severe symptoms require stronger analgesic agents such as opioids and steroids.

Physical therapy targets problems affecting muscles and joints. The main forms of physical therapy that exist include massage, supervised physical activity, heat and cold therapy, electrical stimulation and so on. After a few weeks of these treatments, muscle strength is significantly increased. It is important to note that patients will respond differently to these treatments depending on the type and severity of their condition.

Surgery is usually used as a last resort. There are two main types of surguries that can be performed namely; spinal fusion and decompression. When the cause of symptoms is a prolapsed disc or vertebral components, surgery tends to yield good results.




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