Thursday, August 27, 2009

Back pain - NYC as seen in the New York Time-Back pain NYC


Back pain NYC- visit www.livingwellnewyork.com
The more I research about back pain causes and treatment the more I realize that a Multi-discipline approach is the best,to not only eliminate the pain but solve the underlying problem.

Most of the time the problem stems from a Mechanical problem ie( pelvic misalignment, tight muscle)
Dr. Vladimir Janda MD before he died years ago had an understanding of how the body worked and how to correct problems.
Most of the time a patient has a tight muscle group that needed to be stretched or a weak muscle group that needed to be strengthened.
A patients diet and needs to be looked into as well as their working posture and ergonomics. Maintaining proper spinal alignment is important.
When all the disciplines (Chiropractic, Physical therapy,Medical) can look at the patient as a whole the patient gets better quicker and stays better.

Back Pain Eludes Perfect Solutions

By LESLIE BERGER

BACK pain is one of the most common physical complaints, so it’s no surprise that treatments for it have multiplied over the years. That ought to be good; instead, many patients find that sudden back pain opens the door to a world of medical confusion.


The effectiveness of virtually every pharmaceutical or surgical remedy, however, has been questioned. And for all the money sufferers spend on doctor visits, hospital stays, procedures and drugs, backs are not improving. The Journal of the American Medical Association reported that spending on back treatments jumped 65 percent to nearly $86 billion from 1997 to 2005, after adjusting for inflation. But during the same period, the proportion of people with reduced function because of spine problems increased, even after controlling for an aging population.

Low back pain represents so many different diseases that there really hasn’t been a breakthrough treatment,” said Dr. Russell K. Portenoy, chairman of the department of pain medicine and palliative care at Beth Israel Medical Center in New York. “It’s good for the public to know how little we know.”

The mystery begins with the first doctor’s visit. The exact cause of back pain is never found in 85 percent of patients, said Dr. Dennis C. Turk, professor of anesthesiology and pain research at the University of Washington and a past president of the American Pain Society. Even magnetic resonance imaging seldom sheds light; in many studies the scans have picked up spinal abnormalities in many people who have never reported back pain.

So what’s a sufferer to do?

Narcotic pain relievers like OxyContin, used regularly by more than eight million Americans, can help, but doctors remain deeply divided over when to prescribe them. The painkillers can also be highly addictive and lead to mood changes.

“I think we are an overmedicated society, and I would not recommend narcotics for everyday back pain except for in most rare of circumstances,” said Dr. James N. Weinstein, editor of the medical journal Spine and chairman of the department of orthopedic surgery at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

Alternatives to narcotics have proved problematic, too. Two anti-inflammatory drugs, Vioxx and Bextra, were taken off the market after being linked to heart attacks. And ibuprofen and aspirin can cause gastrointestinal bleeding or organ damage at high doses.

Spinal injections of steroids and anesthetics increased by nearly a third during the 1990s, but several scientific reviews found scant evidence that these provided more than short-term relief. Some doctors have begun prescribing drugs like Lyrica, an anticonvulsant, and Cymbalta, an antidepressant, to treat chronic back pain. But the data on antidepressants is also mixed. A study last fall in The Annals of Internal Medicine found that antidepressants help back sufferers, but this year a review by the respected Cochrane Collaboration, a nonprofit organization for health information, concluded there was no evidence that antidepressants offered relief.

While the quest for a safe and effective pain pill continues, Americans undergo more than 300,000 spinal fusion surgeries a year, at an average cost of $59,000 each, according to the National Center for Health Statistics. Almost as many undergo laminectomies or diskectomies to remove damaged vertebrae and disks.

For some, back surgery can be life-changing, eliminating pain and disability. But for others, it can have serious consequences. One study found that 11.6 percent of patients in the 78 spinal surgeries that were analyzed developed infections and other complications.

Newer procedures, like implants of medication pumps and stimulators, have received mixed reviews, too. The jury is still out on kyphoplasty, an outpatient procedure for patients with vertebrae fracture from osteoporosis. The doctor inserts a needle into the spine and inflates a balloon, then injects a cement, gluing the bones together. The procedure works only for some patients.

With such uncertainties, it is little wonder that many doctors have fallen back on more traditional approaches to easing the pain, like exercise or counseling. This year, the Accreditation Council for Graduate Medical Education began requiring that medical residents who want to become pain specialists study not only anesthesiology but also psychology, neurology and rehabilitative medicine.

The reality is that most people with back pain heal on their own, slowly, without major intervention. “The best treatment for straightforward back pain without a specific diagnosis is reactivating yourself to what you normally do as fast as possible,” Dr. Weinstein, the Spine editor, said.

This was a interesting article BUT we do know that Chiropractic care is extremely safe and effective for back pain suffers. We do know that once we teach patients on how to sit properly and bend without putting strain on the low back the chances of re injury are decreased.
I like the portion of the article that mentions painkillers,These medications are highly addictive and can destroy patients lives. I have seen friends change into someone else once they get hooked on something like vicodin. There is a time and place for medication but Back pain responds well to Chiropractic care.
We utilize Spinal Decompression using the DRX 9000 and Spinal Strengthening using the SpineForce.
We see patient that have had Back surgeries and are taking Vicodin,Percosets and suffer with Sciatica and Herniated and bulging discs.
When we can reduce the intra discal pressure using spinal decompression and utilize technologies like Cold laser therapy,Kinesiolgy taping and Oxygen therapy the results are outstanding.
to learn more about our practice visit us online at www.livingwellnewyork.com
or call us at (212) 645-8151 for Chiropractic, Physical therapy, Pain Management, Acupuncture,Massage or Herniated disc treatment in NYC.

A little more information about Back pain from the American Chiropractic Association

Back Pain Facts & Statistics


Although chiropractors care for more than just back pain, many patients visit chiropractors looking for relief from this pervasive condition. In fact, 31 million Americans experience low-back pain at any given time.1



A few interesting facts about back pain:

One-half of all working Americans admit to having back pain symptoms each year.2
Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.3
Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.4
What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.



Manipulation as a Treatment for Back Problems

Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today's growing emphasis on treatment and cost effectiveness, manipulation is receiving more widespread attention.



Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5



In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research—a federal government research organization—recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6



The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how chiropractic manipulation may help you, contact a Doctor of Chiropractic in your area. Search our online database of ACA members to find a doctor of chiropractic near you.



Tips to Prevent Back Pain

Maintain a healthy diet and weight.
Remain active—under the supervision of your doctor of chiropractic.
Avoid prolonged inactivity or bed rest.
Warm up or stretch before exercising or other physical activities, such as gardening.
Maintain proper posture.
Wear comfortable, low-heeled shoes.
Sleep on a mattress of medium firmness to minimize any curve in your spine.
Lift with your knees, keep the object close to your body, and do not twist when lifting.
Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.



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References:

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD, Summer 1994.

4. In Vallfors B, previously cited.



5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

6. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.


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