Thursday, July 24, 2008

Back pain has many causes, treatments

By Amy Macavinta
Deseret News
Published: June 14, 2008
Overuse, strain, injury, bone loss, arthritis, aging, illness, wear and tear — they're all among the factors that contribute to make back pain, in some form at some stage of life, nearly as inevitable as death and taxes.

It may be acute, recurrent or chronic. It's always miserable. And although most back pain will go away over time with some basic self-care, there are times when only a professional's help will do.

Back pain in all its forms is the topic of the Deseret News/Intermountain Healthcare Hotline today. From 10 a.m. to noon, Dr. Terry Sawchuk, who is board certified in physical medicine and rehabilitation, with a strong emphasis in interventional physiatry, and Dr. Reed Fogg, director of the Intermountain Spine Institute, both at The Orthopedic Specialty Hospital, will take phoned-in questions at 1-800-925-8177. You can also e-mail questions until 5 p.m. to hotline@desnews.com. Answers will be posted Thursday at www.deseretnews.com.

Back surgery has come a long way, but by no means is it the only way of relieving chronic back pain, said Sawchuk. He's part of a team of professionals who offer neurological rehabilitation to patients who have suffered stroke, brain or spinal cord injuries, musculoskeletal injuries and pain syndromes.

"Ninety-eight percent of patients do not require surgery," he said.

Non-surgical treatment of back pain utilizes a combination of resources, including physical, occupational or recreational therapists and psychologists.

Treatment might revolve around exercise, physical therapy, activity modification, relaxation techniques and pain modification.

Cortisone injections are another alternative, not only for treatment but for diagnosis, Sawchuk said.

"There are not a lot of reliable and significant things we can do to specifically diagnose the cause of back pain," he said. "But if we inject part of the back and the patient gets relief, then we know we have identified the spot."

If there is still a great deal of pain, or if there is progressive muscle weakness, then a patient can still be referred for surgery.

Sawchuk said the key is taking a comprehensive, multidisciplinary approach by a team, rather than just one person.