December 22, 2013

Chronic Back Pain: Non-Surgical Treatments, Prevention

Working with your doctor is key

Yoga class back stretch

If you have chronic back pain, there may be effective treatments besides surgery that may help, depending on your particular condition. It’s important to see your doctor and discuss the options.


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Robin Jackson had chronic pain originating in her lower back, traveling down her left leg and into her foot. She was diagnosed with sciatica, typically the result of an irritated nerve in the spinal column.

Teresa Dews, MD, Vice Chair, Department of Pain Management, and Medical Director of Cleveland Clinic’s Pain Management Center at Hillcrest Hospital, treated her with epidural steroid injections, which can also be used to treat other types of pain. “Steroids are a strong anti-inflammatory agent — injecting them close to a nerve helps to temporarily reduce back and leg pain,” Dr. Dews says.

Pain returns, other treatment alternatives

But within a few years, the pain returned with a vengeance. “The pain was so bad, it felt like a charley horse gone nuclear,” Mrs. Jackson says. This time, in addition to sciatica, Dr. Dews diagnosed Mrs. Jackson with a disk herniation with some nerve compression.


Treatment came in the form of three epidural steroid injections, given two weeks apart, and these, provided significant relief.

“Robin underwent a very dramatic transformation for a very common condition,” says Dr. Dews. “She is very typical of the type of patient we want to see, treat appropriately, and help return to their active daily lives.”

Just one day after her first injection, Mrs. Jackson participated in a yoga class offered at her workplace. She continues to do yoga two times each week. She takes only over-the-counter pain medication on occasion, and she uses care when bending over, tying her shoes and picking things up.


Preventing back pain

At some point in their lives, eight out of 10 Americans will suffer from back pain. While it is not possible to prevent all back pain or injury, here are some things you can do to keep your back healthy:

  • Eat well. A healthy, well-balanced diet keeps your bones and muscles strong.
  • Maintain a healthy weight. Excess weight puts added stress on the structures of the lower back.
  • Exercise regularly. This includes stretching, to keep your joints flexible and your back and abdominal muscles strong.
  • Pick sports with care. Choose activities and sports, such as swimming and biking, that do not place your lower back at risk of injury.
  • Use good body mechanics. Pay attention to how you sit, stand and lift. Try to keep your back straight and your shoulders back. When sitting, keep your knees bent and your feet flat on the floor. Don’t over-reach, and avoid twisting movements. When lifting, bend your knees and use your strong leg muscles to help balance the load.
  • Maintain good posture. If you start to feel sore or stiff, change your posture and modify your body mechanics. Your body will warn you, using pain as a signal, when your mechanics are improperly aligned.
  • Practice safety measures to help prevent falls. This includes wearing shoes that fit properly and keeping stairs and walkways free of clutter.
  • Don’t smoke. Tobacco interferes with blood flow to the spine.

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