A few procedures to treat back pain

Back pain is something many people have to suffer through on a daily basis. If that sounds like you, here are a few procedures that can help. Consult your doctor to find out what is best for your.

With back pain, what helps one person doesn't necessarily work for the next. Your best bet with an acute episode is a day or two of bed rest if you think you need it, and over-the-counter medications. The intense pain usually lets up in the first few hours, and there'll be steady improvement within the first two weeks. If your back continues to hurt, see your doctor (go sooner if you have numbness, weakness in your foot or a tingling sensation that radiates into the buttocks or legs — all signs of sciatica).

• About 30 percent of those with low back pain undergo chiropractic or osteopathic spinal manipulation in their search for relief. Studies show that this helps acute low back pain.
• One review found that spinal manipulation with a chiropractor or osteopath increased the chances of recovering from acute low back pain within two to three weeks by nearly 20 percent.
• Some physical therapists do spinal manipulation as well. The goal of this procedure is to help build strength and flexibility.
• Because chiropractors focus almost solely on the back, they are often the best choice for back pain. At your first visit you will be thoroughly examined and possibly have an X-ray or an MRI, if a herniated disk is suspected.
• Spinal manipulation can do more harm than good if your pain is the result of a disorder such as osteoporosis, a herniated disk, a vertebral fracture or an infection or tumor of the spine. You'll need to give chiropractic treatment about four weeks to work.
• To relieve symptoms and break a cycle of pain, some doctors recommend injections of anesthetics, nerve blocks, or steroids into "trigger" points along the spine.
• Experiments have also been done with injections of salt water and botulinum toxin (Botox), but its lasting benefits are still unclear.
• To manage chronic pain from a failed back surgery or for severe leg pain (sciatica), many find relief with a spinal cord stimulation device. Such a unit blocks pain signals by stimulating the spinal cord with electrical pulses from a surgically implanted pulse generator. You control the pain by directing the outside generator to prompt the electrical pulsing.

When pain persists, many people think back surgery. This is not a good choice for most, however, and is less commonly recommended than previously.

• Fewer than five percent of back pain sufferers are good candidates.
• In most cases, pain may subside with surgery, but long-term results are about the same as with non-surgical treatments.
• Be sure to get two or three opinions from qualified surgeons.
•  If your herniated disk is causing nerve damage, you may need a diskectomy. In this procedure the surgeon takes the pressure off the pinched nerve by making an incision in the outer layers of the disk and removing the gel-like centre.
• Sometimes, part of the vertebra itself has to be removed (called laminectomy). Problems can develop following diskectomy, however, due to the added strain on the other disks and the shift in the overall structure of the spine.
• Several less invasive techniques to major back surgery have also been developed.
• In one, an enzyme called chymo­papain, derived from papaya, is injected into a herniated disk to break it down.
• Chymopapain treatment is effective about 70 percent of the time, but is considered risky because of bad reactions to the enzyme; it’s more commonly done abroad.
• In another, a probe is inserted through a tiny incision to remove part of a damaged disk.
• A less invasive — but controversial — technique uses lasers to burn out the disk. Success rates vary widely, however.

Back pain can be a debilitating ailment for many people, and it's something you shouldn't have to suffer through every day. Consult your doctor and see if any of these procedures would be a good choice for you.