Back Pain Health Article

Clinical trials

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes at the National Institutes of Health (NIH) fund, support, and conduct general pain research, as well as studies of new treatments for pain and nerve damage associated with back pain and other conditions.

Ongoing studies are comparing the effects of different drugs; different treatment approaches such as standard care, chiropractic, or acupuncture; and surgery versus non-surgical treatments. Treatments under investigation include acupuncture and yoga in chronic low back pain, low-dose radiation to decrease postsurgical scarring around the spinal cord, and artificial spinal disc replacement surgery.

Studies that are currently recruiting patients include magnets in the treatment of sciatica and a comparison of nortriptyline and MS Contin in sciatica. Contact information for both trials is (800) 411-1222, or prpl@mail.cc.nih.gov.

Prognosis

In about 90% of people, back pain resolves within one month without treatment. Although most people with acute low back pain improve within a few days, others take much longer to recover or develop more serious conditions, especially if left untreated. Fractures, tumors, severe disc herniations, or other spinal conditions compromising nerve roots, spinal cord, or spinal stability may lead to progressive neurologic deterioration if not treated promptly.

Special concerns

Although back pain is usually not a cause for serious concern, it can interfere with work and activities and may even be disabling. Adopting lifestyle habits to prevent back pain and injury are therefore worthwhile, beginning at an early age. These include weight control and nutritionally sound diet, regular exercise, stretching before strenuous exercise, stopping smoking, good posture, and reducing emotional stress contributing to muscle tension.

In the workplace, at home, and while driving, supportive seats can reduce stress and fatigue. Other ergonomically designed furniture, tools, workstations, and living space help protect the body from injury.

Sleeping on the side with knees bent and cradling a pillow, or on the back with a pillow under bent knees, reduces back strain. Proper lifting techniques include bending at the knees rather than the waist, holding the weight close to the body rather than at arm's length, exhaling while lifting a heavy load, not twisting while lifting, and not attempting to lift a load that is too heavy. Frequent stretch breaks while sitting, standing, or working in one position for long periods will reduce muscle fatigue and back discomfort. Wearing comfortable, supportive, lowheeled shoes helps prevent falls and cushions the weight load on the spine during standing and walking.

Children using backpacks should be taught proper lifting techniques, should reduce the amount of books or supplies carried, or should switch to a wheeled carrier.

PERIODICALS

Birbara, C. A., et al. "Treatment of Chronic Low Back Pain with Etoricoxib, A New Cyclo-Oxygenase-2 Selective Inhibitor: Improvement in Pain and Disability—A Randomized, Placebo-Controlled, 3-Month Trial." Journal of Pain 2003 Aug 4(6): 307–15.

Breckenridge, J., and J. D. Clark. "Patient Characteristics Associated with Opioid Versus Nonsteroidal Anti-Inflammatory Drug Management of Chronic Low Back Pain." Journal of Pain 2003 Aug 4(6): 344–50.

Lewis, Carol. "What to Do When Your Back Is in Pain." U.S. Food And Drug Administration. FDA Consumer Magazine (March-April 1998).

Ohnmeiss, D. D., and R. F. Rashbaum. "Patient Satisfaction with Spinal Cord Stimulation for Predominant Complaints of Chronic, Intractable Low Back Pain." Spine Journal 2001 Sep-Oct 1(5): 358–63.

Staiger, T. O., B. Gaster, M. D. Sullivan, and R. A. Deyo. "Systematic Review of Antidepressants in the Treatment of Chronic Low Back Pain." Spine 2003 Nov 15 28(22): 2540–5C.

WEBSITES

Clinical Trials. (March 18, 2004.) <http://www.clinicaltrials.gov/ct/action/GetStudy>.

National Institute Of Neurological Disorders and Stroke. NIH Neurological Institute. PO Box 5801, Bethesda, MD 20824. (800) 352-9424. (March 18, 2004.) <http://www.ninds.nih.gov/health_and_medical/disorders/backpain_doc.htm>.

Spine-health.com. 1840 Oak Avenue, Suite 112, Evanston, IL 60201. (March 18, 2004.) <http://www.spinehealth.com/topics/cd/kids/kids1.html>.

Spine-health.com. 1840 Oak Avenue, Suite 112, Evanston, IL 60201. (March 18, 2004.) <http://www.spine-health.com/topics/cd/tlbp/type01.html>.

U.S. Food And Drug Administration. 5600 Fishers Lane, Rockville, MD 20857-0001. (888) 463-6332. (March 18, 2004.) <http://www.fda.gov/fdac/features/1998/298_back.html>.

Your Medical Source. (March 18, 2004.) <http://www.yourmedicalsource.com/library/backpain/BAK_types.html>.

Laurie Barclay