to Battle Back Pain
By Robert Preidt, HealthScoutNews
information on the prevention of back pain,
If you're plagued by back pain, it can be a bit confusing about
where to go to seek help.
Don't expect doctors
to clear things up for you, however. Even they can't agree on where
you should start.
A New York
City neurologist says he shouldn't be the "physician of last
resort" for back pain sufferers. Rather, neurologists should
be where those patients begin their search for relief.
a neurologist is equipped more than any other specialist to evaluate
such complaints," says Dr. Gary Starkman, who is also a pain
University of Michigan spine specialist says people with back pain
should go to one of the multi-disciplinary spine programs that are
becoming common across the country.
programs provide patients with access to many kinds of specialists
who can deal with the wide range of psychological and physical issues
facing people with back pain, says Dr. Andrew J. Haig, associate
professor of physical medicine and rehabilitation and surgery. He's
also director of the university's Interdepartmental Spine Program.
that back pain patients face a daunting maze as they seek medical
help for their condition.
They may be
referred to any one of a wide variety of specialists such as an
orthopedist, chiropractor, physical therapist, acupuncturist or
psychiatrist. Some may even go to a personal trainer or yoga instructor.
they find the right doctor and they get help but, unfortunately,
a lot of times they waste time. Often the results are that the acute
problem becomes chronic, and the chronic problem is not treated
properly. It's either under-treated or over-treated or just mistreated,
and results in unnecessary tests or procedures, even surgeries,"
He says a neurological
exam can be the best way to make a correct diagnosis and a good
neurologist is best equipped to probe, pinpoint and analyze back
Seeing a neurologist
about back pain isn't overly dramatic, expensive or complicated,
Starkman says. It includes an evaluation of the patient's medical
history and a complete physical exam. Muscle groups are tested,
and there may be diagnostic tests such as X-rays, magnetic resonance
imaging (MRI) or computerized tomography (CT).
can then determine whether the patient needs more treatment, and
which specialist can best provide that treatment.
argues, it can be difficult to pinpoint the cause of back pain.
rare that a neurologist or any of us (specialists) will find a specific
provable anatomic diagnosis (for back pain). It happens maybe 15
percent of the time. So saying the solution to a back pain problem
is diagnosis can't really be supported. That's not the whole picture
for most people with back pain," Haig says.
He adds that
pain is just a small part of the picture for someone who's suffering
serious back problems. Disability associated with back troubles
can prevent a person from working or doing daily activities. That
can affect their mental health.
40 percent of the patients we see with chronic back pain also have
major depression by the time we see them," Haig says.
And about 70
per cent of the patients who come to the Spine Program are in poor
physical shape because of the immobility caused by their back problems.
looking at a problem where the person has to be dealt with as a
whole person in terms of their disability," Haig says.
emphasis at a spine program, where a patient first sees a physiatrist
-- a physician who specializes in physical medicine and rehabilitation.
The physiatrist assesses the patient, and determines which spine
program specialists would best be able to help the patient, Haig
For more information
about back pain, go to the National
Library of Medicine or the American
Academy of Orthopaedic Surgeons
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