Back Pain Understood: A Cutting-Edge Approach to Healing Your Back »

"Back Pain Understood: A Cutting-Edge Approach to Healing Your Back

In our quick-fix society, we often search for easy medical fixes. We make a diagnosis, put it in a box, and provide a medication, manipulation or surgical intervention to treat the diagnosis. Sixty million Americans who suffer with chronic pain tell us that this approach does not work.

Back pain is a major manifestation of chronic suffering, and effective treatment is based on understanding both the body and the mind. The science of medicine explores the mind-body interface. The art of medicine transforms this exploration into practical solutions.

Back Pain Understood provides an easy-to-follow format that provides practical solutions for the healthcare practitioner and patient.

Explore for yourself what Back Pain Understood can offer you:

*An understanding of chronic pain

*An understanding of the anatomy and function of the back

*An understanding of the mind-body connection

*An understanding of the many types of back pain presentations

*An understanding of multi-disciplinary treatment options

*Wonderful illustrations and photographs that complement the text

*Numerous real-life patient stories of healing"

Introduction     xv
Acknowledgments     xix
Overview of Low Back Pain
Types of Pain     3
Nociceptive Pain     3
Neuropathic Pain     4
Acute Pain     6
Chronic Pain     7
Pain and Emotion     7
Summary Points     8
Low Back Anatomy     10
The Spinal Column     10
Low Back Musculature     14
Pain-Sensitive Structures     16
Anatomical versus Physiologic Basis of Pain     18
Summary Points     19
Clinicians Who Treat Low Back Pain     21
Physicians     21
Anesthesiologist     22
Family Medicine Physician     22
Internist     22
Neurologist     23
Neurosurgeon     23
Orthopedic Surgeon     24
Pain Medicine Specialist     24
Physiatrist     24
Psychiatrist     25
Radiologist     25
Rheumatologist     25
Multispecialty Pain Center     25
Non-Physician Clinicians     26
Nurse     w26
Physical Therapist     26
Physician Assistant     26
Psychologist     27
Complementary and Alternative Medicine     27
Acupuncturist     27
Biofeedback Specialist     28
Chiropractor     28
Massage Therapist     29
Reflexologist     29
Summary Points     29
Imaging and Diagnostic Studies     30
Radiographs     30
Computed Tomography Scan     32
Magnetic Resonance Imaging     33
Myelogram     33
Discogram     35
Ultrasound     35
Bone Scan     36
Electromyography and Nerve Conduction Studies     36
Summary Points     37
Medications     39
Food and Drug Administration Approval     39
Nonsteroidal Anti-Inflammatory Drugs     40
How They Work     40
Side Effects     41
Indications in Pain Management     42
Commonly Prescribed Nonsteroidal Anti-Inflammatory Drugs     43
Muscle Relaxants     47
How They Work     47
Side Effects     47
Indications in Pain Management     48
Commonly Prescribed Muscle Relaxants     48
Narcotic Analgesics     52
How They Work     52
Side Effects     53
Indications in Pain Management     53
Commonly Prescribed Narcotic Analgesics     55
Antidepressants     58
How They Work     58
Side Effects     59
Indications in Pain Management     61
Commonly Prescribed Antidepressants: Tricyclic Antidepressants     61
Selective Serotonin Reuptake Inhibitors     63
Serotonin-Norepinephrine Reuptake Inhibitors     64
Other Antidepressants     65
Anticonvulsants     66
How They Work     66
Side Effects     67
Indications in Pain Management     67
Commonly Prescribed Anticonvulsants     67
Topical Analgesics     71
Corticosteroids     71
Summary Points     72
Non-Surgical Treatments     73
Hands-On Treatment and Exercise     73
Physical Therapy     73
Acupuncture     80
Massage Therapy     80
Spinal Manipulation     82
Biofeedback     84
Relaxation and Meditation      85
Exercises     86
Therapeutic Injections     91
Trigger-Point Injections     91
Epidural Injections     92
Selective Nerve Root Injection (Trans-Foraminal Injection)     94
Facet Injections     95
Intradiscal Electrothermal Therapy     97
Summary Points     98
Surgical Treatments     99
Medical Risks of Surgery     99
Laminectomy and Laminotomy     100
Diskectomy and Microdiskectomy     100
Spinal Fusion     104
Lumbar Disc Replacement     104
Rehabilitation Risks Following Surgery     106
Return to Full Activity     107
Pain Risks following Surgery     107
Spinal Cord Stimulation     108
Morphine Pump     109
Summary Points     111
Mind-Body and Integrative Strategies     112
Mind-Body     112
Emotions, Chemicals and Receptors     113
Emotional Processing and Chronic Pain     113=970 14$lExample 1     114=970 14$lExample 2     116
Interpreting Mind-Body Examples     120
Summary Points     121
Low Back Pain Syndromes
Lumbar Strain     125
Clinical Presentation     125
Cause of Lumbar Strain     125
Physical Examination     126
Imaging and Diagnostic Studies     126
Treatment Considerations     126
Nonsurgical     126
Surgical     127
Mind-Body Considerations     127
Illustrative Case     127
Author's Note     129
Summary Points     129
Lumbar Disc Herniation     130
Clinical Presentation     130
Cause of Lumbar Disc Herniation     134
Physical Examination     134
Imaging and Diagnostic Studies     134
Treatment Considerations     137
Nonsurgical     137
Surgical     138
Mind-Body Considerations     140
Illustrative Case     141
Author's Note     142
Summary Points     142
Lumbar Degenerative Disc Disease/Lumbar Spondylosis     143
Clinical Presentation     143
Cause of Lumbar Degenerative Disc Disease     144
Physical Examination     145
Imaging and Diagnostic Studies     146
Treatment Considerations     147
Nonsurgical     147
Surgical     148
Mind-Body Considerations     149
Illustrative Case     150
Author's Note     151
Summary Points     151
Facet Pain     153
Clinical Presentation     153
Cause of Facet Pain     155
Physical Examination     155
Imaging and Diagnostic Studies     156
Treatment Considerations     157
Nonsurgical     157
Surgical     157
Mind-Body Considerations     158
Illustrative Case     158
Author's Note     159
Summary Points     159
Lumbar Stenosis     161
Clinical Presentation     161
Cause of Lumbar Stenosis     162
Physical Examination     163
Imaging and Diagnostic Studies     164
Treatment Considerations     164
Nonsurgical     164
Surgical     165
Mind-Body Considerations     167
Illustrative Case     168
Author's Note     170
Summary Points     170
Sacroiliac Pain      171
Clinical Presentation     171
Cause of Sacroiliac Pain     172
Physical Examination     173
Imaging and Diagnostic Studies     174
Treatment Considerations     175
Nonsurgical     175
Surgical     176
Mind-Body Considerations     176
Illustrative Case     177
Author's Note     178
Summary Points     179
Myofascial Pain     180
Clinical Presentation     180
Cause of Myofascial Pain     182
Physical Examination     183
Imaging and Diagnostic Studies     183
Treatment Considerations     183
Nonsurgical     183
Surgical     185
Mind-Body Considerations     185
Illustrative Case     186
Author's Note     188
Summary Points     189
Failed-Back Syndrome (Post-Laminectomy Syndrome)     190
Clinical Presentation     190
Cause of Failed-Back Syndrome     191
Physical Examination     192
Imaging and Diagnostic Studies     192
Treatment Considerations     193
Nonsurgical      193
Surgical     194
Mind-Body Considerations     195
Illustrative Case     195
Author's Note     197
Summary Points     197
Chronic Pain Syndrome     199
Clinical Presentation     199
Cause of Chronic Pain Syndrome     200
Physical Examination     201
Imaging and Diagnostic Studies     201
Treatment Considerations     202
Nonsurgical     202
Surgical     203
Mind-Body Considerations     204
Illustrative Case     205
Author's Note     207
Summary Points     208
Closing Thoughts     209
Glossary of Terms     211
Index     227