|
 UNDERSTANDING Back
PAIN
Marc
Darrow, M.D.
There are many structures in the lower back that
can cause severe pain. These include muscles,
ligaments, tendons, bones, joints
and discs. For example, the outer rim of the disc can be a significant source of
back pain due to its rich nerve supply and tendency toward injury.
During our
body's development, there is a great deal of overlap of nerve supply to all
these structures. This makes it nearly impossible for the brain to distinguish
between injury to one structure versus another.
For example, a torn or
herniated
disc can feel identical to a bruised muscle or ligament injury. This is where an
examination into the cause of the pain is important.
Axial, or mechanical back pain.
This pain can run the gamut from a very sharp to a dull ache. It may occur
all the time, or it may come and go. It also varies in intensity from very mild
to extremely severe. One patient may report that his/ her lower back is only
sore when having been seated for a long time, or after working in the garden.
Another patient may report severe, debilitating pain and need assistance to walk
or stand, or even to get up from a sitting position. While one patient is
perfectly straight, the other is bent over and locked in a crooked posture. The
one thing that is common in these conditions is that the pain is restricted to
the lower back area.
Referred pain.
Here, patients complain of having an achy, dull type of pain that seems to move
around. The discomfort comes and goes and varies in intensity. This achy pain
starts in the low back area and commonly spreads into the
groin, buttocks and
upper thighs.
Radicular pain.
In this case, the pain is described as deep and usually constant. It follows the
nerve down the leg and is often accompanied by numbness or tingling and muscle
weakness.
The most common example of this type of problem is the sciatic pain that
radiates along that sciatic nerve - down the back of the thigh and calf into the
foot. This type of pain is caused by injury to a spinal nerve. Some of the
possible causes of this are a disc protrusion or bulge, arthritic changes or a
narrowing of the opening through which the nerve exits.
In all types of back pain, your health habits play an important role. For
example, there are certain foods that are high in the fats that cause more
Inflammation. Limiting intake of these animal fats and increasing your intake of
the good fats that reduce inflammation may play an important role in your
healing. Smoking is another health concern. Statistically, smokers are slow
healers with respect to back pain.
Prolotherapy and Back Pain
A study published in 1987—by which time the procedures of Prolotherapy were
fairly well established—offered dramatic support to proponents of the still
basically unknown technique. In the first double-blind study on the effects of
Prolotherapy on back pain, two groups of carefully screened patients—with at
least a one year history of back problems that hadn't responded to other
non-surgical treatments—were injected with either a true Prolotherapy
proliferant (a
dextrose-glycerine-phenol solution), or with a saline-based
placebo.
The test subjects had been thoroughly pre-screened, with full clinical
evaluations,
x-rays and lab tests, and the 82 patients accepted had arrived with
painful conditions. Sixty-percent were currently using non-steroidal
anti-inflammatory drugs (NSAIDS). A half-dozen were experiencing such intense
pain that they were taking
Narcotic. A whopping 91% had difficulty
sitting still for any length of time, and 65% had difficulty
sleeping due to
their pain. Seventeen-percent had difficulty walking, 21% experienced decreased
sexual activity, and 4% were completely bed-ridden.
Six months after the treatment, 35 of the 40 people who had received the actual
Prolotherapy treatment had experienced at least a 50% reduction in pain—a
success rate of 88%. And 15 of them were completely pain free—compared to only
4 in the control group. (Ongley M, Klein R, Dorman T, Eek B, Hubert L.
A New
Approach to the Treatment of Chronic Low Back Pain.. Lancet 1987;2:143-146.) |
