How common is back pain for Americans?
Back Pain is the most common pain disorder in the United States population. There are several hypotheses; the spine is a complex structure. It’s very important for us to stand and walk, so the spine is subject to a lot of minor traumas over the years. It’s made of multiple joints. In reality, the discs between the two vertebras is a type of joint. So if you want, over the years, degeneration of the joint, microtraumas and a variety of other problems are thought to be the culprit or the cause of this back pain or chronic pain. You know, other conditions like disc herniations are better known, but the majority of cases of back pain are unknown or unclear. In fact, the most common cause of chronic back pain is unknown or non-specific low back pain.
What are the most common forms of treatment for back pain right now? Medications, from nonsteroidal anti-inflammatory drugs to Tylenol, are very common. Physical therapies or some sort of other known pharmacological interventions are also a common treatment. The most common approach to patients with chronic back pain is medications like anti-inflammatory drugs and some sort of physical therapy. Surgery for back pain patients is only necessary in a minority of cases. It’s only necessary when there is a clear-cut structural problem that can be fixed. For example, a major disc hernia compressing a nerve causing not only pain but also weakness or bladder problems might be an indication for surgery.
Back pain surgery is often overdiagnosed. Chronic back pain or back pain doesn’t say much because it doesn’t say the cause of the problem. It’s a very common, very prevalent, but not really true diagnosis. It’s just a descriptive term to say that one part of the body hurts.
Traditionally, we pay a lot of attention to discs, which are the soft tissue material in between the vertebras. We pay attention to the degeneration of the disc as a source of pain, but the majority of people will start having or developing degeneration. Only some individuals have back pain. You cannot say the cause of back pain is degeneration of the disc. The patient has chronic back pain and take an MRI or an X-ray of the area. However, we mostly see the same picture in patients with and without back pain, so the MRI is telling us there must be something else besides degeneration of the disc as a cause of chronic back pain.
Now, in a large group of patients with nonspecific back pain, it’s very prevalent problem. Pain is not just activation of nerves. Pain is a very complex phenomenon. Pain is a very complex phenomenon. Pain ultimately is perceived in our brain. We have attached to a sensation a lot of other meanings, so it becomes such a complex phenomenon that it would be too simplistic to say there is something wrong in your spine. So probably in a group of other patients, the problem is much more complex.
It’s very important to come up with new, non-invasive therapies for chronic back pain because invasive therapies always run a carried risk of complications obviously. It goes along with the procedure, the nature of the intervention. The invasive procedure will produce, perhaps, other risks. So, it’s all related to risk-benefit.
If you have something major like something that you need to intervene right away to prevent further damage to a nerve, probably surgery is indicated, and sometimes it’s an emergency.
But a lot of times [non-invasive therapies are important] just because of the potential risk of complications like nerve damage or we see what we call failed back surgery syndrome. This term is very commonly used — it’s essentially patients who undergo surgery and come out with worse pain, more pain or still unresolved pain, and unnecessary surgeries basically.