After six years of suffering with low back pain with no known cause, my doctor tells me I'm just going to have to learn to live with the pain. That's just not acceptable to me. Are there any other options for people like me?

No one doubts that patients with chronic low back pain have pain and even an underlying cause for that pain. But what to do about it can be a baffling challenge. Scientists, researchers, doctors, and physical therapists have not been able to find one individual treatment that's most effective for chronic back pain sufferers.

The three most common causes for chronic low back pain are disc disorders (degenerative discs, disc herniation), back disorders (arthritis, spinal stenosis), and back injuries. Scientists don't know the exact neural mechanism that sets up the pain signals. There's some evidence that pain signals disrupt normal brain structure, processing, and function related to thinking and feeling. Until we know more and can find a way to turn those signals off without drugs, the best medicine is a focus on pain management through exercise, activity, and counseling.

Studies support the use of a multidisciplinary program of pain management, physical therapy, cognitive behavioral therapy, counseling, and activity for patients like you. Others following this approach have been able to get back to work, walk three miles a day without being limited by pain, raise a family, stay active, and remain a contributing member of society.

But just like it takes a village to raise a child, it can take a coordinated plan through a community of health care providers to provide all the tools needed to manage chronic pain. If you suffer from chronic low back pain, don't let it have a negative impact on your quality of life and level of function. Talk to your doctor about services of this type in your community. See the American Chronic Pain Association (www.theacpa.org/) for more information concerning services, conditions and pain management issues.

Allen Lebovits, PhD, et al. Struck From Behind: Maintaining Quality of Life with Chronic Low Back Pain. In The Journal of Pain. September 2009. Vol. 10. No. 9. Pp. 927-931.



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