Spine Lumbar

Why is treating back pain so darned expensive? My back hurts and by the time I've seen everyone who claims to help me, I'll be broke.

Dealing with chronic pain can be an expensive endeavor. If you must keep an eye on what the costs are, speak with your doctor about what options you have. If he or she feels that physiotherapy is an option for you, perhaps you can do some investigating to see where the physio is available at a cost that is more reasonable for you.

When my brother-in-law hurt his back at work, he was unable to work for several months. This, plus his treatment, was a financial hardship for him. Many of the treatments he had were expensive but didn't work. Isn't there a set process to follow for back care so you're not doing treatments that won't work?

Caring for low back pain is expensive. The people who are living with the pain frequently can't work and must end up on disability for a while or even take early retirement. In fact, this is something that adds significantly to the cost.

Why am I so afraid of hurting my back again? I injured it about six months ago. After being home for three months, I went back to work. It's a demanding job, and although I try to take care of my back, I find I tense up a lot and I'm afraid - which I'm sure makes it worse. What can I do?

Being afraid of re-injuring yourself is not uncommon. You know how it feels to have a sore back and you want to make sure you don't hurt it again. Unfortunately, as you've learned, this can backfire on you and the more your worry and try to protect your back, the worse it can actually make it.

I just came back from the doctor's where I got the news that my lumbar spine motion is the same after spinal fusion as before. But I thought the fusion was supposed to stop motion. The surgeon did say the fusion site looks good and that the surgery was successful. I didn't think of this at the time to ask the question and, of course, my next appointment isn't for six months. Can you possibly explain this to me?

You may be experiencing a phenomenon seen in other spinal fusion patients. When there is a loss of motion at one segment, the segments above compensate and make up for some of the motion lost. If the X-rays show a solid fusion, you may be seeing greater physiologic motion somewhere else in the spine and probably at more than one segment.

Researchers Need to Investigate Costs Associated with Low Back Pain

Health care, like most other things in life, has a cost attached to it. For people with low back pain, this cost can be significant. According to a recent study in the United States, costs from low back pain had increased from 52 billion dollars to 102 billion dollars - doubling in only seven years. If there were more people with back pain, this could be understandable, but the number of people experiencing low back pain has not doubled as the cost has.

Iliac Crest Bone Harvesting May Leave Lasting Pain

Bone grafts, attaching bone to bone, are a frequently performed surgery in the United States. Many of them are autologous, where a piece of bone is taken from the person who is getting the bone graft (auto = self). When doctors take bone for an autologous graft, it is most often taken from the iliac crest, part of the pelvis.

The Effect of Spinal Fusion Versus Disc Replacement on Lumbar Motion

Surgery for degenerative disc disease has traditionally been discectomy (removal of the disc) and spinal fusion. But with the new total disc replacement procedure, more patients are opting for this motion sparing technique. Fusion limits motion at the fused vertebral segments, whereas disc replacement tries to keep as much of the natural motion as possible. With either method, research has shown that total spinal motion is maintained, if not improved.

My mother is taking some sort of narcotic for her back pain. She's been taking it for a few months now and I'm afraid she's getting addicted because she has asked her doctor a few times for higher doses, which he gives. What can I do?

Increasing a dosage of a medication doesn't necessarily mean that a person has become addicted to it. The human body has an amazing ability to adapt and sometimes, adaptation means getting used to or tolerating a certain dosage of medication. What can happen is that the pain level of someone taking an opioid, or narcotic, may be relieved at one point, but as the body becomes used to the medication, it no longer does the job and higher doses are needed.

My back hurts a lot. I mean a lot. I injured it at work several months ago and haven't been able to go back. My doctor orders me some medications but none of them help. I want her to prescribe me some morphine or something, but she won't. Isn't that one of the more powerful drugs and why would she say that it won't help my back then?

Morphine is an opioid, a narcotic. It's one of the controlled drugs that has the potential of being addictive. Until a decade or so ago, opioids were only really used in the United States for acute pain (such as after surgery) or for cancer pain. After the government relaxed the rules and allowed doctors to prescribe it for chronic pain, some doctors began using it for patients with severe chronic back pain.

My father had cauda equina syndrome but he didn't hurt hit back in any way that he remembers. His doctor said his spinal canal had narrowed. Could this be a cause?

Cauda equina syndrome is pressure on the cauda equina, the nerve roots in the lower, or lumbar, back. This pressure could be from a back injury, but it also can happen if the spinal canal narrows, also called stenosis. This can be caused by an injury that your father may not recall or by diseases or tumors in the spine.

Stuart Fraser, BSc, Lisa Roberts, PhD, and Eve Murphy, MSc. Cauda Equina Syndrome: A Literature Review of Its Definition and Clinical Presentation.

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