Back Pain Does Not Always Mean Surgery

By Jennifer H. Zahn, MD, Texas Spine, Orthopedics and Rehabilitation

“I can’t swing a golf club without experiencing extreme low back pain.”

“I can’t walk more than a block without pain in my back radiating to my calves.”

“I can’t lean over and tie my shoes!”

These are among the most common concerns I hear from my patients. Fortunately, these are not uncommon symptoms, and, in many cases, can be treated if seen by the appropriate specialist.

Clinical back pain affects 212 million adults ages 18 and over. About 70-85% of Americans experience back pain at some time in their lives, and about a third of adults experience some back pain each year. Of these individuals, about 40% of people report they have experienced back pain in the past month. Finally, and even more disturbing, 7-14% of adults in the US report some restriction of their daily activities due to back pain in the past 12 months.

As we age, it is common for many of us to be affected by back pain. Whether the pain is the result of arthritis, a herniated disc or spinal stenosis (narrowing of the spine that causes compression of the nerves), it can be very debilitating and compromise an individual’s quality of life. Nothing is more devastating than being forced to ask your loved one for assistance tying your shoes or getting out of bed. Although affected individuals often feel they are willing to do anything to decrease their pain, the idea of surgery can sound very intimidating. Surgery may also prove to be an overly aggressive option for some, a decision that can only be made after looking at a patient’s comprehensive workup.

While some patient conditions require surgical intervention, the vast majority of patients experiencing back or neck pain are successfully treated with much more conservative care plans. In fact, many patients experience pain relief after participating in conservative care plans inclusive of physical therapy and anti-inflammatory medications.

Physical Medicine and Rehabilitation (PM&R) is a medical specialty that emphasizes the prevention, diagnosis and non-surgical treatment of disorders and injuries of the nerves, muscles and bones that result in impaired movement and severe pain. PM&R physicians are trained to treat common conditions such as back pain, neck pain, non-surgical musculoskeletal pain, arthritis, osteoporosis, brain injuries, spinal cord injuries, sports-related injuries, stroke, spasticity (stiffening or tightening of the muscles that can impair movement and speech), work-related injuries, and nerve pain.

These specialists concentrate on preventative care through strengthening and rehabilitation using their expertise to treat conditions that can occur in any stage of life. PM&R physicians employ a variety of treatment options. Resulting treatments may include medications, therapeutic exercise, injections (including spine and joint injections), electrodiagnostics, Botox® and activity modification. Among these, an Electromyography test, or EMG, is used to diagnose patients experiencing pain, weakness or numbness of the back, neck or hands. Injections, including Botox® injections, can be used to treat spasticity in stroke patients and those suffering from neurological disorders. Through the use of these and other evidence-based non-surgical treatment options and customized care plans, PM&R physicians successfully and safely return the injured individual or worker back to his or her prior level of function, productivity or performance.

PM&R physicians work in tandem with other healthcare professionals including orthopedic surgeons, sports medicine specialists, podiatrists, and primary care physicians. I am privileged to consult with fellowship-trained orthopedic spine surgeon Dr Michael Catino for those patients who require surgical intervention. As partners, we are able to offer evidence-based surgical, as well as non-surgical options, for treating back pain. Through this approach, we can help reach the ultimate goal of catering treatment options to patients’ specific needs.

So, before you skip out on that weekend round of golf with your buddies, or refuse to take that next walk with a loved one, consider contacting a PM&R physician for a consultation.

Author Jennifer H. Zahn, M.D. is a Physical Medicine and Rehabilitation physician at Texas Spine, Orthopedics and Rehabilitation in Denton. She can be contacted at 940- 323-3400 or on the web at www.tsordocs.com.