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Medical Update

The Latest Treatments for Back Pain

Not all consumers are lucky enough to find a remedy for their back pain, even when they use the latest treatment options. New surgical techniques show promise, but the number of unnecessary back surgeries overall appears to be on the rise. And although studies show that nonsurgical treatments can be effective, insurance companies are reluctant to cover those costs in most states.

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Kelly Staikopolous struggled for 3 years to find relief from back pain after a train door slammed into her in 2005 and tore and dislodged two disks in her lower back. She tried over-the-counter and prescription medications and saw chiropractors, but none of those treatments worked. Desperate for help, Staikopolous considered surgery but backed away from that option after a friend’s back surgery left the friend in more pain than she had experienced before the surgery.

Finally, in 2008, Staikopolous, who is 42 and a freelance food editor in New York, found two treatments that proved effective: spinal traction and cortisone shots. Today, Staikopolous no longer is plagued by daily pain. She says she’s grateful that she avoided surgery because of its potential dangers and high cost. Besides, independent studies indicate that surgery is no more effective than are nonsurgical treatments.

Case in point: A 2006 Dartmouth Medical School study found that for Staikopolous’ particular condition—herniated spinal disks—surgery and other treatments yield the same result, which is a 70 percent chance of improvement over time.

Back pain is the leading cause of disability among people who are under the age of 45, and it affects 8 in 10 Americans at some point in their life. Some 26 million adults endure back pain that is chronic and that lasts for more than 6 weeks. So it’s no surprise that Americans spend a reported $50 billion a year in search of back-pain relief.

Unfortunately, there’s no sure-fire cure—back pain returns in 80 percent of all treated cases. And that can leave patients in as much pain—or more—than they were in before they sought treatment.

Finding a remedy for your back pain can be time-consuming and maddening. You might have to try several approaches before something finally helps. That’s why it’s disturbing to see doctors push surgery more than ever before as a back-pain treatment, even though it’s clear that it’s no more effective and much more expensive than are nonsurgical treatments.

The good news is that in 2011, you have more alternatives to surgery than ever before. Physical therapists now use more-active types of exercises instead of the passive ultrasound and electrical-nerve-stimulation treatments of old.

Acupuncture also has become an increasingly accepted approach to treating back pain, according to independent studies, even though health-insurance companies in most states are reluctant or refuse to cover the cost of treatments.

SURGERY CONCERNS. A growing number of Americans who are desperate to end their debilitating back pain are going under the knife. American Academy of Orthopaedic Surgeons (AAOS) reports that the number of back surgeries that were performed in the United States increased to 1.15 million in 2007 (the most recent year for which figures are available) from 530,000 in 1997. Health advocates are raising an alarm about this trend, noting that back surgery is not only expensive (averaging $36,000 to $38,200 per procedure) but also cures back pain in only 60 percent of cases.

The most recent study that illustrates problems that are related to back surgery involves the fusion of more than two vertebrae, which is called complex-spinal-fusion surgery. The surgery is used to treat spinal stenosis, which is a narrowing of the spinal canal that typically is caused by arthritis.

A report in the October 2010 issue of the journal Spine examined the records of 1,450 back-pain patients (half of whom had surgery; the other half of whom had nonsurgical treatments). Of the group that had to fuse two or more vertebrae, only 26 percent had returned to work after 2 years. Of the group that avoided surgery, 67 percent were back at work 2 years later.

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