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UNDERSTANDING BACK PAIN I. M. Doctor, M.D. My Office My City, State.

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Presentation on theme: "UNDERSTANDING BACK PAIN I. M. Doctor, M.D. My Office My City, State."— Presentation transcript:

1 UNDERSTANDING BACK PAIN I. M. Doctor, M.D. My Office My City, State

2 2 The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred. Thank you to A. Herbert Alexander, MD for his significant contributions to the content of this presentation.

3 3 Understanding Back Pain  Orthopaedics and The Bone and Joint Decade  Types of back pain  Diagnosing the causes of back pain  Who is at risk for back pain?

4 4 Understanding Back Pain zSeeking help yTherapies to help back pain sufferers xMedications xSurgery xNonsurgical treatments xComplementary approaches

5 5 What is an orthopaedic surgeon?  MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

6 6 What is an orthopaedic surgeon?  The expert in treating the musculoskeletal system  The expert in maintaining musculoskeletal health  The expert in understanding both operative and non-operative treatment options

7 7 Educating an Orthopaedic Surgeon  College  Medical School  Internship  Orthopaedic Residency  Fellowship (optional)  2 Years Practice TOTAL (1) 2 16 years!

8 8 What do orthopaedic surgeons do?  Diagnose  Treat  Medication  Physical Therapy  Exercise  Brace  Surgery  Prevent

9 9 Back Pain Your Orthopaedic Surgeon— Getting You Back In The Game

10 10 Back Pain  Structural Issues:  Muscular  Arthritic  Disk  Psychological Issues:  Emotional stress  Medical Issues:  Infections  Inflammatory conditions

11 11 Symptoms  Throbbing, aching, shooting, stabbing, dull or sharp pain  Pain down one or both legs with very little pain in the lower back  Numbness or weakness in the legs

12 12 Symptoms  Pain down in the lower back & legs in certain positions such as standing or walking  Sleep problems, decreased energy, depression, and anxiety  Pain that stress and emotional issues causes or makes worse

13 13 General Treatment  Examination by an orthopaedic surgeon  Period of activity modification  Perhaps medication to decrease pain and inflammation  Complete inactivity is not advised for more than a couple of days

14 14 General Treatment  Rehabilitation Goals  Increased muscle strength  Increased endurance  Increased flexibility  Improve aerobic fitness

15 15 Sacrum Coccyx Cervical Thoracic Lumbar Spinal Column Healthy Spine Function

16 16 Vertebra Facet joint Spinal canal Disc Healthy Spine Function Vertebra

17 17 Healthy Spine Function

18 18 Psoas Trapezius Erectorspinaemuscles Latissimus Gluteals Obliques Healthy Spine Function Abdominal wall muscles

19 19 Burden of Disease  Lower back pain is the one of the most commons common causes of missed work  Eight out of ten adults will experience back pain at some time

20 20 Burden of Disease  58 million ambulatory care visits for back and neck pain  82 million work days lost

21 21 Robert Dover Olympic equestrian Age: 44 Condition/Injury: Low Back Pain Getting You Back In the Game

22 22 Diagnosis  Herniated disc/sciatica  Sprain/Strain  Stress-related back pain

23 23 Diagnosis  Arthritis of spine  Symptomatic disc degeneration  Facet Syndrome  Spondylolisthesis & Spondylolysis

24 24 Diagnosis  Spinal fractures  Lumbar spinal stenosis  Chronic back pain syndrome

25 25 Conchita Espinosa Chediak Age: 41 Condition/Injury: Large herniated lumbar disc, severe back pain, and foot drop Actual Clinical Case Example:

26 26 Large Disc Herniation

27 27 Are You At Risk?  Job requires frequent bending and lifting  Twisting body when lifting & carrying an object  Lifting and carrying in a hurry

28 28 Are You At Risk?  Overweight  Do not exercise regularly  Do not engage in recreational physical activity  Smoker

29 Plan ahead, don’t hurry Spread feet shoulder distance apart Bend knees Lift with leg muscles Tighten stomach muscles Move in close when placing object on high shelf Don’t twist 29

30 30 Primary Care Physicians Orthopaedic Surgeons Spine Surgeons Seeking Help

31 31 Seeking Help Before Your Appointment  Prepare to describe your symptoms  Gather medical history  Make list of medications  Write down concerns and questions and bring them

32 32 Seeking Help During Your Appointment 1. What should I expect from my treatment? 2. What effect will my treatment have on my daily activities? 3. What can I do to prevent further disability?

33 33 Active Therapies  Exercise is key  Aerobic conditioning program  Special back exercises

34 34 Active Therapies: Exercise

35 Active Therapies: Stretching 35

36 36 Active Therapies  Pain Programs  Involve multiple healthcare professionals  Different treatments at different times  Goal is to decrease pain, increase functioning  Patient must be highly motivated

37 37 Passive Therapies  Ultrasound and massage  Water therapy  Transcutaneous Electrical Nerve Stimulation (TENS)

38 38 Passive Therapies  Traction  Corsets and braces

39 39 Medication 1. Why are you recommending this medication? 2. How will this medication help me to feel better? 3. What are the benefits and when will we know if it works? 8 Important Questions to Ask Your Orthopaedic Surgeon

40 40 Medication 4. How do I take this medication? 5. What are the side effects? What to do if I have side effects? Are they temporary? 6. Is it okay to use generic?

41 41 Medication 7.Can I take this medication with others I’m currently taking? 8.How do I stop taking it safely?

42 42 Medication  Analgesics  Anti-inflammatories  Muscle relaxants  Sedatives  Anti-anxiety agents  Antidepressants

43 43 What to show here? Invasive Conservative Treatments  Trigger point injections  Facet injection  Spinal epidural steroid injections  Selective nerve root blocks

44 44 Surgery May Be Your Choice When…  Leg pain rather than back pain  Non-operative treatments are ineffective  Symptoms match test findings  Symptoms prevent daily living activities

45 45 Finding a Surgeon Surgery

46 46 Asking Questions About Surgery  Why?  Alternatives?  Benefits and for how long?

47 47 Asking Questions About Surgery  Risks?  What is procedure called?  How is it done?  Results?

48 48 Asking Questions About Surgery  Duration of recovery?  Assistance at home and how long?  Disability after surgery?  Physical therapy?  Return to normal activity?

49 49 Back Pain Therapies Medication Surgery Complementary Approaches

50 50 American Academy of Orthopaedic Surgeons 6300 N. River Road Rosemont, IL Resources

51 51 What are your questions and concerns? Back Pain

52 52 zThank you for participating today zRemember, your orthopaedic surgeon can help get you back in the game Back Pain

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