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Title: Finding The Right Doctor Is A Pain In Your Back
Author: Dr. Rick Morris
Article:
Most of us incur the wrath of low back pain sometime in our
lives. In fact, next to colds and flu, it's the leading cause of
time loss from work. Symptoms ranges from a temporary annoyance
to chronic, debilitating pain.
There is no "one size fits all" approach to treatment. While a
few stretches or a board under the mattress may do the trick for
some, others believe that the pain originated in their heads.
These modifications or changing our perceptions sometimes work,
but not often enough? The Agency for Healthcare Research and
Quality, a branch of the U.S. Department of Health and Human
Services, developed the following guidelines:
1. ½ of 1% of low back pain cases fit into the category of a
serious medical condition that is best treated by an orthopedic
surgeon or neurologist. The red flags include:
a. Difficulty controlling the bowel or bladder b. Numbness in
the groin or rectum c. Extreme leg weakness
2. The other 99% respond best to altering our activities
(posture, ergonomics...), spinal manipulation and exercise.
3. Surgery is helpful in 1% of the cases but can cause greater
problems. Rarely is it an emergency, so other approaches and
opinions should be sought first.
So lets look at the various approaches and evaluate their
strengths and weaknesses.
Self Treatment-Most instances of lower back pain will be
resolved by altering the sources that initiated it such as a
faulty mattress, a poor car seat, or a change in activity
General Practitioners or Internists-The most frequently
consulted initial provider and are somewhat qualified to spot
serious conditions, yet limited in ability to treat the usual
causes.
Orthopedic Surgeons-Highly trained at diagnosing the "disease"
causes of back pain (e.g. cancer and infection) and the only
ones (with the exception of neurosurgeons) to offer surgery.
They are usually poorly skilled at conservative treatments. They
are often biased against Chiropractic and therefore rarely refer
to them offering more invasive and dangerous protocols (e.g.
surgery, medication and injections) in its place.
Physical Therapists-Well trained at rehabilitation and exercise.
They use physical therapy modalities (e.g. ultrasound and
electric stimulation) and often look at life style changes but
have limited or no training in spinal manipulation.
Chiropractors-Contrary to traditional views, most scientific
studies favor these providers. They are the most skilled at
spinal manipulation and perform physical therapy, but their
abilities at diagnosis and rehabilitation vary greatly between
practitioners. Their treatments, again contrary to popular
belief, are the safest and are reflected by a malpractice rate
which is 1/10 to 1/30 that of their medical counterpart.
Acupuncturists-Have helped when other approaches haven't,
although large studies have not shown them to be consistently
effective. They have limited training at determining mechanical
and organic causes.
Osteopaths-Highly trained at the diagnosis of back disorders
although treatment varies considerably since most practice as
family practitioners.
Since few practitioners have a comprehensive view, back pain
sufferers often must seek treatment from more than one doctor.
Further compounding the problem, traditional doctors are
frequently averse to referring outside their own field. This
demands considerable management skills upon the sufferer who is
already in pain and distress. So be aware that regardless of the
provider, improvement should be notable within one month. At
that time, if the doctor does not change protocols--change
doctors. Start with the least invasive approaches (life style,
exercise, manipulation and acupuncture) then, if necessary,
progress to the more invasive (medication, injections and
surgery). As in all matters of your health, take charge of your
treatment--hire those who have something to offer and fire those
who don't.
Note to our patients...The doctors in our office are among the
most skilled in the diagnosis and treatment of low back pain in
the country. We teach classes and seminars to the medical,
chiropractic and acupuncture professions on this subject and
have for the last 20 years. We are published in peer reviewed
medical journals.
You have choices. Discuss any and all options related to your
back care with me. I will be happy to help you out!
About the author:
Dr. Rick Morris is the founder of the The Morris Spinal Stenosis
and Disc Center in Santa Monica, Ca. You can read more of his
health articles or contact him at his website and find out about
his <a href="http://www.wevegotyourback.org">non-surgical
treatment of low back pain disorders</a>. This article
originally appeared in Investor's Business Daily.
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