Chronic back pain was thought to be a by-product of stress and mostly a mental more than physical issue up until a few years ago. Just over a decade ago research proved that chronic back pain was not due to hypochondria, depression or anxiety but actually a disease in its own right. Fortunately, there has been a lot of research done since then, especially when nearly 80 percent of adults in the UK have suffered from back ache at some point in their lives.
Treating back pain
There are many medications, devices, injections, exercises, stretches, acupuncture, bio-feedback and other treatments in use and under further research that can be used to treat back pain. There are a number of suggestions that indicate that pain treatment should be done holistically. The person should be treated as a whole person and include mental and physical treatments along with medication to improve the person’s life as a whole. Diet and exercise can also form part of the treatment of chronic back pain.
Sustained release pain medications are now available for back pain, which control the pain for long periods without having to take another pill every 3 to 4 hours to keep the pain under control.
Other drugs that are being explored include medications that target the ion channels which move electrolytes in and out of the nerves. These send the pain messages to the brain. Research is attempting to impact specific channels to prevent the nerve firing without impacting on the nerves that are not being targeted. Medications such as anticonvulsants, opioids, antidepressants have been used to successfully treat back pain. The interaction between some of these medications and the chronic back pain is not yet fully understood and more research still needs to be done in this field.
The use of various supplements have been found to impact positively on back pain such as fish oils which have anti-inflammatory properties due to their Omega-3 fatty acids. Evening primrose oil help nerves function properly due to the lipoic acid it contains. Glucosamine and chondroitin have also proven to have some effect on nerves and pain in general. Always consult your doctor before using supplements as they may have side effects when combined with your current medications.
Other treatments that will be available in the near future include spinal cord stimulation which makes use of a device implanted into the spine which is able to understand the electrical signals sent out by the nerves and can effectively prevent the pain signal from travelling to the brain. This surgery is intended mostly for patients with nerve damage after back surgery and is currently limited in distribution.
Studies into back pain
Studies have also shown a correlation between brain function and chronic pain. MRIs have shown that patients with chronic pain have less grey matter in the dorsolateral pre-frontal cortex which effects cognitive reasoning. A reduction in pain shows this area recovering and an increase in grey matter occurring. A body that is pain free shows a brain that is healthier and functioning normally as opposed to a body suffering chronic pain.
Various studies have also shown that an improvement in back pain is not always necessarily only physical. Feelings of depression and anxiety, stress and fear can delay the healing process and increase the level of pain experienced by the patient. Recovery is also longer in patients with psychological issues, depression symptoms or those believing that physical activity would increase their pain exponentially. Physical therapy, psychological and social treatments should be incorporated into the regime when treating chronic back pain and not just medication in order to achieve faster healing and better results over all.
Radio-frequency discal procedures are now available to treat back pain and sciatica through an insertion of a needle into the disc which generated a highly focussed plasma field. This field breaks up the bonds of the gel in the nucleus which reduces the size of the nucleus by up to 20 percent. This effectively reduces pressure on the disc and the surrounding nerves, relieving pain in the area. Another type of radio-frequency ablation known as intradiscal biacuplasty is under research and may be available in the near future. These technologies are as yet unproven, but offer a less invasive option that back surgery to relieve the pain in the lower back where the discs are involved.
Spinal pumps can be used to administer pain relievers directly into the spine without affecting the rest of the body and can keep a constant flow of medication to handle chronic back ache. This treatment is generally only considered after other types of treatment have failed or caused side effects that are intolerable.
Spinal stimulators which emit electrical impulses on the surface of the spinal cord are become more common for use on back and neck pain. Although also implanted, these do not use medication and the patient is able to control the strength of the pulse to control pain.