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Beating Lower Back Pain -- Without Surgery
Study Shows That Patients Get Same Benefits Regardless of
Whether or Not They Choose the Knife
By C. JASMINE KARALAKULASINGAM
ABC News Medical Unit
Nov. 22, 2006
Patients suffering from lower back pain could get the same
benefits in pain relief and function from nonsurgical treatment
as from back surgery, a new study shows.
Physicians
treating patients with back pain may be able to offer a
no-surgery option, as non-surgical long-term outcomes might be
similar.
(ABCNEWS.com)
Low back pain is one of the
most common complaints doctors hear from their patients, but
choosing the best treatment has long been a mystery. New
research in The Journal of the American Medical Association
today suggests that patients who opt for nonsurgical treatments
can get the same benefits in pain reduction and function in the
long term as those who chose surgery.
"This confirms what we
already know about [back pain]," says Dr. William Richardson,
an orthopedic surgeon at Duke University Medical Center.
"Patients get better quicker with surgery, but long-term
results are no different."
"These studies will become
the worldwide standard of care for patients who suffer from
herniated discs," says Dr. Mark Brown, chairman emeritus of the
Department of Orthopaedics and Rehabilitation at the University
of Miami in Florida. "This should eliminate the wide regional
variation in numbers of disc surgeries performed in the U.S.
today."
Options for Back
Pain
Up to two-thirds of Americans
experience back pain at some point in their lives, and sciatica
can be one of its most debilitating complications. This
condition of the lower back, characterized by pain and numbness
that travel down the legs, is an extremely common
complaint.
The main options for
treatment range from popping a pill to a lumbar discectomy --
surgery to remove a part of the spine. In between are such
options as injectable steroid treatments, physical therapy, or
even counseling.
To look at whether surgical
or nonsurgical treatments are better for treatment of sciatica,
researchers combined the results of more than 1,200 patients
across the country in the Spine Patient Outcomes Research
Trial, or SPORT.
What they found was that
while surgery offered quicker relief of sciatica-related leg
pain in the short run, over time, both surgical and nonsurgical
approaches delivered positive results.
"The issue is when to switch
paths and consider surgery," says Dr. Scott Boden, professor of
orthopedic surgery at the Emory University School of Medicine
in Atlanta, and one of the studies lead
investigators.
"So, for surgeons who
previously did not believe in nonoperative treatment, this
study should remind them that it is effective. For surgeons who
would routinely wait 12 weeks before considering surgery, this
study should suggest that it is reasonable to offer the
patients the option of surgery after six weeks, and those that
choose surgery will tend to do better than those that choose
the 'continue to wait and see' approach."
"This
trial confirms some of the earlier findings, suggesting results
are similar with modern surgical and nonsurgical treatment
techniques," says Dr. Richard Deyo, another of the study's
authors and a professor of medicine and of health services at
the University of Washington Harborview Medical Center in
Seattle. "The results reinforce that most patients get better
with either type of treatment, but that if symptoms persist for
more than six weeks, surgery appears to offer faster
relief."
The information above was provided by ABC.com
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