Feb
18
2018

Causes Of Back Pain And Their Treatment

There are many possible causes of back pain and their treatment is described in this blog. I have listed the 10 most common causes of back pain below. I also added brief therapeutic suggestions.

Facet joint disease (lower back strain)

When there is a misalignment of the facet joints, the joint capsules of these small joints are pulled, which can cause severe back pain. Chiropractic or physiotherapy treatments initially followed by active exercises will help (facet joint pain).

Degenerative disc and facet joint disease

Degenerative changes of the disc material between vertebral bodies and osteoarthritis of the facet joints can cause back pain. This is due to irritation of the nerve roots. Anti-inflammatory medication and physiotherapy treatments often help; swimming will be beneficial as well. End stage intractable disease, if confined to one or two levels, may respond to fusion surgery by a spinal surgeon. While you research the surgical option, I suggest you investigate about the possibility of stem cell therapy with PRP (platelet rich plasma). This is less invasive and will likely heal better than conventional surgery.

Spondyloarthropathies

This is a family of chronic inflammatory joint diseases of the spine . The physician treats the underlying disease and uses anti-inflammatories to control inflammation. Most of all, a person with this condition needs a referral to a rheumatologist for more specific therapy.

Osteoporosis

Osteoporosis is a bone condition that can lead to compression fractures of the spine. These in turn can irritate one of the nerve roots to lea to radiating pain into one or both legs. The physician will treat the underlying hormone disbalance, if present. Regular walking and swimming are used to remobilize. Avoid alcohol, caffeine and stop smoking. Supplements like calcium, bisphosphonates, vitamin D in higher doses and vitamin K2 can help re-calcify the bone.

Scoliosis

Scoliosis is often congenital. This spinal curvature leads to back pain and hurts more the more the spine is curved. Treatment: bracing during growth spurts; good posture; strengthening exercises; in severe cases corrective surgery by a spinal surgeon through the use of Harrington rods.

Spinal stenosis

Spinal stenosis is often the end condition of severe degenerative arthritis of the spine. It is more common in the older generation. As this link explains, there is a narrowing of the channel through which the spinal cord travels. In the past decompression surgery for severe cases was the only means to free spinal cord and nerve roots. In the last few years stem cell therapy is a new addition as an alternative to orthopedic surgery. The advantage of stem cell therapy is that there is no scarring following the procedure and the stem cells function like a biological knife from inside.

 Posttraumatic fibromyalgia

Some people develop lower back pain following traumatic injuries. Instead of resolving their muscle sprain, they end up with chronic pain. Often low dose antidepressants and cognitive therapy will help. Mild physical exercises may help to rehabilitate the patient and return to normal muscle mobility. Unconventional therapy like prolotherapy, dry-needling and low-dose laser therapy (Dr. Weber) may be useful.

Disc herniation with or without sciatica

With disc herniation the back pain is intense, which often prompts the orthopedic surgeon to do an early discectomy (back surgery). But long term studies have shown that only in 3% of all acute back pain cases surgery is necessary; many cases heal on their own. In this case the new regenerative medicine approach of stem cell therapy with PRP will give superb clinical results. Stem cells will rebuild the disc and also take care of any arthritis in the small joint along the spine.

Spondylolisthesis and other congenital malformations

There are 4 grades of slipped vertebral body diseases (spondylolisthesis), where grade IV is the most severe case. Grade I to IIIA do not need surgery, stage IIIB and IV need fusion with instrumentation by a spinal surgeon.

Bone metastases

In stage 4 of many cancers metastases travel through the whole body including the skeleton. The underlying cancer needs treatment, often chemotherapy is required. Unfortunately cancers with bone metastases have a very poor prognosis. Here is a link how to manage symptoms of bone metastases.

Causes Of Back Pain And Their Treatment

Causes Of Back Pain And Their Treatment

Conclusion

I have listed the ten most common ones of back pain. For muscle spasms, simple physiotherapy or chiropractic treatment are often very helpful. Early degenerative changes in joints and discs will often respond to anti-inflammatory medication. But anti inflammatory drugs can be hard on your liver and your kidneys. If your back pain is getting more chronic, your doctor may want to arrange for an MRI scan of the area that causes pain. If this shows degenerative change in the discs and facet joints it is time to contact a regenerative medicine clinic. They specialize in stem cell and platelet rich plasma (PRP) treatments. This may be what you need to restore your back to normal. Conventional surgical methods are often the choice, but they are not always successful. Surgery can leave scarring behind, which by itself can give you chronic back pain.

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Jun
15
2013

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Imagine that you had lower back pain and your doctor said that physically everything was OK. Would you consider traditional Chinese acupuncture? According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). It is now replaced by the much simpler, but more effective electro-acupuncture using electrical skin pads instead of needles.

The science of electro-acupuncture

In 1958 news came from China that they had done major surgeries with patients being awake and having been made pain free only with the use of electro-acupuncture. In other words no chemical anesthesia was used or else very little was needed to make patients comfortable. Professor Ji-Sheng Han from the Beijing Medical University observed that only electrical stimulation was powerful enough to produce the pain relief that was necessary to allow general surgery. Dr. Han conducted systematic experiments to study the phenomenon of electro-acupuncture and published this in Ref. 2. One of the experiments involved two rabbits where the donor rabbit was anesthetized with electro-acupuncture. Spinal fluid was taken and transferred into a recipient rabbit that had not been further treated. This second rabbit was now rendered pain free to the point where surgery could be performed without pain. Other researchers such as Dr. Pomeranz found that the brain released endorphins in response to electro-acupuncture, powerful morphine-like substances. It was the endorphins that were responsible for making the recipient rabbit of Dr. Han’s experiment pain free. Other experiments of Dr. Pomeranz showed that naloxone, a morphine and endorphin blocker also blocked the analgesic effect previously found by transferring spinal fluid. These lines of experiments also explain why some patients did not respond to electro-acupuncture, as they have a deficiency in the pain control system of their brain lacking endorphin release. Dr. Han did 30 years of experimentation and also observed patients very closely. Dr. Han also investigated the placebo effect and found that this can explain about 30% of healing  However, the remainder of the 70 to 75% response to electro-acupuncture in his opinion was due to the procedure. He was able to explain that traditional Chinese acupuncture points were merely spots on the body where electric currents are picked up easier and transmitted up to the spinal cord and into the brain. They are then switched over in the brain and spinal cord to nerves that go to other areas of the body. This explains how electrical impulses can travel from conducting polymer pads applied over acupuncture points, release neuropeptides in the brain and help the body to heal. Functional MRI studies have confirmed that the brain is stimulated by certain frequencies through electro-acupuncture or traditional Chinese acupuncture to give pain relief.

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

Electro-Acupuncture Twice As Effective As Conventional Acupuncture

These types of studies have also shown that electro-acupuncture produces stronger signals in the brain than traditional Chinese acupuncture.

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. It can be used to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy.

It may also be useful as an adjunct to treating high blood pressure and cardiovascular disease.

One area where clinical hypnosis and electro-acupuncture are coupled is called “conditioned healing” (Ref.1). For instance with posttraumatic stress disorder (PTSD) in returned solders or in rape victims it has been shown that hypnotherapy treatment while using electro-acupuncture for 30 minutes at the same time can be useful in alleviating the symptoms these patients experience.

A few case studies using electro-acupuncture

Here are a few case studies that illustrate the use of electro-acupuncture with regard to patients (cases modified from Ref.1). A treatment consists of a 30-minute session where the patient is either sitting or resting comfortably on an examining table. Treatments initially are often given twice per week until the pain has been reduced to about 50% of the original pain (severity of pain is scored on a 0 to 10 scale right from the beginning). From that point in the treatment program the visits are reduced to weekly sessions. Most clinical problems require three to 12 sessions. If the pain goes away, but returns after a few weeks, repeat sessions can be scheduled, which often lead to pain relief in a shorter time interval than was the case with the original problem. Chronic problems can be treated on an ongoing basis once per month, if there was a clinical response, but the pain reoccurs.

  1. A 53-year-old painter with left shoulder pain, which radiated into the left chest, had problems with painting above his head. His physician did heart studies, but everything was OK. He was told that this was due to a muscle spasm in the shoulder muscles. One electrode was placed over the hoku point (also called LI-4 acupuncture point), which is located over the first interosseus muscle between the thumb and index finger, the other electrode over the area of pain in the left shoulder. Only seven treatments, twice per week for 2 weeks were given, then treatments with weekly intervals were administered. This approach cured his shoulder problems, and he could return to paining.
  2.  A 39-year-old woman came to the office complaining of lower back pain, which radiated into her right leg to the knee area. After tests she was told that she had spinal stenosis with sciatica (irritation of the sciatic nerve). No surgery could be done for this. She was given twelve electro-acupuncture treatments with one electrode placed below her right knee (ST-36 acupuncture point) and another electrode placed over her right lower back over one of the BL acupuncture points. She was almost pain free for about two weeks, but the pain came back after the last treatment. Since then she has been getting ongoing monthly electro-acupuncture visits with about 80% pain relief. Keep in mind that spinal stenosis is a condition for which regular medicine has nothing to offer other than symptomatic pain medication, which she did not want.
  3. A 30-year-old schoolteacher has been suffering from anxiety attacks and agoraphobia (fear of open spaces) for several years. Conditioning with electro-acupuncture (conditioned healing as mentioned above) was used to treat this woman. She received a series of treatments with electro-acupuncture over both interosseus muscles (hoku acupuncture point or LI-4) for 30 minutes during which time she was also listening to a relaxation tape with music in the background and suggestions for self-hypnosis. She was told how to do self-imagery at home. She did this for 10 minutes two or three times per day. Several weeks later she was able to control her anxiety attacks and overcome her fear of open spaces. In the beginning her symptoms were rated as 8 to 10 in severity on a scale from 0 to 10. At the end of the sessions she only had occasional symptoms with a 1 to 2 rating on this scale.
  4. A 50-year-old man with cluster headaches who had been investigated extensively by a neurologist without any other underlying cause was treated with electro-acupuncture. The electrodes were placed on acupuncture points of the head. Within only 4 sessions most of the headaches were gone. After 8 sessions he had no more headaches. However, a few weeks later his cluster headaches returned, but with ongoing monthly treatments he is able to prevent them from recurring. He did not like the side effects of all the pain medications, so he rather goes for his monthly booster electro-acupuncture treatments.

Take-home message regarding electro-acupuncture

Many people never considered traditional Chinese acupuncture for fear of needles. However, extensive research by Dr. Han and Dr. Ulett showed that electro-acupuncture with electrically conducting polymer pads or with EKG pads will replace the acupuncture needles. Not only is this method needle free, but also the weak electrical impulses that are used with electro-acupuncture treatment double the effectiveness of the older acupuncture method.

Many acupuncturists use both methods of acupuncture, but Dr. Ulett who used traditional acupuncture in the past has completely abandoned it and uses electro-acupuncture with the HANS machine instead. It is a complementary medical treatment, which has been authorized by the FDA.

More on pain conditions: http://nethealthbook.com/neurology-neurological-disease/pain/

References

1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

2. J.S. Han: “The Neurochemical Basis of Pain Relief by Acupuncture”. Vol. 2. Hu Bei Science and Technology Press, Beijing, 1998 (784 pages).

Last edited Nov. 6, 2014

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