Heal Your Back: Your Complete Prescription for Preventing, Treating, and Eliminating Back Pain

295 Pages·2011·1.8 MB·English

HEAL YOUR BACK
1100--555544__BBoorreennsstteeiinn..iinnddbb ii 1100//2200//1100 99::2288 AAMM
1100--555544__BBoorreennsstteeiinn..iinnddbb iiii 1100//2200//1100 99::2288 AAMM
HEAL YOUR BACK
Your Complete Prescription
for Preventing, Treating,
and Eliminating Back Pain
David Borenstein, M.D.
M. Evans
Lanham • New York • Boulder • Toronto • Plymouth, UK
1100--555544__BBoorreennsstteeiinn..iinnddbb iiiiii 1100//2200//1100 99::2288 AAMM
ATTENTION: This book includes the most up-to-date information about conventional and
complementary therapy for low back pain, based upon my thirty-two years of clinical experience
with people with spine problems. The object of this book is to educate people about low back
pain and offer relief of this disorder. Despite these good intentions, this book cannot offer
any guarantee about the ultimate resolution of your back condition. Do not be tempted to use
this book as a substitute for a medical evaluation. An examination by a health professional
is always an appropriate approach to the evaluation of low back pain. Your physician has the
unique advantage of listening to your description of your problem and completing a physical
examination before forming an opinion about the cause of your back pain. The information in
this book may differ from the advice offered by your health care provider. The recommendations
in this book are not meant to replace medical treatment or diagnosis by your physician. When
in doubt about the advice you have received, obtain a second opinion from another health care
professional. Ultimately, you are solely responsible for your own medical decisions.
Published by M. Evans
An imprint of The Rowman & Littlefield Publishing Group, Inc.
4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706
http://www.rlpgtrade.com
Estover Road, Plymouth PL6 7PY, United Kingdom
Distributed by National Book Network
Copyright © 2011 by David Borenstein
All rights reserved. No part of this book may be reproduced in any form or by any electronic
or mechanical means, including information storage and retrieval systems, without written
permission from the publisher, except by a reviewer who may quote passages in a review.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Borenstein, David G.
Heal your back : your complete prescription for preventing, treating, and eliminating back pain
/ David Borenstein.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-59077-185-3 (pbk. : alk. paper) — ISBN 978-1-59077-186-0 (electronic : alk.
paper)
1. Backache—Popular works. 2. Backache—Treatment—Popular works. 3. Backache—
Prevention—Popular works. I. Title.
RD771.B217B6695 2011
617.5'64—dc22
2010037696
™
The paper used in this publication meets the minimum requirements of American
National Standard for Information Sciences—Permanence of Paper for Printed Library
Materials, ANSI/NISO Z39.48-1992.
Printed in the United States of America
1100--555544__BBoorreennsstteeiinn..iinnddbb iivv 1100//2200//1100 99::2288 AAMM
This book is dedicated to all my patients
who have given me the honor of being their physician.
This work is the result of their persistent requests
to put my explanations of their back problems on paper.
1100--555544__BBoorreennsstteeiinn..iinnddbb vv 1100//2200//1100 99::2288 AAMM
1100--555544__BBoorreennsstteeiinn..iinnddbb vvii 1100//2200//1100 99::2288 AAMM
Contents
Acknowledgments xi
Introduction: One Big Sneeze Can Do You In
and the Twist and Shout xiii
PART I: TAKING THE MYSTERY OUT OF LOW BACK PAIN
Chapter 1: Understanding Why Your Back Hurts 3
Is It Mechanical or Medical? (cid:129) How Your Back Works (cid:129) Pain Is
Different in Men and Women (cid:129) How Your Pain Threshold Fluctuates
Chapter 2: Working with Your Doctor 19
Questions to Help You Find the Cause (cid:129) The Physical Examination (cid:129)
Doctors and Health Care Professionals Who Treat Low Back Pain
Chapter 3: What Diagnostic Tests Can—and Cannot—
Tell You 33
Pictures May Not Tell the Whole Story (cid:129) Conventional X rays (cid:129)
Magnetic Resonance Imaging (MRI) (cid:129) Computed Axial Tomography
(CT) (cid:129) Myelography (cid:129) Bone Scan (cid:129) Discography (cid:129) Bone
Densitometry (cid:129) Electrodiagnostic Tests (cid:129) Blood Tests
PART II: KNOWING YOUR TREATMENT OPTIONS
Chapter 4: The Basic Back Pain Relief Program 51
Control Physical Activities but Limit Bed Rest (cid:129) Using Over-the-
Counter Medications (cid:129) Applied Therapy (cid:129) Aerobics: Expanding
Your Comfort Zone—Gradually (cid:129) Maintain a Positive Attitude (cid:129)
If Back Pain Is Chronic
[vii]
1100--555544__BBoorreennsstteeiinn..iinnddbb vviiii 1100//2200//1100 99::2288 AAMM
Chapter 5: Recognizing and Treating Mechanical
Low Back Pain 63
Muscle Strain, Spasm, and Trauma (cid:129) Disc Degeneration and
Osteoarthritis (Lumbar Spondylosis) (cid:129) Herniated Disc and Sciatica (cid:129)
Piriformis Syndrome (cid:129) Cracked Vertebral Bodies (Spondylolysis and
Spondylolisthesis) (cid:129) Spinal Stenosis (cid:129) Scoliosis
Chapter 6: Recognizing and Treating Medical Causes
of Low Back Pain 83
Infection (cid:129) Bone Tumors and Cancer (cid:129) Inflammatory Diseases
(cid:129) DISH Syndrome (Diffuse Idiopathic Skeletal Hyperostosis) (cid:129)
Ochronosis (cid:129) Fibromyalgia (cid:129) Polymyalgia Rheumatica (cid:129) Tension
Myositis Syndrome (cid:129) Myofascial Pain Syndrome (cid:129) Blood and Vessel
Disorders(cid:129) Diabetic Neuropathy (cid:129) Pain from Nearby Organs (cid:129) Back
Pain in Pregnancy and Menstruation
Chapter 7: How Can I Keep from Getting Bent Over? 101
Osteoporosis (cid:129) Osteoporosis Diagnosis (cid:129) Men and Osteoporosis (cid:129)
Keep Your Bones Strong (cid:129) Regaining Height (cid:129) Preventing Falls
Chapter 8: Back Pain in Kids: Is It Just Growing Pains
or Is It More Serious? 113
Growing Pains (cid:129) Nonspecific Low Back Pain (cid:129) Kids’ Red Flags
(cid:129) Adolescent Scoliosis (cid:129) Adolescent Dowager’s Hump—
Scheuermann’s Disease (cid:129) Adolescent Spondylolisthesis
Chapter 9: How and When to Use Medications
Effectively for Pain 121
NSAIDs and COX-2 Inhibitors (cid:129) Muscle Relaxants (cid:129) Opioid and
Nonopioid Analgesics (cid:129) Corticosteroids (cid:129) Other Pain Therapies
Chapter 10: Treatment with Exercise and
Physical Therapy 137
Working with a Physical Therapist (cid:129) Flexion Exercises (cid:129) Extension
Exercises (cid:129) The “C” and “S” Curves (cid:129) Transcutaneous Electrical
Nerve Stimulation (TENS) (cid:129) Iontophoresis: Another Form of
“Injection” Therapy (cid:129) Getting in the Water
Chapter 11: Complementary Therapies 157
Manual Manipulation (cid:129) Massage and Other Bodywork Techniques
(cid:129) Acupuncture (cid:129) Yoga and Other Body, Mind, and Spirit Techniques
[viii] Contents
1100--555544__BBoorreennsstteeiinn..iinnddbb vviiiiii 1100//2200//1100 99::2288 AAMM
(cid:129) Mind-Body Therapies (cid:129) Meditation and Relaxation (cid:129) Body
Self-Awareness (cid:129) Magnet Therapy (cid:129) Homeopathy (cid:129) Nutritional
Supplements
Chapter 12: What to Know Before You Consider Surgery 183
Understanding the Risks (cid:129) Discectomy (cid:129) Spinal Fusion (cid:129) Spinal
Instrumentation: The Hardware Store (cid:129) The Artificial Disc—Buyer
Beware (cid:129) Emergency Surgery (cid:129) Anterior Spine Surgery (cid:129) Spine
Spacers (cid:129) Choosing an Orthopedic Surgeon or Neurosurgeon (cid:129) Your
Hospital Stay (cid:129) After Surgery—The Hard Part (cid:129) Failed Back Surgery
Syndrome (cid:129) Future Surgical Treatments
PART III: LIVING WITHOUT BACK PAIN
Chapter 13: Lower Your Risk for Back Pain with
Prevention: The ABC Plan 203
A—Abstain from Smoking (cid:129) B—Better Body Mechanics (cid:129) C—
Correct Diet (cid:129) Keep Working
Chapter 14: Enjoying Sex without Hurting Your Back 213
It’s Not All Physical (cid:129) Painless Positions (cid:129) Medication and Libido (cid:129)
Sexercises (cid:129) Back Surgery and Sexual Function
Epilogue: Being Back in Control Will Heal Your Back! 221
Glossary 223
Appendix A: Dr. B’s Back School FAQ 229
Is Any Particular Chair Helpful for Low Back Pain? (cid:129) Does Inversion Boot
Therapy Help Back Pain? (cid:129) Do My High Heel Shoes Cause Back Pain? (cid:129)
Does Prolotherapy Help Low Back Pain? (cid:129) What Does the Circular That
Comes with My Prescription Drug Package Mean? It Scares Me Half to
Death. (cid:129) How about Botox Injections for My Back Spasm? (cid:129) Which Is
the Best Aerobic Exercise Machine for a Person with Back Pain? (cid:129) Can
I Go Horseback Riding? (cid:129) What Sports Can I Safely Play If I Have Back
Pain? (cid:129) Can I Play Golf without Increasing My Back Pain?
Appendix B: Medications for Low Back Pain 239
Appendix C: Best Back Resources 245
References 249
Index 261
About the Author 275
Contents [ix]
1100--555544__BBoorreennsstteeiinn..iinnddbb iixx 1100//2200//1100 99::2288 AAMM