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Oh, my aching back

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When it comes to back pain, Americans spend. They run up a collective bill of more than $50 billion a year, according to the American Institute of Neurological Disorders and Stroke. Back pain is also the second most common reason for a visit to a primary care physician.

Yet for many people, back pain remains a mysterious dilemma. Krzysztof Siemionow, M.D., a spinal surgeon with the Chicago Center for Orthopedics at Weiss, set out to answer questions for local community members earlier this month. He spoke at the Learning Café lecture at Weiss, presenting the talk “Oh, My Aching Back: Common Causes of Back Pain & When to Seek the Advice of a Doctor.”


Causes of lower back pain include:


  • Lumbar strain or sprain—70%
  • Degenerative changes—10%
  • Herniated disc—4%
  • Osteoporosis or compression factors—4%
  • Spinal stenosis—3%
  • Spondyloolysis—3%
  • Traumatic fracture—less than 1%
  • Cancer—less than 1%

Dr. Siemionow makes one recommendation above all else for back pain prevention. “Exercise. I always stress the exercise,” he said. Standing and lying down, he added, put less pressure on the back than sitting.

To understand the spine, picture the pole that goes through the middle of a tent, he explained. From the top of the pole, ropes stretch to the different sides of the tent, securing the pole in place. Those ropes are the muscles in your core and back, which help keep the spine as straight as possible. The stronger they are, the less work and pressure for the vertebrae.

He recommends seeking a physician’s advice if pain does not subside after three days on an over-the-counter pain reliever such as ibuprofen or if the person has weakness or numbness in the leg, fever or bladder/bowel problems.

People also need to consider “red flags” when debating contacting a physician about their pain. Red flags include a family history of cancer, unexplained weight loss, intravenous drug use, prolonged steroid use, osteoporosis, fever and bowel/bladder dysfunction. These may be indicative of bigger issues, about which patients should alert their physicians.

To ease lower back pain, many people turn to medication, including anti-inflammatories, Tylenol and narcotic pain relievers. Some also use more holistic approaches, such as chiropractic care, massage and acupuncture therapies.

Regarding these options, Dr. Siemionow said, “People always ask me what I think about them, and I think they’re great if they’re helping you feel better, but more evidence is needed.”

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