Pain in the Back: Relief Can Be Found Through Pain Management

Winning an amateur golf tournament would be nice, but Jose Alvarez, 42, just wants a pain-free golf swing. Lower back pain, however, has cramped his style.

Since Mr. Alvarez was sidelined by a painful herniated disc, which developed in the years following a car accident, his spine has been manipulated, massaged, injected and pricked at different area clinics.

Finally, his search for pain relief led him to Baptist Health Neuroscience Center, where he attended a standing-room-only seminar about back pain in late May. The program featured presentations from the Center’s multidisciplinary team of pain specialists, neurosurgeons, physical therapists and physiatrists (physical medicine doctors who specialize in rehabilitation).

The team works together to treat back disorders and develop pain management programs. That’s hopeful news for Mr. Alvarez, who plans to go to the Center for physical therapy and a pain management program.

“I’m looking for options to get better soon,” he said. He’s not alone. During a lifetime, eight out of 10 Americans experience lower back pain, according to Ronald Tolchin, D.O., medical director of the Center for Spine Care at Baptist Hospital, a part of Baptist Health Neuroscience Center.

Thirty-five percent of sedentary workers and 47 percent of physical laborers experience back pain. And if you’re over age 70, the risks are greater. Youth, however, is no guarantee. Pain from a back or neck disorder is the number-one cause of disability for young adults, ages 24-39.

Although back pain is common, effective treatment is a specialized process that begins with an accurate diagnosis, said pain specialist Moises Lustgarten, M.D. The diagnostic step is important because chronic or acute back pain can be caused by a variety of conditions — stress, infection, arthritis and injury — or even life-threatening illnesses, such as cancer and pancreatitis.

“We take a multidisciplinary approach to the treatment of spinal conditions,” said neurosurgeon Sergio Gonzalez-Arias, M.D., Ph.D., medical director of the Neuroscience Center. “Restoring patients to health is the focus of everything we do.”

At the Center for Spine Care, diagnostic tests include X-ray, MRI, CT scan and myelogram, an X-ray process that uses dye to make images of the spinal canal and vertebral bones.

Lifestyle, mental/emotional health and work conditions are factored into the diagnosis. Based on the diagnosis, treatment plans could include one or several complementary therapies:

• Physical therapy and rehabilitation: Rehabilitation programs include guided exercise, heat/ice therapy, noninvasive electrical nerve stimulation and other techniques that reduce pain. The prescription may also call for stress management, biofeedback and counseling, according to psychologist Ronald Rosenthal, Ph.D. “When you are more relaxed, pain diminishes,” Dr. Rosenthal said. “Relaxation is anti-inflammatory.”

• Pain management: Options for acute and chronic pain management include anti-inflammatory medication, muscle relaxants, and other prescription and nonprescription painkillers. Chronic pain treatment options include epidural shots in the spine, which help to deaden sensation, and the surgical insertion of small electronic devices that either block pain signals to the brain (radiofrequency denervation) or deliver steady doses of pain medicine, according to pain specialist Julian Naranjo, M.D.

• Surgery: Only about 10 percent of back disorders require surgery, according to Dr. Gonzalez-Arias, a leader in groundbreaking techniques for minimally invasive neck and back surgery. He and other Neuroscience Center surgeons perform some types of back surgery on an outpatient basis; other traditional surgeries require a hospital stay.

“Pain management has changed completely into a new field,” said Eduardo Escorcia, M.D., a pain management specialist at Doctors, Homestead and West Kendall Baptist Hospitals. “The goal is to get patients back to the activities of daily life.”

To schedule an appointment or to learn more about the services, call 786-596-BACK (2225),email SpineCare@BaptistHealth.net or visit BaptistSpineCenter.com.

Expert Advice
See a doctor if your lower back pain is accompanied by any of the following symptoms or conditions:

• Recent significant trauma, or milder trauma
• Unexplained weight loss
• Unexplained fever
• Suppressed immune system
• History of cancer
• Intravenous (IV) drug use
• Osteoporosis
• Prolonged use of corticosteroids
• Numbness, tingling or other neurological symptoms
• Pain for six weeks or longer