Low Back Clinc Toronto

Document Sample
Low Back Clinc Toronto Powered By Docstoc
					Low Back Clinic Canada
Emerging treatments

* Vertebroplasty involves the percutaneous injection of surgical cement into vertebral
bodies that have collapsed due to compression fractures has been found to be ineffective
in the treatment of compression fractures of the spine.
* The use of specific biologic inhibitors of the inflammatory cytokine tumor necrosis
factor-alpha may result in rapid relief of disc-related back pain.

Conservative treatments

* Exercises can be an effective approach to reducing pain, but should be done under
supervision of a licensed health professional. Generally, some form of consistent
stretching and exercise is believed to be an essential component of most back treatment
programs. However, one study found that exercise is also effective for chronic back pain,
but not for acute pain. Another study found that back-mobilizing exercises in acute
settings are less effective than continuation of ordinary activities as tolerated.

* Physical therapy consisting of manipulation and exercise, including stretching and
strengthening (with specific focus on the muscles which support the spine). 'Back
schools' have shown benefit in occupational settings. The Schroth method, a specialized
physical exercise therapy for scoliosis, kyphosis, spondylolisthesis, and related spinal
disorders, has been shown to reduce severity and frequency of back pain in adults with
* A randomized control trial, published in the British Medical Journal, found that the The
Alexander Technique provided long term benefits for patients with chronic back pain.. A
subsequent review concluded that 'a series of six lessons in Alexander technique
combined with an exercise prescription seems the most effective and cost effective option
for the treatment of back pain in primary care'.

* Studies of manipulation suggest that this approach has a benefit similar to other
therapies and superior to placebo.

* Acupuncture has some proven benefit for back pain ; however, a recent randomized
controlled trial suggested insignificant difference between real and sham acupuncture .

* Education, and attitude adjustment to focus on psychological or emotional causes -
respondent-cognitive therapy and progressive relaxation therapy can reduce chronic pain.

Low Back Clinic Canada :Prevention

Although specific back exercises may not relieve existing low back pain, exercise can
help to prevent it from occurring in the first place or recurring after it has eased. An ideal
exercise routine combines stretching and strength-building exercises with endurance

Low Back Clinic Healthy

Upper back pain, also called middle back pain or thoracic pain, is pain that is felt between
the bottom of the neck and top of the lumbar spine. The upper spine is very strong and
stable to support the weight of the upper body, as well as to anchor the rib cage which
provides a cavity to allow the heart and lungs to function and protect them.


Back pain can be divided anatomically: neck pain, upper back pain, lower back pain or
tailbone pain.

By its duration: acute (less than 4 weeks), subacute (4 – 12 weeks), chronic (greater than
12 weeks).

By its cause: MSK, infectious, cancer, etc.

Low Back Clinic Toronto : Causes and solutions

The most common cause of upper back pain is believed to originate from muscular
irritation or other soft tissue (e.g. ligament) problems. These can arise from lack of
strength, poor posture, overuse injuries (such as repetitive motion), or a trauma (such as a
car accident or sports injury). Muscular strain in the upper back is usually treated by one
or a combination of the following:

* Exercise/Active and passive physical therapy
* Joint manipulation, as commonly performed by chiropractors or osteopathic physicians
* Deep massage or massage therapy
* Acupuncture
* Ice and/or heat therapy
* Analgesics such as non-steroidal anti-inflammatory drugs

If there is a specific tender spot, then trigger point massage or injections can be helpful.

Another cause of upper back pain is problems with the joints that connect the vertebrae
and the ribs. Treatment for joint problems such as this usually includes:

* Manual manipulation (with an osteopathic physician or chiropractor)
* Exercise and physical therapy
* Pain medications such as anti-inflammatory medications

A compression fracture of the vertebra can also cause acute and/or chronic pain in the
upper back. Especially for women over age 50 with complaints of upper back pain, a
vertebral compression fracture due to osteoporosis should always be considered a
possibility. A painful vertebral compression fracture may be treated with pain medication
and rest, or with vertebroplasty or kyphoplasty surgery.

Other, less common causes of upper back pain include a spinal disc herniation,
degenerative disc disease, or some type of trauma (such as a fall) that may have fractured
a vertebra in the thoracic spine.

Low Back Clinic Imaging

* X-ray: Although traditional plain X-rays are limited in their ability to image soft tissues
such as discs, muscles, and nerves, they are still used to confirm or exclude other
possibilities such as tumors, infections, fractures, etc.. In spite of these limitations, X-ray
can still play a relatively inexpensive role in confirming the suspicion of the presence of a
herniated disc. If a suspicion is thus strengthened, other methods may be used to provide
final confirmation.
* Computed tomography scan (CT or CAT scan): A diagnostic image created after a
computer reads x-rays. It can show the shape and size of the spinal canal, its contents,
and the structures around it, including soft tissues.

MRI Scan of lumbar disc herniation between fourth and fifth lumbar vertebral bodies.

* Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional
images of body structures using powerful magnets and computer technology. It can show
the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration,
and tumors. It shows soft tissues even better than CAT scans.
* Myelogram: An x-ray of the spinal canal following injection of a contrast material into
the surrounding cerebrospinal fluid spaces. By revealing displacement of the contrast
material, it can show the presence of structures that can cause pressure on the spinal cord
or nerves, such as herniated discs, tumors, or bone spurs. Because it involves the injection
of foreign substances, MRI scans are now preferred in most patients. Myelograms still
provide excellent outlines of space-occupying lesions, especially when combined with
CT scanning (CT myelography).
* Electromyogram and Nerve conduction studies (EMG/NCS): These tests measure the
electrical impulse along nerve roots, peripheral nerves, and muscle tissue. This will
indicate whether there is ongoing nerve damage, if the nerves are in a state of healing
from a past injury, or whether there is another site of nerve compression.

Low Back Clinic Canada Upper back pain, also called middle back pain or thoracic
pain, is pain that is felt between the bottom of the neck and top of the lumbar spine. The
upper spine is very strong and stable to support the weight of the upper body, as well as
to anchor the rib cage which provides a cavity to allow the heart and lungs to function
and protect them.
More results:
Low Back Clinic Solution About Low Back Clinic Low Back Clinic Solution

Shared By:
Description: Low Back Clinc Toronto