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UNDERSTANDING BACK PAIN

I. M. Doctor, M.D. My Office My City, State. UNDERSTANDING BACK PAIN. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred. Thank you to

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UNDERSTANDING BACK PAIN

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  1. I. M. Doctor, M.D. My Office My City, State UNDERSTANDING BACK PAIN

  2. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred. Thank you to A. Herbert Alexander, MD for his significant contributions to the content of this presentation.

  3. Understanding Back Pain Orthopaedics and The Bone and Joint Decade Types of back pain Diagnosing the causes of back pain Who is at risk for back pain?

  4. Understanding Back Pain • Seeking help • Therapies to help back pain sufferers • Medications • Surgery • Nonsurgical treatments • Complementary approaches

  5. What is an orthopaedic surgeon? MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

  6. What is an orthopaedic surgeon? The expert in treating the musculoskeletal system The expert in maintaining musculoskeletal health The expert in understanding both operative and non-operative treatment options

  7. Educating an Orthopaedic Surgeon • College • Medical School • Internship • Orthopaedic Residency • Fellowship (optional) • 2 Years Practice TOTAL 4 4 1 4 (1) 2 16 years!

  8. What do orthopaedic surgeons do? • Diagnose • Treat • Medication • Physical Therapy • Exercise • Brace • Surgery • Prevent

  9. Back Pain Your Orthopaedic Surgeon— Getting You Back In The Game

  10. Back Pain • Structural Issues: • Muscular • Arthritic • Disk • Psychological Issues: • Emotional stress • Medical Issues: • Infections • Inflammatory conditions

  11. Throbbing, aching, shooting, stabbing, dull or sharp pain Pain down one or both legs with very little pain in the lower back Numbness or weakness in the legs Symptoms

  12. Pain down in the lower back & legs in certain positions such as standing or walking Sleep problems, decreased energy, depression, and anxiety Pain that stress and emotional issues causes or makes worse Symptoms

  13. Examination by an orthopaedic surgeon Period of activity modification Perhaps medication to decrease pain and inflammation Complete inactivity is not advised for more than a couple of days General Treatment

  14. Rehabilitation Goals Increased muscle strength Increased endurance Increased flexibility Improve aerobic fitness General Treatment

  15. Healthy Spine Function Spinal Column Cervical Thoracic Lumbar Sacrum Coccyx

  16. Healthy Spine Function Facet joint Vertebra Disc Spinal canal Vertebra

  17. Healthy Spine Function

  18. Healthy Spine Function Trapezius Latissimus Erector spinae muscles Abdominal wall muscles Obliques Psoas Gluteals

  19. Lower back pain is the one of the most commons common causes of missed work Eight out of ten adults will experience back pain at some time Burden of Disease

  20. 58 million ambulatory care visits for back and neck pain 82 million work days lost Burden of Disease

  21. Getting You Back In the Game Robert Dover Olympic equestrian Age: 44 Condition/Injury: Low Back Pain

  22. Herniated disc/sciatica Sprain/Strain Stress-related back pain Diagnosis

  23. Arthritis of spine Symptomatic disc degeneration Facet Syndrome Spondylolisthesis & Spondylolysis Diagnosis

  24. Spinal fractures Lumbar spinal stenosis Chronic back pain syndrome Diagnosis

  25. Actual Clinical Case Example: Conchita Espinosa Chediak Age: 41 Condition/Injury: Large herniated lumbar disc, severe back pain, and foot drop

  26. Large Disc Herniation

  27. Job requires frequent bending and lifting Twisting body when lifting & carrying an object Lifting and carrying in a hurry Are You At Risk?

  28. Overweight Do not exercise regularly Do not engage in recreational physical activity Smoker Are You At Risk?

  29. Plan ahead, don’t hurry Tighten stomach muscles Move in close when placing object on high shelf Bend knees Don’t twist Lift with leg muscles Spread feet shoulder distance apart 29

  30. Seeking Help Primary Care Physicians Orthopaedic Surgeons Spine Surgeons

  31. Before Your Appointment Prepare to describe your symptoms Gather medical history Make list of medications Write down concerns and questions and bring them Seeking Help

  32. During Your Appointment 1. What should I expect from my treatment? 2. What effect will my treatment have on my daily activities? 3. What can I do to prevent further disability? Seeking Help

  33. Exercise is key Aerobic conditioning program Special back exercises Active Therapies

  34. Active Therapies: Exercise

  35. Active Therapies: Stretching 35

  36. Pain Programs Involve multiple healthcare professionals Different treatments at different times Goal is to decrease pain, increase functioning Patient must be highly motivated Active Therapies

  37. Passive Therapies Ultrasound and massage Water therapy Transcutaneous Electrical Nerve Stimulation (TENS)

  38. Passive Therapies Traction Corsets and braces

  39. Why are you recommending this medication? How will this medication help me to feel better? What are the benefits and when will we know if it works? Medication 8 Important Questions to Ask Your Orthopaedic Surgeon

  40. 4. How do I take this medication? 5. What are the side effects? What to do if I have side effects? Are they temporary? 6. Is it okay to use generic? Medication

  41. 7. Can I take this medication with others I’m currently taking? 8. How do I stop taking it safely? Medication

  42. Medication Analgesics Anti-inflammatories Muscle relaxants Sedatives Anti-anxiety agents Antidepressants

  43. Trigger point injections Facet injection Spinal epidural steroid injections Selective nerve root blocks Invasive Conservative Treatments What to show here?

  44. Leg pain rather than back pain Non-operative treatments are ineffective Symptoms match test findings Symptoms prevent daily living activities Surgery May Be Your Choice When…

  45. Surgery Finding a Surgeon

  46. Why? Alternatives? Benefits and for how long? Asking Questions About Surgery

  47. Risks? What is procedure called? How is it done? Results? Asking Questions About Surgery

  48. Duration of recovery? Assistance at home and how long? Disability after surgery? Physical therapy? Return to normal activity? Asking Questions About Surgery

  49. Back Pain Therapies Medication Surgery Complementary Approaches

  50. Resources American Academy of Orthopaedic Surgeons 6300 N. River Road Rosemont, IL 60018 www.orthoinfo.org

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