Back pain is one of the leading causes of disability, affecting millions of Americans each year. But the bigger problem is that most of us are rushing in with the wrong treatments. We sat down with Dr. Alex Vaccaro, one of the world's leading spine surgeons and President of the Rothman Institute, to point you in the right direction.
How common is back pain?
80 percent of us, at some point in our life, will experience an episode of disabling back discomfort. It's usually transient, but does become a sustained problem for some.
Do most people require formal treatment?
That's the greatest misconception. A whopping 60 percent of patients with really bad back pain get much better within six to eight weeks; 90 percent feel significantly better after two to three months. It's the 10 percent who don't get better that represent the real concern. For everyone else, an X-ray or MRI aren't necessary.
The only real exception is if you've fallen and potentially have a fracture, or if you're over 50 as that may indicate a more serious medical concern like cancer. Those are really the only times you'd need a more urgent workup.
What's the best way to treat back pain?
If back pain isn't getting better on its own within six to eight weeks, intermittent anti-inflammatory medication and/or non-impact physical therapy are the only modalities proven to be effective. The latter encompasses a lot of activities, including yoga, pilates and aerobics. The point is that these less severe interventions are usually your best bet when fighting back pain.
What about surgery?
Despite popular belief, surgery is far from the best way to treat back pain. In fact, less than 2 to 3 percent of people who get a more thorough diagnostic workup actually get to the operating room. While spine surgery is very effective in treating leg pain, removing tumors and healing spinal issues, it's not a go-to back pain treatment. We tell people they shouldn't even consider any type of surgical intervention for at least six months, failing an organized, non-operative treatment protocol.
What about epidural steroids?
These are really only effective for leg pain. It's a total waste of time for back issues and actually increases the odds of developing an infection.
Is there anything else people can do?
Yes! Lifestyle tweaks can go a long way. Exercising for 40 minutes a day, maintaining a healthy weight and avoiding nicotine are your best defenses. The thing to remember is that back pain usually gets better. If it doesn't, anti-inflammatory medications paired with physical therapy is usually the best way to go.