Back Pain Wears Me Out–or Does It?

Many clinicians who treat patients with chronic low back pain believe their patients need to do conditioning exercises for the heart and lungs. They believe these patients limit activity because of their pain, which leads to poor overall fitness. So patients with chronic low back pain are generally prescribed exercises to improve their aerobic stamina.

The first part of this study involved forming an equation to predict fitness levels in people with chronic low back pain. The authors then tested the long-held notion that these patients are generally less fit. The new formula showed that people with chronic low back pain had similar scores when compared with subjects who don’t have pain. The authors found that the patient group with chronic low back pain is “moderately fit” and not significantly deconditioned as commonly thought. However, the authors still suggest that people with chronic low back pain should be given aerobic conditioning exercises in order to help improve their overall ability to do their activities. 

New Thermal Treatments Put the Heat on Chronic Low Back Pain

When the fire of low back pain burns out of control, it may be time to fight fire with fire. A newer surgical treatment for disc problems called intradiscal electrothermal therapy (IDET) may come to the rescue. This type of procedure shows promise as an alternate treatment for people with bad back pain.

In IDET, doctors use a TV screen to guide a special needle into the sore disc. They then slip a heating element through the needle and into the injured zone. When the temperature of the element is raised, it is believed to shrink disc material, reducing a bulge or closing off a torn portion. It also seems to have a calming effect on pain sensors within the sore disc.

Doctors recently tested the benefit of this kind of treatment. They chose 25 patients with chronic low back pain who were having problems after at least six months of non-operative treatments. These patients were considered to be candidates for lumbar fusion surgery, but instead they chose to undergo the IDET procedure.

Before having IDET, they rated their pain  on a scale between zero and 10. They also filled out a form about their ability to function on a day-to-day basis. The authors checked back with the patients an average of seven months after surgery to measure their new pain and functional levels.

The surgery made a measurable difference. The pain levels of nineteen patients (80%) went down at least two points on the 10-point pain scale. Eighteen patients (72%) either stopped using pain pills or were able to get by with significantly less medication. They also reported improvements in being able to sit for longer time periods. The authors also found that patients who went through IDET treatment used less pain medication.

Future studies are needed to confirm this preliminary report. Yet these results suggest that IDET will likely become helpful way to extinguish the fire of chronic low back pain.