Table of Contents
Acknowledgments xi
Introduction: One Big Sneeze Can Do You In and the Twist and Shout xiii
Part I Taking the Mystery Out of Low Back Pain
Chapter 1 Understanding Why Your Back Hurts 3
Is It Mechanical or Medical?
How Your Back Works
Pain Is Different in Men and Women
How Your Pain Threshold Fluctuates
Chapter 2 Working with Your Doctor 19
Questions to Help You Find the Cause
The Physical Examination
Doctors and Health Care Professionals Who Treat Low Back Pain
Chapter 3 What Diagnostic Tests Can-and Cannot-Tell You 33
Pictures May Not Tell the Whole Story
Conventional X rays
Magnetic Resonance Imaging (MRI)
Computed Axial Tomography (CT)
Myelography
Bone Scan
Discography
Bone Densitometry
Electrodiagnostic Tests
Blood Tests
Part II Knowing Your Treatment Options
Chapter 4 The Basic Back Pain Relief Program 51
Control Physical Activities but Limit Bed Rest
Using Over-the-Counter Medications
Applied Therapy
Aerobics: Expanding Your Comfort Zone-Gradually
Maintain a Positive Attitude
If Back Pain Is Chronic
Chapter 5 Recognizing and Treating Mechanical Low Back Pain 63
Muscle Strain, Spasm, and Trauma
Disc Degeneration and Osteoarthritis (Lumbar Spondylosis)
Herniated Disc and Sciatica
Piriformis Syndrome
Cracked Vertebral Bodies (Spondylolysis and Spondylolisthesis)
Spinal Stenosis
Scoliosis
Chapter 6 Recognizing and Treating Medical Causes of Low Back Pain 83
Infection
Bone Tumors and Cancer
Inflammatory Diseases
DISH Syndrome (Diffuse Idiopathic Skeletal Hyperostosis)
Ochronosis
Fibromyalgia
Polymyalgia Rheumatica
Tension Myositis Syndrome
Myofascial Pain Syndrome
Blood and Vessel Disorders
Diabetic Neuropathy
Pain from Nearby Organs
Back Pain in Pregnancy and Menstruation
Chapter 7 How Can I Keep from Getting Bent Over? 101
Osteoporosis
Osteoporosis Diagnosis
Men and Osteoporosis
Keep Your Bones Strong
Regaining Height
Preventing Falls
Chapter 8 Back Pain in Kids: Is It Just Growing Pains or Is It More Serious? 113
Growing Pains
Nonspecific Low Back Pain
Kids' Red Flags
Adolescent Scoliosis
Adolescent Dowager's Hump-Scheuermann's Disease
Adolescent Spondylolisthesis
Chapter 9 How and When to Use Medications Effectively for Pain 121
NSAIDs and COX-2 Inhibitors
Muscle Relaxants
Opioid and Nonopioid Analgesics
Conrticosteroids
Other Pain Therapies
Chapter 10 Treatment with Exercise and Physical Therapy 137
Working with a Physical Therapist
Flexion Exercises
Extension Exercises
The "C" and "S" Curves
Transcutaneous Electrical Nerve Stimulation (TENS)
Iontophoresis: Another Form of "Injection" Therapy
Getting in the Water
Chapter 11 Complementary Therapies 157
Manual Manipulation
Massage and Other Bodywork Techniques
Acupuncture
Yoga and Other Body, Mind, and Spirit Techniques
Mind-Body Therapies
Meditation and Relaxation
Body Self-Awareness
Magnet Therapy
Homeopathy
Nutritional Supplements
Chapter 12 What to Know Before You Consider Surgery 183
Understanding the Risks
Discectomy
Spinal Fusion
Spinal Instrumentation: The Hardware Store
The Artificial Disc-Buyer Beware
Emergency Surgery
Anterior Spine Surgery
Spine Spacers
Choosing an Orthopedic Surgeon or Neurosurgeon
Your Hospital Stay
After Surgery-The Hard Part
Failed Back Surgery Syndrome
Future Surgical Treatments
Part III Living Without Back Pain
Chapter 13 Lower Your Risk for Back Pain with Prevention: The ABC Plan 203
A-Abstain from Smoking
B-Better Body Mechanics
C-Correct Diet
Keep Working
Chapter 14 Enjoying Sex without Hurting Your Back 213
It's Not All Physical
Painless Positions
Medication and Libido
Sexercises
Back Surgery and Sexual Function
Epilogue: Being Back in Control Will Heal Your Back! 221
Glossary 223
Appendix A Dr. B's Back School FAQ 229
Is Any Particular Chair Helpful for Low Back Pain?
Does Inversion Boot Therapy Help Back Pain?
Do My High Heel Shoes Cause Back Pain?
Does Prolotherapy Help Low Back Pain?
What Does the Circular That Comes with My Prescription Drug Package Mean? It Scares Me Half to Death
How about Botox Injections for My Back Spasm?
Which Is the Best Aerobic Exercise Machine for a Person with Back Pain?
Can I Go Horseback Riding?
What Sports Can I Safely Play If I Have Back Pain?
Can I Play Golf without Increasing My Back Pain?
Appendix B Medications for Low Back Pain 239
Appendix C Best Back Resources 245
References 249
Index 261
About the Author 275
