We should remember that LBP surgery is rarely indicated. Most patients will do well with non surgical treatments, provided that both the physical and non physical components of low back pain are addressed in a careful and reassuring manner, which allows wise choices by an informed patient. Conditioning, education and early introduction of gradual activity are the cornerstones of management for most cases of low back pain. Surgery should be reserved only for few cases after a 2-6 month trial of non surgical management even in those patients where the indications for surgery are strong.

As a foot note: What about the miracle cures you hear or see advertized on the radio or in magazines, such as therapies using little electric jabs, certain magic concoctions you can apply and rub or therapies that “stretch” your back to “decompress” and result in a miraculous cure after 20 and 30 years of debilitating pain? Does it sound too good to be true? You are absolutely right! These advertisements sell more hope than cure. Such therapies may produce some temporary and modest relief (if any) for your back pain, but the “relief” to your wallet is the greater of the two. There is no getting around the fact that back pain is a very common affliction and appears more often as we grow older. Taking responsibility for strengthening your core muscles, knowing how to lift properly, keeping physically active, eating properly and living a healthy lifestyle is an all inclusive recipe to keeping your back (and the rest of your body) healthy.

Angela Mailis Gagnon, MD, MSc, FRCPC(PhysMed)
Director, Comprehensive Pain Program,
Senior Investigator, Krembil Neuroscience Centre
Toronto Western Hospital,
www.drangelamailis.com
Chair ACTION Ontario www.actionontario.ca

Keywords: pain, treatment