The Back Story
Conservative Approaches Treat Most Cases of Back Pain

More than 80 percent of American adults will experience some form of back pain during their lives, and physical therapy and rehabilitation often produce the best results.

"Most people will experience back pain — often in the lower back —
at some point or another, and it is
highly treatable," notes Ziad Yafi,
MD. "It's also important to realize
that surgery is not required in
most cases."

Thankfully, many cases of back pain can be treated with conservative approaches, such as
physical therapy, exercise and
treatments to reduce discomfort
and enhance well-being. These
approaches include: core
strengthening exercises and Pilates,
flexibility exercises, ultrasound, traction, electrical stimulation, myofascial release therapy (to improve pain and improve soft tissue flexibility) and trigger point massage.

Conditions causing nerve pain require other treatments. One approach is neurostimulation, which blocks pain signals from the spinal cord as they go to the brain. Pain medications are another solution. These include non-steroidal anti-inflammatory drugs (NSAIDs), steroids, opiates and muscle relaxants. Pain injections, such as epidural steroid injections, are another form of pain management. Finally, cognitive behavioral therapy may be equally or more effective than drugs or surgery.

Only 5 to 10 percent of spine problems require surgical solutions. A decision to have surgery requires the careful evaluation of several factors.

Living With Back Pain

Bob Neatrour, who turned
61 at the end of December,
knows what it is like to
suffer from back pain. His
back problems started about
a year ago when he fell while
working on a ladder at his
home. The client sales
executive didn't feel much
pain at the time. But last
Christmas when he took his
Christmas tree from the car
and flung it over his shoulder,
he felt a twinge in his back.
By January, he could hardly
get out of a chair.

After receiving an MRI, orthopedic surgeon Christopher Silveri, MD, recommended Neatrour receive cortisone shots and physical therapy. Dr. Yafi gave Neatrour his initial injection. The patient then underwent physical therapy for eight weeks. The hardest thing about living with a ruptured disc is modifying his lifestyle, he says, noting, "I have to accept the fact I'm not 24 anymore. But then again, I don't have to be 95 either. So I'm trying to be smart."

Neatrour, who received his second shot last July, is grateful for the support he has received at Inova Fair Oaks Hospital — and especially from Jean Snyder. The spine care navigator has offered reassurance and encouragement to him throughout his ordeal.

"Jean has been a great advocate," says Neatrour, who continues to work out every morning and ride his bike.

"She's kind of kept me calm. That's one of the biggest challenges."