Heal Your Aching Back (Harvard Medical School Guides)

290 Pages·2007·3.21 MB·English

by  Jeffrey N. Katz

Heal Your
Aching
Back
What a Harvard Doctor Wants You to Know
About Finding Relief & Keeping Your Back Strong
JEFFREY N. KATZ, M.D.
ASSOCIATE PROFESSOR, HARVARD MEDICAL SCHOOL,
AND CODIRECTOR OF THE BRIGHAM SPINE CENTER
AND GLORIA PARKINSON
New York Chicago San Francisco Lisbon London Madrid Mexico City
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DOI: 10.1036/0071467653
For Susy, Daniel, and Micah—
there is no stronger medicine than a home of love.
—Jeff
For Jim, my husband and best friend.
I cherish you, my love.
—Gloria
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Contents
Preface xi
Acknowledgments xv
Part I The Perplexities of Back Pain
Chapter 1
Bewildered by Your Back Pain? 3
A Bewildering Condition 4
Join the Crowd 8
My Back’s Killing Me 10
You’re in Charge 10
Bewildered No More 16
Chapter 2
Factors Affecting Who Gets Back Pain 17
Your Age 18
Your Gender 19
Pregnancy and Your Back 20
Your Genes 21
How You Work and Play 21
Your Physical Makeup and Posture 22
How You Deal Emotionally with Life’s Slings and Arrows 23
Other Risk Factors 24
v
vi Contents
Part II Understanding Back Pain
Chapter 3
The Workings of Your Back 29
The Wonder That Is Your Back 30
Your Back Through the Ages 36
Your Spine from Top to Bottom 37
Enough with the Anatomy! 50
Chapter 4
Why Your Back Hurts 53
Sprain-and-Strain Syndromes 58
Pinched (Compressed) Nerve Syndromes 63
Degenerative Disk Conditions 63
Degenerative Spinal Disease 70
Other Causes of Back Pain 71
Backache from Other Organs 77
Chapter 5
Getting a Diagnosis 79
How Should I Begin My Search? 80
Visit a Doctor, But Which One? 82
A Well-Prepared Medical History 83
The Value of the Physical Examination 85
When Imaging Tests Are Helpful 86
Other Diagnostic Procedures 95
Contents vii
Part III Controlling Your Pain
Chapter 6
Priority Number One: Relieving Your Pain 101
What Is Pain? 102
Pain: Out with the Old; In with the New 103
Classifying Your Pain by Its Duration 106
How Pain Works 107
Your Body’s Natural Pain Relief Plan 111
Once More with Feeling: Describe Your Back Pain 113
Medicating Your Back Pain 116
Electrical Stimulation Therapies 136
Chapter 7
Can Complementary Therapies
Help Your Aching Back? 141
Get the Best: Is Your Therapist Qualifi ed? 145
Spinal Manipulation 146
Massage 149
Acupuncture 152
Mind-Body Therapies 154
Complementary Exercise Programs 164
Other Complementary Pain Treatments 167
Glucosamine and Chondroitin Sulfate Supplements 168
Herbal Products and Back Pain 169
A Prudent Approach 172
viii Contents
Part IV Managing Your Back Condition
Chapter 8
Nonsurgical Treatments for Your Backache 175
Your Back’s Capacity to Heal Itself 176
Waiting Out Acute Back Pain 177
Getting Going Again 182
Sign Up with an Exercise Professional 184
Principles of Rehabilitative Exercise for Back Pain 186
Strengthening and Stretching the Muscles of Your Back 190
Low-Impact Aerobic Exercises for Acute Back Pain 201
Chapter 9
Is Surgery Right for You? 203
How Do You Decide? 203
Do You Meet Surgical Criteria? 206
Weighing Surgical Risks and Benefi ts 206
Surgery for Disk Disease 208
Surgery for Compression (Osteoporotic) Fractures 214
Surgery for Lumbar Spinal Stenosis 217
Spinal Fusion Surgery 218
Surgery for Other Back Problems 220
Knowing When You’re Ready to Decide 222
Contents ix
Chapter 10
Preventing a Repeat Episode 225
Stay Fit 225
Getting in the Exercise Groove 227
Watch Your Weight 229
Kick the Smoking Habit 231
The Everyday Business of Moving and Sitting 231
Chapter 11
When Pain Persists 239
Pain That Takes on a Life of Its Own 239
What Is Debilitating Chronic Pain? 240
Who’s at Risk? 241
What Can Be Done for Patients with Chronic Pain? 243
Glossary 247
Additional Resources 255
Index 261