THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Friday, December 9, 1994 TAG: 9412090547
SECTION: FRONT PAGE: A9 EDITION: FINAL
SOURCE: ASSOCIATED PRESS
DATELINE: WASHINGTON LENGTH: Medium: 83 lines
Chiropractors get a boost and surgeons a setback in new, government-backed guidelines on how to treat low back pain. For most sufferers, they say, problems will go away on their own within a month.
In the interim, the experts said Thursday, the best advice is to spend no more than two or three days in bed, take over-the-counter painkillers and start moderate, low-stress exercise such as walking or swimming as soon as possible.
The new guidelines for acute low back pain frown on surgery and a host of high-cost tests - including X-rays, CAT scans and magnetic resonance imaging - and dismiss as unproven such treatments as spinal traction, biofeedback, transcutaneous electrical nerve stimulation, acupuncture, steroids and injections.
But it says spinal manipulation, usually by a chiropractor, ``can be helpful for patients with acute low back problems . . . within the first month of symptoms.''
Up to 20 percent of adults suffer low back problems each year, and four out of five will experience the agonizing problem at least once before their 50th birthday.
Dr. Stanley J. Bigos, professor of orthopedic surgery at the University of Washington School of Medicine in Seattle and chairman of the 23-member panel of experts, said the guidelines offer ``new hope to those who are confused about the myriad of approaches to acute low back problems.''
Too often in the past, Bigos said, doctors have sent patients to bed for extended periods, given them ``disorienting painkillers'' and ordered ``needless, confusing tests.''
The experts said surgery helps only one in 100 people with sudden back problems. Extensive diagnostic tests are in order only for patients who a doctor suspects might have a fracture, a tumor, an infection or severe nerve involvement.
The guidelines state, ``Even having a lot of back pain does not by itself mean you need surgery.''
For nine out of 10 adults, the back problem will go away spontaneously within four weeks, even if it is a repeat episode.
An ice pack applied to the painful area for five or 10 minutes may help in the first 48 hours. Beyond that, a heating pad or hot shower or bath may work.
The experts reviewed more than 3,900 studies in preparing the guidelines for the U.S. Agency for Health Care Policy and Research.
They were cause for rejoicing by chiropractors.
``This guideline validates what chiropractors have asserted for nearly 100 years and what millions of chiropractic patients already know: Spinal manipulation offers safe and effective relief for low back problems without drugs or surgery,'' Lowry R. Morton, chairman of the board of the American Chiropractic Association, said. ILLUSTRATION: Graphics
MORE INFO
For free copies of the guidelines, call 1-800-358-9295.
BACK PAIN ADVICE
Suggestions from the Agency for Health Care Policy and Research
on how to avoid low back problems:
Exercise regularly.
Wear comfortable, low-heeled shoes.
Place a pillow or rolled-up towel behind the small of the back
when driving long distances.
Place a pillow under the knees when sleeping on the back, or in
between knees when sleeping on the side.
Use a chair with good lower back support.
Put work surfaces at a comfortable height.
When lifting, keep objects close to the body.
Lumbar corsets may help prevent problems in people who lift
things frequently at work. They haven't been proven beneficial for
those who already have acute low back problems.
Rest feet on a low stool when sitting for long periods.
by CNB