Opinions. Everyone's got one, including doctors who make recommendations to their back patients about activity and work levels. A recent mail survey indicates that these recommendations vary widely. The results also show that most doctors tend to restrict the activities of their patients with back pain.

Medical professionals continue to search for ways to put chronic low back pain in a box and nail the lid shut. Expert physical therapists have recently unveiled a new way to classify back pain. Their new system guides clinicians in finding and treating causes of pain. The new system may be just the "box" that medical science wants.

A fresh approach for helping injured workers get back to work sooner is gaining ground. The newer ideas may eventually replace outmoded ones that are based on back pain myths. One such myth is that back pain happens because of physical loads and forces from activity (like work). Treatment is thus aimed at limiting the patient's activity. Health providers who cling to this idea often caution their patients about doing too much. These doctors may even order patients to rest in bed.

You will need help from your doctor to determine whether the pain comes from your arthritic hip or a new problem in your low back. Your doctor will probably inject a numbing medication such as lidocaine into your hip. If the pain in your thigh goes away, you know the hip is the problem. You will need to look at different treatments for your hip problem.

For many years there has been a controversy about the connection between back pain and what doctors can see on X-rays and other special pictures of the spine. The problem is that about 30% of people without any back pain show abnormal findings on pictures of the spine. Also, some people with severe back pain have entirely normal spine pictures. Is there really a connection between abnormal back pictures and back pain?

What if your family physician were trained to do some of the same basic moves used by chiropractors and physical therapists to help with low back problems? By adding these techniques to regular office visits, would you get better sooner, need less medication, and feel better about the care you received?

New advances in medicine and science are making it possible to narrow down and locate pain-causing tissues in people with chronic low back pain. Frequently, the lumbar disc is the source of pain. Scientists have also discovered that the outer ring of the disc is rich in pain sensors.  

Your doctor probably saw a condition called spondylolisthesis, where one vertebra shifts foward. It usually occurs in the lower back. It can happen because of an injury or a problem in the joint between the vertebrae. It can also be the result of spondylolysis, which is a stress fracture in the bony ring that forms the spinal canal.

What triggered my low back pain (LBP)? Simple question--complicated answer. Studies have found several factors that raise the risk of developing LBP. Known risk factors include:

• previous episodes of back pain


• injuries


• smoking


• sedentary work.


• poor social support


• lack of social confidence


• work that involves whole-body vibrations


• dealing with heavy loads at work


• low education levels

Medical professionals have long been concerned that patients with diabetes mellitus don't do as well after spine surgery. To date, however, there has been no research to prove--or disprove--this theory.