Patient Information Resources

Centre for Orthopaedics
Suite 10-33/34/35 Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road
Singapore, 329563, Singapore
Ph: (65) 6684 5828
Fax: (65) 6684 5829

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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Is it really enough to take Tylenol or Ibuprofen for back pain? I'm in a lot more pain than that, but that's what both my doctor and PA have told me. Should I go see someone else for more treatment than that?

Many people (and even some health care professionals) are surprised by this simple recommendation. But the research and evidence just don't support more than that as a first-line treatment approach to nonspecific back pain. Nonspecific refers to the fact that there is no known cause for the pain. At this point, groups such as the American College of Physicians (ACP) and the American Pain Society (APS) have even suggested holding off on more aggressive treatment or even imaging studies for that matter. They say that a review of the studies done so far show that self-care is the way to go. When it comes to back pain, simple pain relievers and gentle physical activity work as well as anything else. There's no evidence that more invasive care is going to help. Steroid injections, invasive diagnostic testing, and surgery are no longer on the front lines of care for patients with low back pain. There is some concern about this type of minimalist approach. The American Society of Interventional Pain Physicians (ASIPP) have their own set of guidelines. This group supports pain management with intervention early. They say an aggressive approach may prevent chronic pain and disabilty from developing. Decompressive laminectomy (removal of bone from around spinal nerve roots) and discectomy (removal of damaged or herniated disc material) bring faster pain relief and return to function. But the ACP and the APS counter this argument by saying that long-term studies show no difference in final results several years down the road. Self-care is probably a good way to get started. Stay in close contact and communication with your physician. Ask for follow-up care if you don't have a steady return to normal. Sometimes a second step in pain management is needed. It doesn't have to be invasive such as surgery. Physical therapy for some specific exercises may be a good intermediate step when analgesics and activity aren't enough.


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