Common 'Fix' May Not Work for Back Pain
Experts urge prevention, or perhaps a simple painkiller

(HealthDay News) -- So, you did too much yard work or too much bending and lifting while cleaning out the garage, and now your back hurts.

Welcome to the club. An estimated 80 percent of Americans get low-back pain at some point in their lives.

What to do about it? The knee-jerk reaction for many people is to take nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve) and get spinal manipulation. But an Australian study has found that those treatments are not the answer.

They "just don't work better than placebo control," said Dr. Todd J. Albert, chairman of orthopedic surgery at Jefferson Medical College and Thomas Jefferson University Hospital in Philadelphia, who was not involved in the research. "But they are two common things that physicians do all the time."

For the Australian study, which was done at the University of Sydney, 240 people with back pain were divided into four treatment groups: One took the NSAID diclofenac (Voltaren) at 100 milligrams a day and had manipulative therapy, another took the drug and had fake manipulative therapy, a third got real manipulative therapy and a placebo drug, and the fourth took a placebo drug and had fake manipulative therapy.

"Neither diclofenac nor spinal manipulative therapy gave clinically useful effects on the primary outcome of time to recovery," the researchers reported.

And to add weight to the findings, guidelines recently issued by the American College of Physicians and the American Pain Society advise against general use of the two therapies, said Dr. Daniel Mazanec, who heads the medical spine services at the Cleveland Clinic.

"For this group of patients, with acute nonspecific low-back pain with an average duration of nine days, the guidelines recommend the importance of staying active and [taking] relatively simple painkillers, such as acetaminophen," Mazanec said.

Another way to fight back pain is to prevent it.

According to the National Institutes of Health, factors that increase the risk of back problems include:

• Getting older.
• Being out of shape or overweight.
• Having a job that requires lifting, pushing or pulling while twisting the spine.
• Having poor posture.
• Smoking.
• Having a disease or condition that causes back pain.

To help prevent back pain, the institute suggests that people:

• Stand up straight.
• Minimize the amount of heavy lifting they do.
• Exercise to keep back muscles strong.
• Maintain a healthy weight or shed some pounds if overweight.
• Maintain strong bones by taking in sufficient amounts of calcium and vitamin D every day.

Back pain can also be a sign of an array of medical conditions, including arthritis, pregnancy, kidney stones, infections, tumors and stress. That's why it's a good idea to see a doctor if back pain is particularly bad or lasts for more than a few days.

On the Web

To learn more about preventing and relieving back pain, visit the American Academy of Family Physicians.

SOURCES: HealthDay News ; Todd J. Albert, M.D., professor of orthopedic surgery and neurosurgery, Jefferson Medical College, Philadelphia; Daniel Mazanec, M.D., associate director, Cleveland Clinic Center for Spinal Health; Nov. 10, 2007, The Lancet ; U.S. National Library of Medicine (www.nlm.nih.gov)
Author: Anne Thompson
Publication Date: Oct. 31, 2008
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