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Simplest, least expensive treatment for low back pain may be best

The simplest method for treating low back pain may actually be the best method, according to a study published in the February 2009 issue of Journal of the American Academy of Orthopaedic Surgeons. The study finds that in most cases of symptomatic lumbar degenerative disk disease, a common cause of low back pain, the most effective treatment is simply a combination of physical therapy and anti-inflammatory medication. While back injuries in Workers' Compensation commonly arise from a specific incident, degenerative disc disease is often involved.

According to the review findings:

1. 90% of patients with low back pain will see their symptoms fade on their own within three months

2. Most of those patients will recover within six weeks.

According to a press release summarizing the study, researchers determined that, barring an emergency, the initial treatment of all patients with low back pain should be noninvasive. Noninvasive treatments have helped patients strengthen the injured area and prevent further strain. These include:

1. Physical therapy that focuses on strengthening core muscle groups in the abdominal area and the lower back reducing disc-related pain.

2. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen provide short-term relief of low back pain. No one NSAID was found to be more effective than another.

3. Educating patients on better body mechanics--for example, lifting with the legs instead of the back-- lessens the strain that is placed on the lumbar region.

4. Exercise, as opposed to bed rest, improves function and decreases pain in adult patients with chronic low back pain.

"Surgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it," says Luke Madigan, M.D., an attending physician at Knoxville Orthopaedic Clinic, Knoxville, TN, and the lead author of the review. "Also, surgeons should pay close attention to the list of contraindications, and recommend surgery only for those patients who are truly likely to benefit from it."