MiNDFOOD sits down with a spinal surgeon to discuss effective strategies for dealing with chronic back pain.
Pain is the most common reason people seek medical help, yet it remains one of the most neglected and misunderstood areas of healthcare. One in five Australians live with chronic pain, including adolescents and children, according to Pain Australia.
Dr Michael Wong is one of Victoria’s leading and most experienced Neurosurgeons and Spinal Surgeons. He specialises in minimally invasive and complex spinal surgery. He shares the top five ways you can manage chronic back pain.
Dr Wong says that active physical therapy is necessary to rehabilitate the spine and relieve chronic back pain. “It should include remedial massage, manual therapy – the hands-on mobilisation of joints in the back, hamstring stretching exercises on a daily basis, 15-20 minutes of core muscle strengthening exercises and low impact aerobics, which are important for long term pain reduction,” he says. Excersise therapy options include cycling, swimming or hydrotherapy.
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is a form of psychological therapy says Dr Wong. “‘Focusing on your thoughts’ makes up the cognitive part of CBT and ‘putting attention on your actions’ is the behavioural part. A therapist or doctor will teach you how to recognise negative feelings and thoughts that occur when you have chronic back pain, how to stop them and practice using positive thinking,” Dr Wong explains. Healthy thinking involves calming your mind and body by using techniques such as yoga, massage or visualisation techniques.
According to Dr Wong there are two main spinal interventional procedures which can help manage chronic back pain – epidural injection and nerve root block. “The difference with these treatments is that they use techniques to directly address the source of pain and can sometimes help rule out certain causes if the treatment doesn’t work. A nerve root block is an injection of local anaesthetic and a small amount of steroid injected in a specific nerve near the spinal cord. The injection enables the doctor to determine exactly which nerve root or roots are affected. An epidural injection is the delivery of anti-inflammatory medicine directly into the space outside of the sac of fluid around your spinal cord. It decreases swelling and pressure on larger nerves and the spine and helps relieve pain.”
“Medication can be a vital part of managing and treating chronic back pain and can help you stay pain-free and active. However, patients have to ensure they are using the correct ones and in the right way, particularly as some may have serious side effects,” says Dr Wong. Non-steroidal Anti-inflammatory Drugs (NSAIDS) are often the go-to drugs for back pain relief. They helps reduce pain, swelling and inflammation in muscles and around damaged spinal discs.
The most important thing about treating chronic back pain is to identify the reason and cause Dr Wong cautions. “While surgery as a treatment has improved dramatically, you do not want to undergo unnecessary surgery. In most cases, the answer is not surgery but more conservative treatment including physiotherapy and pain management by a specialist physician. However, going straight to physiotherapy without proper diagnosis is not advised. The first step is to ask your doctor to find out the specific cause of your pain, which can show up on MRI or other tests. Before choosing and proceeding with surgery, it is important that you are aware and informed by your doctor of all the options available to you. Don’t be afraid to get a second opinion from another doctor.”