Anthony H. Guarino - Get Your Lower Back Pain under Control—and Get on with Life

Get Your Lower Back Pain under Control
and Get on with Life

Anthony H. Guarino, M.D.

Note to the reader: Diet, exercise programs, and the use of medications are all matters that by their very nature vary from individual to individual. You should speak with your own doctor about your individual needs before beginning any diet or exercise program. It is especially important to discuss the use of any medications with your doctor. These precautionary notes are most important if you are already under medical care for an illness.

Drug dosage: The author and publisher have made reasonable efforts to determine that the selection and dosage of drugs discussed in this text conform to the practices of the general medical community. The medications described do not necessarily have specific approval by the U.S. Food and Drug Administration for use in the diseases and dosages for which they are recommended. In view of ongoing research, changes in governmental regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert of each drug for any change in indications and dosage and for warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently used drug.

The author is a speaker and educator for several pharmaceutical companies, including Cephalon (Amrix, Fentora), Lilly (Cymbalta), and Wyeth (Relistor).

2010 Anthony H. Guarino
All rights reserved. Published 2010
Printed in the United States of America on acid-free paper
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Library of Congress Cataloging-in-Publication Data

Guarino, Anthony H.

Get your lower back pain under controland get on with life / Anthony H. Guarino.

p. cm.

Includes index.

ISBN-13: 978-0-8018-9730-6 (hardcover : alk. paper)

ISBN-10: 0-8018-9730-0 (hardcover : alk. paper)

ISBN-13: 978-0-8018-9731-3 (pbk. : alk. paper)

ISBN-10: 0-8018-9731-9 (pbk. : alk. paper)

1. BackachePopular works. I. Title.

RD771.B217G83 2010

617.5'64dc22 2010001249

A catalog record for this book is available from the British Library.

Illustrations on pages 165, 166, 168, 169, 171, and 173 by Jacqueline Schaffer.

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The Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible. All of our book papers are acid-free, and our jackets and covers are printed on paper with recycled content.

My greatest insights into the nature of low back pain come from my patients.

YOU KNOW IT IF you have ita constant pain low in your back that never leaves. Its always there. You seek out new doctors. You try new medications. You participate in a specialized exercise regimen. You even try to work on your attitude, because youve heard that if you can alter your perception of pain, you can alter the pain itself.

Some days are good days, and you are hopeful. Other days are particularly painful, and you try not to despair. You view the world through the distorted lens of your ever-present pain. You wonder if you will ever get any relief.

As director of pain management services at Barnes-Jewish West County Hospital and as faculty at Washington University School of Medicine, I help people with all kinds of painand all the problems that go along with having lots of pain or having pain that lasts a long time. The sheer number of my patients who experience low back pain has inspired me to focus my attention on those who suffer from this devastating condition and to find a way to make a difference in their lives. My patients have shown me how low back pain alters their livesand their familys lives, too. Low back pain can cause or worsen depression and addiction, can cause or contribute to disability and divorce. Individuals suffer, families suffer, and ultimately society as a whole suffers.

I wrote this book to offer hope and guidance for anyone affected by low back pain. In this book you will discover that managing pain means taking a multipronged approach. You can become stronger, and regain confidence and peace in your life, by learning what causes pain and then actively participating with your doctor and other therapists to treat and manage your pain.

Over years of treating people, I have come to understand that the psychological benefits of pain management are as important as the physical ones. Pains reach goes way beyond sensation. It invades emotions and interferes with relationships. It skews a persons view of him- or herself and the surrounding world. It can rob people of spirituality and cause them to doubt their beliefs. But just as an injured soldier must practice walking, talking, and any number of other functions that he or she used to take for granted, people who suffer from chronic back pain must persevere. If you suffer with chronic back pain, you must work with determination and self-control to modify your pain state and take back control of your body. Even with these efforts you may not be pain free, but you will be able to function better at home and in the workplace, and find enjoyment in life.

Back pain is the most common cause of chronic pain in the United States. By some estimates, it affects 80 percent of adults at some time during their life. While you dont wish suffering on others, there is something consoling in knowing you are not alone.

Anyone with back pain is going to do better if he or she understands the nature of painthe anatomical components and emotional components of it. of the book describes the full range of medical interventions to be had, from physical therapy and exercise to injections, medications, and surgery. If you are aware of all the options available to help you with your pain, you will be much better equipped to ask informed questions of your doctor and work with your doctor to get you feeling better.

Because the cost of chronic pain can be high, both in dollars and in time lost from work, insurance and disability coverage are often a concern for people with low back pain. In will guide you to use your relationships as an incentive to take back control of your life.

My patients have taught me many lessons that cant be found in medical books. I hope everyone reading this book will benefit from what my patients and my medical books have taught me. Feel better, and get back into life.

After head colds, low back pain is the most common reason to visit a physician.

LOW BACK PAIN is one of the most common conditions in the United States, affecting approximately 80 percent of the adult population at some time in their lives. Back pain affects men and women of all races. The highest incidence of low back pain reported to doctors is among people 35 to 55 years old.

The prevalence of this condition has enormous financial and socioeconomic implications: