The current health care system in the UK is heavily involved in the research of back pain. The question still remains as to why certain sufferers of back pain recover relatively well and make full recoveries, whilst other sufferers of back pain seem to never fully regain normal function? Their back pain seem to continue despite multiple attempts to ‘fix’ the problem. This is a small clue as to how complicated back pain is and how difficult it is to treat successfully across the broad spectrum of people whom suffer back pain, sciactica and back aches. Believe it or not, a lot of research in the last 20 years has looked into chronic sufferers of back pain and found that there are certain specific neurological changes that occur in the brain that make continuation of chronic back pain more likely. Some people show this neurological change or ‘re-wiring’ whereas some do not. This could be helpful in determining which members of society are more likely to go on further with back pain and be at a far higher risk of long term chronicity. Treatment of back pain could therefore be adapted accordingly and research in this area is ongoing.
Funnily enough, a lot of research now concentrates back on the disc between the vertebrae as a key cause of the chronic and degenerative low back pain that some people suffer in their spine. Research is heading in the direction of understanding what happens at a molecular level to the disc as it wears over time. A weak link seems to be that the treatment and easing of back pain and disc damage is abruptly impeded by the simple fact that cartilaginous structures ( ie: squashy bits between the bones in a joint) cannot regenerate itself like for like. With this in mind, stem cell research is attempting to uncover advances in future. Stem cell research is looking into the possibility of ‘growing’ disc tissue to help repair degenerative parts of the disc….research again continues!
A recent study implemented by the NIH into epidural injections of steroid drugs looked at its use when treating back pain and sciatica. Injections are used for back pain sufferers as they reduce the tissue inflammation that often will aggravate nerve pain, joint pain, muscle spasm and other surround structures. This interesting back pain research continues into the link between back pain, sciatica, nerve pain and inflammation. Studies are now using state of the art computer imaging modalities to measure and assess specific signs of inflammation in the hope that an understanding of back pain can be improved.
The NIH is also looking into the non-surgical methods of treating back pain that is chronic. Chiropractic is a method that has received close scrutiny in recent years as it has grown and received greater acceptance within the healthcare community. Research regarding back pain and Chiropractic has been concentrating on programs of treatment for back pain that are run by the Chiropractor and involve exercises that engage the core muscles of the low back, and rehabilitation exercises that strengthen the supporting muscles so that back pain sufferers are far more self sufficient in the long term.
Manipulation is also being researched for its effectiveness as part of a package of care for back pain. Chiropractors have been implementing this method of treatment for over 100 years, although the modern day Chiropractor when treating back pain will often turn attention to rehabilitation of weak muscles that support the back and spine once the spine is best placed to receive such intervention.
Though limited in the present day, the psychological and emotional state of back pain sufferers is also a key topic of research. The management of ‘pain’ and its consequences is an area that will gain more attention into the future. Back pain is an obvious candidate for research in this regard as it is so common and indeed back pain is in great need of improved understanding in future as the number of people affected by back pain grows.
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Medical Research Council; ‘Low Back pain of mechanical origin: randomised comparison of Chiropractic from hospital outpatient treatment’; Meade et al.
Medical Research Council (Follow-up-study; Trial ‘Randomised comparison of Chiropractic and hospital outpatient management for low back pain; results from extended follow up’; Meade et al.
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Acute Back Pain – Primary Care Project; The Wiltshire and Bath Health Commission.
Carter JT, Birrell LN (Editors) 2000. Occupational health guidelines for the management of low back pain at work – principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work – leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000. Occupational health guidelines for the management of low back pain at work – evidence review. Faculty of Occupational Medicine. London.
Chiropractic Treatment in Workers with Musculoskeletal Complaints; Mark P Blokland DC et al;Journal of the Neuromusculoskeletal System vol 8 No 1, Spring 2000
House of Lords Select Committee on Science and Technology report on Complementary and Alternative Medicine November 2000