Of all types of physical pain you might endure in a lifetime, back pain is among the most common. About 80 percent of Americans experience some form of back pain in their lives, from a minor twinge or strain to a lingering, debilitating injury.
Former ski instructor and lifelong fitness enthusiast Susan Anderson grew accustomed to living with back pain. The La Quinta resident was severely injured on the slopes 10 years ago. At the time of her accident, she was living in Lake Tahoe and her treatment included repair and joint replacement on a significantly affected leg, five spinal fusions, and a hip replacement.
These were trying times for Anderson, who has always believed in staying active. “You have to stay in motion,” the 79-year-old says. “If you can’t, you have to do what the doctor tells you to do so you can get back into motion.”
After she relocated to the desert, Anderson found a pain management specialist who helped her do exactly that.
Pain management, a specialty borne from the practice of anesthesiology, benefits individuals whose injuries or conditions might have received the recommended treatment but still experience chronic pain in its aftermath. With back pain — often lower back pain — topping the list of complaints, it’s worthy of attention.
“Typically, back pain is a symptom, not necessarily a disease,” says Dr. Lee Erlendson, a board-certified pain management specialist and founder of Rancho Mirage Pain Associates. “We have to approach it by diagnosing the disorder or disease that is causing the problem.”
“A minimally invasive procedure is always preferable to major back surgery.”
— Dr. Lee Erlendson
Osteoporosis is as a perfect example. The bone-weakening disease puts older individuals at risk for fractures, including spinal compression fractures, which can lead to acute pain. Spinal stenosis is another condition that narrows the spaces within the spine and can put pressure on the nerves that travel throughout.
However, plain old inactivity sometimes lies at the root of back problems.
“The more people sit, the less active they are, the muscles in the small of the back become atrophied and deconditioned and back pain can arise from that,” Erlendson says. He also points to the prevalence of failed back surgeries that lead to a condition known as post laminectomy syndrome. “Anytime you mess with the nerves in the back, you can irritate them and patients can end up with chronic pain.”
The question is how to best provide relief. In Erlendson’s opinion, it’s wise to initially investigate nonopioid therapies, given that approximately 10 percent of Americans are genetically predisposed toward dependency and addiction. For instance, if prolonged inactivity causes your pain, physical therapy might be recommended to jump-start a fitness regime.
Meanwhile, spinal spacers also known as Vertiflex are a viable option for patients with lumbar spinal stenosis. The implants are placed inside the spine during a minimally invasive procedure. “When you flex the lumbar spine forward, you open up that tight spinal stenosis a few degrees so that they are able to get great pain relief,” Erlendson says. “A minimally invasive procedure is always preferable to major back surgery.”
Epidural steroid injections are yet another form of treatment for lower back pain — and the method that has worked for Anderson. “During the past year and a half that I’ve been seeing Dr. Erlendson, I’ve gone from being in a lot of pain to having practically no pain. He knows where to put the needle to make what was wrong right.”
Remarkably, it was anxiety about the potential of another ski accident occurring more than physical inability that led Anderson to hang up her skis for good.
Since her husband of 60 years died this past spring, Anderson has adopted a puppy to help keep her company and active. “When we go for a walk, he doesn’t want to walk slow!” Pain-free, she keeps up with her dog and plenty of other activities she continues to pursue.
Pain management techniques continue to evolve and prove that in many cases the answer to chronic pain lies beyond oral medication and the terrible side effects it can produce. “Every year there are new advances,” Erlendson says, “and patients are benefiting from them without putting them at risk for further complications.”