Nonsurgical Management of Acute and Chronic Back Pain. Rocco Simmerano, MD Morris County Orthopaedic Group February 3, 2009. Outline. Epidemiology Etiology/Basic Science Diagnosis Treatment options Treatment failures/referrals. What is “back pain”?.
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Rocco Simmerano, MD
Morris County Orthopaedic Group
February 3, 2009
It is a loosely defined diagnosisthat may refer to multiple patterns of pain with complex issues surrounding its diagnosis and treatment. There is a paucity of evidence from the literature regarding its cause, management and prognosis. The difficulty of managing patients with low back pain stems from the fact that there often is very little association between physical findings and the patient’s pain and disability.
spinal stenosis foraminal stenosis
Increased stresses on the facet jointsDegenerative Disease
Begins as back pain
Later stages associated with nerve problems
Not associated with weakness, numbnessMechanical vs. Neurogenic Pain
Pain, numbness, weaknessMechanical vs. Neurogenic Pain
Increases exercise tolerance
Better in the sub-acute period
Modulates painHeat or Ice?