Treatment of chronic back pain remains a challenge for primary care physicians, and a new Cochrane Review confirms previous studies suggesting that analgesics and antidepressants fall short in terms of relief.
Data from another Cochrane Review support the value of exercise for chronic low back pain, although it is often underused, and the Food and Drug Administration's of a spinal cord stimulation device for chronic back pain opens the door for another alternative.
Barriers to the use of exercise to treat pain may include fear of movement on the part of patients, she noted. found some differences between specific types of exercise, we found all exercise types are more effective than minimal treatment," she said."People with chronic low back pain should be encouraged to do exercises that they enjoy and will do consistently to promote adherence.
Despite efforts and guidelines from multiple medical organizations to promote optimal pain management,"much remains unknown regarding how the patient-physician interaction affects the process of delivering medical care for chronic low back pain and, ultimately, patient satisfaction," John C.
"Our findings pertaining to physician empathy are intriguing because they do not necessarily involve a therapeutic alliance with the patient based on collaborative communication or the expectation of a therapeutic effect via pharmacotherapy," the researchers wrote . Looking ahead,"more research is needed about microsurgery, namely for whom and for what anatomic presentations," said Dr. Golden. Other topics for further research include a better understanding about medical marijuana and pain management and its interactions and side effects with other opioids and muscle relaxants.
Furthermore, she said,"there is a physical therapist shortage in the U.S. I practice in a major city with a large health care system, and it can still take months to get an appointment with a physical therapist." Also, insurance coverage may limit which therapists a patient can see and how many visits they can have.
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