Laser MD | Low Back Pain, Sciatica, Herniated Disk

Low Back Pain is Almost as Common as the Common Cold

Low back pain is the most common reason for a visit to a doctor's office after common colds. Four out of five people will have bad back pain at some point in their life, and up to one in four people have back pain this very second.

Chronic Back Pain vs Acute Back Pain

Most back pain short term, "acute back pain", lasting a few days up to a month. For most people, it is best treated with movement (NOT bedrest), NSAIDs, and ice or heat as tolerated. Sub-acute back pain lasts 1-3 months, and chronic back pain lasts more than 3 months. Laser therapy can achieve remarkable results in all types of low back pain. The sooner you get rid of your back pain, the less likely it is to come back again and again.

Back Injuries are the Most Common Workplace Injury

More than 500,000 people miss work each year for at least one day due to a back injury. Typically they miss six days of work, and 20% will miss more than 30 days of work.

Laser & Low Back Pain

High dose laser therapy is relatively new treatment for low back pain, and shows potentially phenomenal results. Among the four most common causes of low back pain:

For the most common acute back pain, non-specific lumbar strain, deep tissue Class IV laser therapy can greatly accelerate the return to work, return to normal, and drop in pain scores. It can be used in conjunction with NSAIDs. Long-term, back strengthening and ergonomic chairs are still key to prevention.
For sciatica, disk problems, disk herniation, trapped or irritated nerve roots, high dose laser therapy can be wonderful. It can directly reduce inflammation of the nerve root and accelerate the body's natural reabsorption of disk material. At our clinic, it is 50% better than epidural steroids short term and has long-term benefits that outlast epidural steroids. Laser is much, much safer than epidural steroids.
For spinal stenosis, high dose laser therapy is better than epidural steroids but not as good as surgical laminectomy. However, laser has a 1000X higher safety profile than operative procedures.
For chronic back pain sufferers, deep tissue laserr therapy can bring relief where other treatments have failed. Patients with chronic back pain may need to repeat the laser every 3-6 months.

Back Pain Costs Big Bucks

The average cost of a low-back associated workers compensation claim is $9,000, double the cost of the average injury claim. Back pain costs the US about $100 billion per year, or 1% of the entire country's GDP. The largest part of the $100 billion is due to work days lost. And that does not count the economic impact of "lost time from life" or general misery, and if you've ever had back pain you know what that's like. That's why it is so critical to expedite and shorten the treatment cycle with high intensity laser therapy. Further, the longer that back pain goes on, the more likely it is to recur, and less likely that it will be easily treated.

Back pain is the #3 leading cause of poor health, higher than any type of cancer. The cost of back pain is the same as the cost of all cancers combined. Low back pain is not limited to the US, the figures from Europe are similar.

Types of Low Back Pain & Causes of Low Back Pain

Sprains and strains are the #1 cause of low back pain. Disk problems are the #2 leading cause of low back problems. Spinal stenosis is a rare cause of back pain, but increasingly common as the population ages. Both disk problems and spinal stenosis can lead to nerve root irritation, called radiculopathy. When the nerve root is irritated, it can cause sciatica, which is pain shooting down the thigh, leg, or foot. In severe cases of radiculopathy there may be numbness or tingling, which indicates a more advanced nerve root problem.

Other causes of low back pain are less common and include Spondylolisthesis, trauma, scoliosis, lordosis, infections, metastatic cancer, back bone cancer, cauda equina syndrome, kidney stones, and abdominal aneurysm.

What About Epidural Steroids?

Epidural steroids have been considered the gold standard in mildly-invasive therapy for disk herniation and trapped nerve roots. Many back surgeons will not operate on a patient until they have tried a trial of 1-3 epidural steroids. Generally, epidural steroids are low-risk compared with surgery, but moderately high risk compared with NSAIDs and laser.

Of course, the spate of deaths and infection from a bad batch of steroids, while no longer a threat, serve as a reminder that epidural steroids are not a non-invasive procedure. Nonetheless, the traditional thinking is that epidural steroids have a good risk-reward ratio.

Unfortunately, epidural steroids have now been shown to be mostly ineffective across multiple large studies. As noted in Clinical Pain Advisor, Corticosteroid Injections of Little Benefit for Low Back Pain. (other references below.)

References

. Vallone, S. Benedicenti, E. Sorrenti, I. Schiavetti, and F. Angiero, " Effect of Diode Laser in the Treatment of Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial," Photomedicine and Laser Surgery, vol. 32, no. 9, pp. 490-494, Sep. 2014 [Online]. Available: View
Shiroto and T. Ohshiro, "A new standard of Efficacy for Low Level Laser Therapy (LLLT) in Pain Attenuation in Japan (a secondary publication)," LASER THERAPY, vol. 23, no. 3, pp. 183-190, 2014 [Online]. Available: View
D. Ip and N.-Y. Fu, "Can intractable discogenic back pain be managed by low-level laser therapy without recourse to operative intervention?," Journal of Pain Research, p. 253, May 2015 [Online]. Available: View
M. S. M. Alayat, A. M. Atya, M. M. E. Ali, and T. M. Shosha, "Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial," Lasers in Medical Science, vol. 29, no. 3, pp. 1065-1073, May 2014 [Online]. Available: View
"Corticosteroid Injections of Little Benefit for Low Back Pain." [Online]. Available: View
"Spinal injections of steroids temporarily ease low back pain | Reuters." [Online]. Available: View
"Epidural steroid injections relieve pain, but only momentarily: study?: Latinos Health News?: Latinos Health." [Online]. Available: View
"With steroid shots, back pain relief is only temporary, at best, study finds - The Washington Post." [Online]. Available: View
R. Chou, "Low Back Pain," Ann Intern Med, vol. 160, no. 11, pp. ITC6-1, Jun. 2014 [Online]. Available: View

Low Back Pain, Sciatica, Herniated Disks

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