Dealing with Back Pain
WebMD Live Events Transcript
Who better to talk to about dealing with back pain than the man who wrote the
book on the subject? Harris McIlwain, MD, author of The Pain-Free Back: 6 Simple
Steps to End Pain and Reclaim Your Active Life,
joined WebMD Live on May 18, 2004, to answer your questions and offer his
The opinions expressed herein are the guests' alone and have not been
reviewed by a WebMD physician. If you have questions about your health, you
should consult your personal physician. This event is meant for informational
back to WebMD Live, Dr. McIlwain. Before we dive into some questions, please
tell us a little bit about the "six steps" you write about in your book.
The six steps are for those who feel the need to control their back pain, to get
old activity back.
- The first step is to show you the ways and the types
of exercise that can give you great relief, even within days, and show you how
to do them safely.
- The next step is the importance of your ideal weight
and shows you how to achieve that with healthy eating choices that help back
- The next step is showing how to use complementary and
alternative medicines, such as natural dietary supplements to alleviate pain.
- The next step is making key lifestyle changes. We show
how to sit, how to lift, how to do everyday activities, such as sitting at a
computer without causing more back pain.
- The next step is showing how to control stress, which makes
back pain worse with some easy ways to distress.
- The next step shows ways that massage and chiropractic, acupuncture and many
other healing touch therapies can help you with your back pain and helps you
discover which ones may be best for you.
According to studies, much back pain is the result of poor postural habits. Are
you familiar with the Alexander Technique, which helps people obtain long-term
relief from back pain by changing their postural habits?
Posture is absolutely important. Many people find that some simple changes in
the way they sit at a desk and how they stand and walk make a huge difference in
their back pain. Massage and chiropractic are two techniques that work well.
Some other techniques include Rolfing and Alexander and other types of bodywork.
We think it is important to have a good therapist who can teach you proper ways
to sit, stand, and lift. The Alexander technique is more than 100 years old and
is used to reduce a painful muscle tension, improve posture, and reduce stress
by re-educating your posture and activity.
I have had upper right back pain with no relief. I have tried PT and massage and
the X-rays show nothing. Should I ask for an MRI?
You should discuss it with your doctor, since an MRI is expensive and a
nuisance, but if there is a good reason to suspect a problem that could be found
by MRI, your doctor will tell you. The most common cause of back pain is in the
muscles and tendons and ligaments around the spine, which would not normally
show on an MRI, so it is possible that the results of the tests are negative
because the pain is in the muscles, tendons, and other soft tissues, which don't
show on X-ray.
In addition, you should try the solutions along with your doctor's advice,
which usually include moist heat, such as hot shower or hot towels or whirlpool,
and exercises to stretch and strengthen the muscles of the back. After a few
weeks there is usually noticeable improvement, and the longer you do this
program the better the relief. The exercises are one of the best ways to prevent
back pain from returning when the pain is coming from the muscles and tendons
around the spine.
I had surgery for a herniated disk last June and still have a lot of pain down
the back of my leg. I'm back in PT and thinking about cortisone shots. What do
you think about that treatment?
There are different types of cortisone shots. Some types are localized to the
tender areas around the lower back, and these are called trigger point
injections. Then other types of shots are called blocks, and they try to stop
pain by blocking the effects of the nerves that transmit the pain. In either
case, depending on the type of problem you're experiencing now, it's probably
worth a try if it was recommended. Either local trigger point injections or the
nerve blocks, which are given usually in a series of three, when they work, may
give relief for months at a time.
And of course this should be combined with the basic treatment program,
including moist heat and gradually increasing exercises, which have to be guided
by your doctor since everyone is different.