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Back pain: Causes and treatment options

by Cheryl Jones

Created on: March 03, 2009

The lumbar region of your back - the section below your waist and above your buttocks - takes a great deal of abuse. It supports almost all of your body weight while it bears up under the tress and strain of bending, lifting, and twisting, It's no surprise that lower back pain is common and often recurring. But by using cholesterol-lowering drugs called statins, researchers are exploring a way to repair damaged spinal discs.




Discs: Shock Absorbers of the Spine




Discs are the shock absorbers of the spine. Filled with a gel-like substance called nucleus pulposus, discs act as cushions to keep the vertebral bones from scraping against each other. At each disc, two nerves radiate from the spinal cord to the body.




Injury, strain, and age may cause the cushiony discs to compress, causing the nucleus to seep out, similar to toothpaste being squeezed out of a tube. This seepage of nucleus pulposus is called a herniated disc and may either be a bulge or, in the worst cases, an actual rupture. The displaced nucleus may press against a spinal nerve, causing pain, or, in the case of a rupture, the substance of the nucleus may irritate the nerve.




Almost all herniated discs are in the lumbar region of the back.




Traditional Treatments




The first step in treating a herniated disc is to explore nonsurgical therapies. These may include:

- Medication, such as pain relievers or muscle relaxers

- Rest

- Exercises to strengthen the lower back

- Hydrotherapy

- Steroid injections into the disc to reduce the inflammation and relieve the pressure on the spinal nerve

- Chiropractic manipulations




Nearly all patients - up to 80% - will respond to nonsurgical treatment within 6 weeks.




Surgical Procedures




Patients who are still in pain after trying nonsurgical therapy may need surgery. The most extensive approaches are spinal fusion, which bonds two vertebrae together, and disc transplantation, which replaces the damaged disc with one taken from a cadaver.




Discectomy, the removal of the portion of the rupture that is pressing against the nerve, is a less invasive surgical option.




New Treatment on the Horizon: Statins




Another less invasive technique involves removal of the nucleus cells from the damaged disc. The cells are cultured with certain proteins and reinjected back into the damaged disc. Nucleus pulposus cells are integral in preserving the structure of the disc and cultured and reinjected, they activate the cells that make up the outer wall of the disc and slow further disc degeneration.




Researchers

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