Low Back Pain: Is Relief In Sight?

By Dov Michaeli

First posted 8/8/11 on The Doctor Weighs In

For people of a certain age low back pain is a fact of daily life. Why, of all people, should our venerable seniors suffer from this affliction? The short answer is disk degeneration. The longer answer requires a longer explanation. So bear with me and I’ll walk you through it.

The intervertebral disk

This structure is a marvel of engineering. Now don’t get me wrong, I am not implying that an all knowing intelligent engineer designed it. What is marvelous about it is that an evolutionary process of trial and error lasting many millions years made us, and all vertebrates, well…vertebrates. And probably as important, it allowed us to walk upright, although we had to pay a penalty for the privilege. More on that later.

The picture below shows the basic structure of a disk.

The center of the disk, called nucleus pulposus, is made up of cartilage material, which has the consistency of a gel; imagine a water-filled sponge. If you apply pressure on the sponge from above, what would keep the water from running off to the sides?

Continue reading “Low Back Pain: Is Relief In Sight?”

Primary Care’s “Top 5” List

Kenneth Lin

First published 5/30/11 on the AFP Community Blog

Last week, the journal Archives of Internal Medicine published “The ‘Top 5’ Lists in Primary Care,” a physician-authored consensus statement that recommended five activities each for the specialties of family medicine, internal medicine, and pediatrics to pursue to reduce waste and improve quality. Here is the top 5 list for family physicians, together with related online resources from AFP By Topic collections:

1) Don’t do imaging for low back pain within the first 6 weeks unless “red flags” are present.

AFP By Topic: Muculoskeletal Care – Neck and Back

Continue reading “Primary Care’s “Top 5” List”