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healthspin by Jared M. Rochelle, MD take back your game with pain management B a c k pain can be can really handicap your golf game, but don’t let it discourage you from seeking steps to If the pain in your back is par Jared M. Rochelle, MD for the course, North Oaks Pain you may want Management to taking steps to manage it. Most people will experience back pain sometime in their lives. There are many causes, and some are due to lifestyle choices and age. Other back pain triggers include accidents, muscle strains and sports injuries. Roy, 56, is a golfer who suffered a back strain years ago while mowing his lawn. Before he developed back problems, he was a 6 handicap. Today, he is lucky to chalk up a 15 handicap. “Every time I take a swing with my club, it sends a sharp pain down my leg,” he shares. “My doctor says it is probably ‘structural.’ But, it’s definitely hurting my game.” The back is an intricate structure of bones, muscles and other tissues. The centerpiece of the structure is the spine, which is highly prone to injury because it is subject to many strong forces: torque and twisting, sudden jolts and daily stress. Common structural problems that may result in back pain include: • Ruptured disks – also called herniated disks, when the disk is damaged and bulges or breaks open • Bulging disks – when the disk bulges outside the space it normally occupies between the vertebrae • Sciatica – a sharp and shooting pain that travels through the buttock and to the leg, caused by inflammation of a nerve • Arthritis • Abnormal curvature of the spine – an example is sco liosis, when the spine curves to the side • Osteoporosis – bones, including the vertebra of the spine, become brittle, making fractures more likely • Spinal stenosis – narrowing of the spinal canal. Although he is relatively healthy, Winston, 64, is at risk for back pain due to his age.  Over time, wear and tear on the spine may result in neck and back pain. This means that people over age 30 or 40 are more at risk for back pain than younger individuals. “My back never bothered me until a few years ago,” he notes. “It seems like every year it gets a little more difficult to deal with and I visit the doctor more often.” Winston, an avid outdoorsman, doesn’t have other risk factors commonly associated with back pain. Those include: smoking; genetics; job hazards; low physical activity; obesity; poor posture; and pregnancy. However, low physical activity and genetics may contribute to 80-year- old Nancy’s back pain, which was so unbearable that she could barely walk or get through her daily routine. After taking a thorough history of Nancy’s health, her doctor performed a physical examination and ordered X-rays and Magnetic Resonance Imaging (MRI) scans. She was diagnosed with several structural problems, from ruptured and bulging disks to arthritis and spinal stenosis. “I have never been in such pain, even with childbirth,” she comments. “There were days that the pain was so bad that I would just sit in my chair and cry.” Although their cases are each unique, Roy, Winston and Nancy share similar symptoms: • Aching or stiffness anywhere along the spine, from the base of the neck to the tail bone • Sharp, pain in the neck, upper back or lower back – especially after activities that involve twisting, lifting or bending • Chronic ache in the middle or lower back, especially after sitting or standing for extended periods • Back pain that radiates from the low back to the buttocks, down into the leg and sometimes into the feet • Difficulty standing straight because of pain or spasms in the low back Despite the similarities, their doctors choose to treat them differently. For example, Roy’s doctor is treating him with nonsurgical procedures that include physical therapy and injections while Winston is undergoing lifestyle modification and psychological support. Nancy, due to the severity of her condition, was treated with medications and surgery. Whatever your symptoms, your health care provider should work closely with you to identify the cause of your pain and find appropriate treatment options. To learn more about managing your pain, call North Oaks Pain Management at (985) 230- 7480 or visit www.northoaks.org/ pain. 29