The Great Back Debate Is massage better for you than surgery?

[Guest guest]

The Great Back Debate

Is massage better for you than surgery? As millions of Americans seek relief

from this ancient ailment, doctors are trying simpler, less invasive ways to

end the agony

By Kalb

Newsweek, April 26 issue

Stop rubbing your sore back for a minute and take a quick tour of Mother

Nature's engineering masterpiece: the human spine. Pretend you are Alice, so

tiny

you can climb among the muscles, nerves, bones and ligaments that make up

the

very core of your body. Crawl down the 24 vertebrae that encase and protect

the spinal cord, from the cervical spine to the thoracic area to the lumbar

region, that pesky lower back. Note the 23 rubbery white discs: the

cartilage

inner tubes that cushion the vertebrae. Observe the dozens of spinal nerves

threading out from the cord between the bones. Poke the bands of muscle that

wrap

and support the bony column.

Now focus on the tugs and thuds of daily life. The quick bend when you pick

up your sobbing 2-year-old, the pounding of your feet as you run to catch

the

bus, the steady pull of your untoned belly, the dull pressure as you sit

bleary-eyed in front of your computer, the sudden twist of your golf swing.

Feel,

too, the constant emotional stress we all live with: worries about aging

parents, the kids' SAT scores, an IRS audit, mayhem in Iraq. Finally,

imagine (or

recall) that knife-in-the-back moment when something suddenly goes wrong

with all

that gorgeous spinal anatomy:

Owwwwwww!

Like an expensive but temperamental sports car, the human spine is

beautifully designed and maddeningly unreliable. If you're a living,

breathing human

being, you have probably suffered the agony of back pain. Eighty percent of

Americans will battle the condition at some point in their lives, making it

the No.

2 reason for doctor visits (after coughs and other respiratory infections).

Already, back-pain sufferers cost this country more than $100 billion

annually

in medical bills, disability and lost productivity at work. And as long as

we

continue to lead overweight, sedentary and stressful lives, that number is

unlikely to go anywhere but up.

As it does, legions of new back-pain sufferers, many desperate and even

disabled, will seek relief. When they do, they'll quickly discover just how

complicated their problem really is, with its mystifying mix of physical

symptoms and

psychological underpinnings. The reality is that the torment will usually go

away on its own-impossible as that may seem when you're writhing on the

kitchen floor. But pain is pain, and Americans, especially baby boomers,

want a

quick fix. The result: spinal-fusion surgery, the most costly (about $34,000

a

pop) and invasive form of therapy, has spiked dramatically-77 percent in the

United States between 1996 and 2001. But many of these procedures simply

don't

work.

Doctors, worried that far too many patients seem far too willing to go

under

the knife, are now actively looking for simpler, more effective ways to

treat

one of the most vexing problems in medicine. " We've come to the point where

we have to think out of the box, " says Dr. Eisenberg, head of Harvard

Medical School's Osher Institute, where he is studying nonsurgical

alternatives

like massage and acupuncture. " The time is now. "

Back pain can originate anywhere in the elaborate spinal architecture.

Degenerated discs, which may lead to herniation and compressed nerves, are a

common

problem. Then there are those wrenching spasms provoked by muscle, tendon

and

ligament injuries, which can drop grown men to the floor. What's most

mysterious about back problems is the disconnect between anatomical defects

and pain.

Unlike blood pressure and cholesterol, which can be easily measured with arm

cuffs and blood tests, lower-back pain has no objective way-the volume of

tears? the intensity of a grimace?-to be gauged. In many cases, the precise

cause

of pain remains unknown. Imaging tests have found that two people with

herniated discs can lead radically different lives: one spends his days

popping

painkillers, the other waltzes through life like Fred Astaire. In one

well-known

study, researchers sent 98 healthy people through an MRI machine: two thirds

had

abnormal discs even though none complained of pain. In other research,

experts compared a group of patients who reported back pain with a control

group who

didn't. Close to two thirds of the pain patients had cracks in their discs,

so-called high-intensity zones, or HIZs. But so did 24 percent of the

noncomplainers.

" The real issue, " says Dr. Eugene Carragee, the study's lead author and

director of Stanford's Orthopaedic Spine Center, " is, why do some people

have a

mild backache and some have really crippling pain? " ...

Continued on

Page 2: A Matter of the Mind Affecting the Body?

Page 3: Alternative and Complementary Therapies Offer New Hope

go to: http://msnbc.msn.com/id/4767268/