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11 Articles in Volume 7, Issue #1
Clinical Bioethics
Electromyography (EMG) and Musculoskeletal Pain
Gastrointestinal Adverse Effects of Opioids
Head and Neck Pain
Minimally-Invasive, Interventional Spine Treatment Part II
Prolotherapy for Musculoskeletal Pain
Surviving a Loved One's Chronic Pain
The Continuing Need for Pain Education
Therapeutic Laser For Chronic Low Back Pain

Therapeutic Laser For Chronic Low Back Pain

Laser therapy offers a safe and effective treatment modality as either primary or adjunctive therapy.

 Low back pain will affect 75-85% of all Americans at some point during their lifetime. Approximately 50% of them will have a recurrence within a year. Approximately 90% improve without surgery.1 Low back pain is the number 2 reason that Americans see their doctor—second only to colds and flu. Approximately 7.4% of patients with low back pain account for 75% of the money spent on low back pain.3 The vast majority of acute low back pain is the result of injury such as sprain or strain, while the cause of chronic low back pain is multi-factorial.2 Chronic low back pain is defined as pain of more than three months duration. It occurs in 2-8% of those who experience low back pain.3

The five most common pain producing structures of low back pain are:
1. Posterior longitudinal ligament
2. Interspinous ligament
3. Spinal nerve root
4. Facet joints
5. Deep muscles.

These structures do not fully account for the pain experienced by many chronic low back pain sufferers. The exact mechanisms of the causes of chronic low back pain continue to be a mystery. Recent scientific studies have implicated a number of chemical mediators as possible contributors to the production of chronic low back pain. These include:

• The peptide somatostatin
• Pro-inflammatory cytokines such as IL-1, IL-6, IL-10, and TNF-alpha
• PGE2
• Nitric oxide.4

Patients with chronic low back pain may also have emotional factors such as depression with a four times higher incidence of clinical depression than those without chronic low back pain. Studies have shown that 62% of the patients treated at pain clinics for low back pain have some type of depression.5'

Please refer to the Jan/Feb 2007 issue for the complete text. In the event you need to order a back issue, please click here.

Last updated on: February 22, 2011
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