Suggest treatment for chronic back pain
Patient: I live in TORONTO Ontario Canada. I am have chronic back pain that has become unbearable. I am now up to taking 8-10 80 mg. tablets of oxyneo daily...and I am still suffering with excruciating back pain. My family doctor has sent out some referral letters to spine surgeons but they are not taking on anymore referrals. I feel hopeless! Can you help me? Thank you! Doctor: Hi there. Back pain can be really severe and incapacitating at times. Now the first question I should ask you is this: is it a pain which radiates down your thighs and legs, and do you have any associated difficulty in passing urine or stools? if so you may be having features of spinal cord compression and need urgent evaluation by spine surgeon. If you're having back pain alone, then a majority of it can be treated with changing your lifestyle, avoiding lifting heavy weights, or bending down and working. For acute onset pain analgesics may be helpful. Bed rest only for 3-5 days maximum. Prolonged bed rest is actually harmful as it causes wasting of your back muscles which are  important stabilisers of your spinal column. So a gradual starting if physio is more useful. There are exercises for core abdominal muscles and paraspinal muscles which can help. Surgery for back pain alone might not give you expected results all the time. it is useful mainly if there is associated cord compression going on.