
How to Treat Low Back Pain
A Guide for Treating causes of Low Back Pain for Physicians and APPs
- 1st Edition - November 30, 2024
- Imprint: Academic Press
- Editors: Timothy R. Deer, Nomen Azeem
- Language: English
- Hardback ISBN:9 7 8 - 0 - 4 4 3 - 1 5 9 6 2 - 6
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 5 9 6 3 - 3
How to Treat Low Back Pain: A Guide for Treating Causes of Low Back Pain for Physicians and APPs focuses on current technology and cutting-edge treatment options, all validated… Read more

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Request a sales quoteHow to Treat Low Back Pain: A Guide for Treating Causes of Low Back Pain for Physicians and APPs focuses on current technology and cutting-edge treatment options, all validated by data. Each chapter presents a thorough review of patient selection, procedure technique, and potential adverse complications for each recommended treatment. Written by experts in the field for practitioners and clinicians treating low back pain, and with anatomic artwork and illustrations throughout, the book covers all aspects of lower back pain, the leading cause of disability in developed countries, with the number of people affected worldwide increasing annually.
In recent years, there has been a substantial increase in health care costs to treat low back pain, and most of these treatments simply provide symptomatic relief with few strategies that actually contribute to correcting the underlying cause.
- Provides a step-by-step approach for each cause of back pain, including diagnosis, imaging, anatomy of the problem, abnormal anatomy, differential diagnosis, and treatment options
- Presents evidence-based treatment options, ranging from conversative treatments, physical medicine, surgery, and many minimally invasive techniques
- Summarizes the data for each problem, from disc to joint and ligament
- Title of Book
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Contributors
- Foreword
- Acknowledgment
- Section I. Understanding the pathology of disease
- Chapter 1. Normal structures of the lumbar spine
- Introduction
- Osseous structures
- Vertebral body
- Pedicles
- Laminae
- Facet (zygapophyseal) joints
- Spinous and transverse processes
- Intervertebral discs
- Spinal cord and spinal nerves
- Vascular structures
- Muscles and ligaments
- Conclusions
- Chapter 2. Obtaining an appropriate history from the low back pain patient
- Introduction
- Importance of history in the workup of LBP
- Benefits of a comprehensive history
- The first step in appropriate management
- History as a foundational step
- Treat the symptoms, not the images
- Limitations of imaging
- Dimensions of the symptom of low back pain
- Paraspinal pain
- Direct tenderness to palpation along the spine
- Unilateral flank pain
- Lateral back pain
- Periscapular Pain
- Onset of pain
- Initial onset of pain
- Sudden or gradual onset
- Duration of symptoms
- Precipitating factors
- Similar pain previously?
- Character
- Describing the quality or character of pain (e.g., dull, sharp, burning)
- Radiation
- Assessing if pain radiates to other body regions
- Pace of illness
- Understanding the progression of symptoms
- Exacerbating or relieving factors
- Identifying factors or movements that worsen or alleviate pain
- Severity
- Quantifying pain severity using a pain scale
- Associated symptoms
- Exploring additional symptoms or systemic complaints
- Chapter 3. Physical examination
- Introduction
- General physical examination
- Neurologic examination
- Motor strength examination
- Sensation
- Deep tendon reflexes
- Coordination
- Provocative tests
- Lumbar radicular pain
- Straight leg raise
- Crossed straight leg raise
- Femoral stretch test
- Discogenic pain/vertebrogenic pain
- Zygapophyseal joint
- Sacroiliac joint
- Chapter 4. Imaging for low back pain
- Introduction
- Magnetic resonance imaging
- Degenerative conditions
- Diskogenic pain
- Vertebrogenic back pain (Modic endplate changes)
- Degenerative spondylolisthesis
- Disk herniation
- Lumbar stenosis with neurogenic claudication
- Lateral recess stenosis
- Foraminal stenosis
- Synovial cysts
- Compression fractures
- Spondylolysis
- Spine infections
- Spine neoplasm
- Postoperative back pain conditions
- Pseudoarthrosis
- CT imaging of low back pain
- Physics and image generation
- Unique benefits
- Limitations
- Clinical cases
- Ultrasonography
- Plain radiographs
- Positron emission tomography–computed tomography
- Bone scan
- Conclusion
- Chapter 5. Other diagnostic work up
- Overview: Use of electromyography/nerve conduction study
- History and background
- Science behind diagnostic study
- Indication and patient selection
- Technique and interpretation
- Complication
- Pearls and pitfalls
- Discography
- History and background
- Science behind diagnostic study
- Indication and patient selection
- Pearls and pitfalls
- Myelograms
- History and background
- Science behind diagnostic study
- Indication and patient selection
- Technique and interpretation
- Complications
- Pearls and pitfalls
- Section II. Conservative treatments
- Chapter 6. Physical therapy and exercise
- Introduction
- History of physical therapy and therapeutic exercise
- Clinical course of low back pain
- Initial assessment and diagnostic triage
- Classifying low back pain
- Mechanical Diagnosis and Therapy
- Summary and conclusion
- Chapter 7. Chiropractic treatment of low back pain
- History and background
- Science behind treatment
- Indication and patient selection
- Nociceptive low back pain
- Treatments
- A typical chiropractic visit
- McKenzie exercises
- Evidence
- Potential complications
- Conclusion
- Chapter 8. Other conservative treatment
- Treatment- overview of acupuncture
- Treatment- overview of dry-needling
- History and background
- Science behind treatment
- Indications and patient selection
- Technique
- Complications
- Pearls and pitfalls
- Treatment overview of cupping
- History & background
- Science behind treatment
- Indication and patient selection
- Technique
- Complications
- Pearls and pitfalls
- Treatment- overview of TENS
- History & background
- Science behind treatment
- Indication and patient selection
- Technique
- Complications
- Pearls and pitfalls
- Treatment – overview of biofeedback
- History and background
- Science behind treatment
- Indications and patient selection
- Other techniques
- Complications
- Pearls and pitfalls
- Treatment- overview of pain psychology
- History & background
- Science behind treatment
- Indication and patient selection
- Technique
- Cognitive behavior therapy
- Acceptance and commitment therapy
- Mindfulness based therapy
- Complications
- Pearls and pitfalls
- Section III. Interventional treatments
- Chapter 9. Injections for lumbar pain syndromes
- Introduction
- Trigger point injections
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Lumbar interlaminar epidural injection
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Lumbar transforaminal epidural injection
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Caudal epidural injection
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Intraarticular facet injection
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Sacroiliac joint injection
- Background
- Anatomy
- Indications and contraindications
- Technique
- Cautions/complications
- Efficacy/literature
- Conclusion
- Chapter 10. Radiofrequency ablation of the medial branches
- History of radiofrequency ablation of the lumbar facet joints
- Anatomy/etiology of facet-mediated pain
- Diagnosis
- Evidence for treatment
- Indications for treatment and patient selection
- Techniques
- Complications
- Clinical pearls and pitfalls in lumbar radiofrequency ablation
- Chapter 11. Ablation of the basivertebral nerve
- Introduction
- Anatomy and pathophysiology
- Clinical presentation
- Diagnostic imaging
- Treatment
- Procedure description
- Complications
- Conclusion
- Chapter 12. Intradiscal biologic implants for low back pain
- Regenerative therapeutic approaches to treating IVDD
- Compositions of PRP and BMC
- Role of biochemical factors
- Role of cells and extracellular vesicles
- Strategies for therapeutic interventions
- Conclusion
- Nonregenerative therapeutic approaches to treating IVDD
- Composition of nucleus pulposus allograft
- Strategies for therapeutic interventions
- Conclusion
- Intradiscal biologic implant technique
- Chapter 13. Percutaneous Interlaminar Lumbar decompression (PILD)
- Background
- History
- Science behind treatment
- Indication and patient selection
- Technique
- Perioperative
- Procedural technique
- Procedural advances
- Postoperative
- Complications
- Pearls and pitfalls
- Pearls
- Pitfalls
- Conclusion
- Chapter 14. Interspinous process spacers
- History/background
- Indications & patient selection
- Evidence
- Benefits/risks
- Technique
- Patient positioning
- Deploying the implant
- Two level implant
- Implant removal
- Interspinous spacers: The vertiflex option
- Pearls and pitfalls
- Chapter 15. Minimally invasive spinal arthrodesis
- Introduction
- Review of current data/evidence
- Indications
- Contraindications
- Current specific implants available
- Aurora: Zip
- Southern spine: StabiLink
- Spinal simplicity: Minuteman
- KIC ventures: InSpan
- Clinical pearls
- Cautions/complications
- Conclusions
- Chapter 16. Minimally invasive sacroiliac joint fusion for the treatment of sacroiliac joint pain
- Background and history
- Available devices and clinical evidence
- Surgical technique for sacroiliac joint fusion—Posterior approach using a single graft
- Lateral approach
- Posterolateral (posterior oblique) approach
- Complications
- Pearls and pitfalls
- Chapter 17. Vertebral augmentation
- Introduction
- Etiology
- Pathophysiology
- Clinical presentation/physical examination
- Diagnosis/differential diagnosis
- Conservative management
- Vertebroplasty
- Vertebroplasty procedure
- Kyphoplasty
- SpineJack
- Review of literature
- Indications and contraindications
- Procedure technique
- Prevention
- Conclusion
- Section IV. Neurostimulation for low back pain
- Chapter 18. Dorsal column spinal cord stimulation (SCS)
- Introduction
- Anatomy and physiology of the spine relevant to dorsal column stimulation
- Indications and contraindications for dorsal column stimulation
- Patient selection criteria
- Contraindications to dorsal column stimulation
- Dorsal column stimulation procedure
- Preprocedure preparation
- Patent positioning and anesthesia
- Implantation of the dorsal column stimulator
- Programming and optimization of the device
- Results and outcomes of dorsal column stimulation
- Efficacy of dorsal column stimulation in treating chronic low back pain
- Comparison of dorsal column stimulation to other treatment options
- Complication rates and management
- Postprocedure care
- Monitoring and management of pain and complications
- Rehabilitation and optimization of pain relief
- Follow-up and maintenance of the dorsal column stimulator
- Chapter 19. Dorsal root ganglion stimulation for low back pain
- Brief history and background of DRG-S and its application for low back pain
- DRG-S mechanism of action
- L2 DRG-S for discogenic pain
- T12 DRG-S for LBP
- Indications and patient selection
- Technique
- The contralateral approach
- The ipsilateral paramedian approach
- Complications
- Hardware related
- Migration and lead fracture
- Safety
- Pearls and pitfalls
- Conclusion
- Chapter 20. Peripheral nerve stimulation for chronic low back pain
- Introduction/background
- Supporting science
- Clinical data
- Indication/patient selection
- Technique
- Restorative neurostimulation
- Complications
- Pearls and pitfalls
- Conclusion
- Chapter 21. Lumbar multifidus muscle stimulation
- History and background
- Science behind treatment and evidence (B trial results) (Chris)
- Indication and patient selection
- Restorative neurostimulator implant—Surgical technique
- Preoperative and patient positioning
- Imaging and guide needles
- Surgical access and fascial entry
- Delivery needle and guidewire placement
- Introducer sheath and lead placement
- Pocket, testing, and closure
- Pearls/pitfalls
- Complications and management
- Section V. Intrathecal therapies for low back pain
- Chapter 22. Intrathecal drug infusion system: Long-term opioid management
- Background and history
- Available implantable devices
- MRI compatibility
- Intrathecal opioids
- Morphine
- Hydromorphone
- Fentanyl
- Sufentanil
- Indications and patient selection
- Technique
- Complications
- Pearls and pitfalls
- Chapter 23. Nonopioid therapy for intrathecal drug delivery
- Introduction
- Nonopioid medications for intrathecal use
- Current guidelines and recommendations
- Factors affecting choice of nonopioid medications
- CSF flow dynamics and catheter tip location
- Future directions
- Chapter 24. The importance of the APP's ability to identify low back pain generators and select patients for appropriate treatment
- Introduction
- Identifying generators of low back pain
- History of present illness
- Onset
- Location
- Duration
- Character
- Aggravating and relieving factors
- Treatment
- Severity
- Associated symptoms
- Red flag presentations
- Physical examination
- Musculoskeletal exam
- Neurological exam
- Provocative tests
- Imaging
- Patient selection for treatment
- Conservative treatment
- Interventional treatment
- Injections
- Trigger point injections
- Epidural steroid injections
- Intraarticular facet steroid injections
- Sacroiliac joint injections
- Radiofrequency ablation
- Lumbar medial branch radiofrequency ablation
- Sacroiliac joint radiofrequency ablation
- Intradiscal treatment
- Vertebral pain treatment
- Minimally invasive spine treatment
- Sacroiliac joint fusion
- Percutaneous image-guided lumbar decompression
- Interspinous spacers
- Interspinous arthrodesis
- Vertebral augmentation (kyphoplasty)
- Neuromodulation treatment
- Spinal cord stimulation
- Peripheral nerve stimulation
- Dorsal root ganglion stimulation
- Multifidus stimulation
- Intrathecal drug delivery treatment
- Conclusion
- Chapter 25. The importance of the APP in perioperative management of MIS and neuromodulation for low back pain
- Introduction
- The role of the APP in pre- and postop patient management
- Preoperative examination, history and imaging
- Patient education
- Expectations
- Postoperative care
- Incision management
- Postoperative education
- The role of the intraoperative APP
- Perioperative management of neuromodulation patient
- Patient selection
- Medical optimization
- Patient education and expectation setting
- Post op management
- Perioperative management of MIS
- Preoperative patient management
- Patient selection
- Medical optimization
- Preoperative imaging
- Patient education and expectation setting
- Postoperative patient management
- Postoperative patient assessment
- Wound management
- Postoperative activity
- Managing postoperative pain
- Assessment and treatment of postoperative complications
- Conclusion
- Index
- Edition: 1
- Published: November 30, 2024
- Imprint: Academic Press
- No. of pages: 400
- Language: English
- Hardback ISBN: 9780443159626
- eBook ISBN: 9780443159633
TD
Timothy R. Deer
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