Early treatment can stave off chronic back pain

Published: Thursday, Dec. 8 2011 5:58 p.m. MST

Dr. Scott Swasey for IHC hotline in Murray Thursday, Dec. 8, 2011.

Jeffrey D. Allred, Deseret News

SALT LAKE CITY — It often starts small but can grow to the point of being a real pain in the back, keeping a person from normal function and enjoying everyday activity.

But back pain can be treated.

"Back and neck pain affects nearly everyone at some point in their lives," said Dr. Scott Swasey, a specialist with Intermountain Medical Center's Physical Medicine and Rehabilitation Clinic.

Swasey said prompt and appropriate treatment may be key to avoiding chronic, long-term and debilitating pain.

"Once pain becomes chronic, it is difficult to diagnose," he said, adding that he recommends people see a physician as soon as the pain "keeps a person from doing what they do every day."

Swasey, along with Brad Dalton, a physical therapist with Intermountain WorkMed, will take questions from the general public about back pain and available treatment options during Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. until noon, anyone can call 800-925-8177 or post questions on the Deseret News' Facebook page.

At Intermountain's Physical Medicine and Rehabilitation Clinic, treatment is offered in a multidisciplinary approach, involving at times a physical therapist, pain psychologist, neurosurgeon and/or a spine surgeon, among others.

Swasey said oftentimes there is no singular solution to pain management.

Back pain, the most common cause of disability in people under age 45, can be spurred by problems with the joints in the spine or pelvis that become displaced or stiff, or discs in the spine that do the same, or even by nerve issues. It can remain localized in the back or can be felt in other areas of the body, specifically the limbs or extremities.

There are multiple treatment options, including steroidal injections that provide temporary relief or even surgical procedures that diminish pain long term, Swasey said. But in a 40-minute initial evaluation and examination, he asks patients about their sleep habits first.

He said sleep disorders, as well as depression and anxiety issues, can lead to back pain — or at least be major contributing factors that need attention before pain can be treated effectively.

"It's all about prevention," Swasey said, and avoiding the potential for chronic pain.

Maintaining a health diet and regular exercise can help keep back pain at bay, as well as avoiding prolonged inactivity or a sedentary lifestyle, according to the American Pain Society.

Posture, comfortable shoes, mattress firmness and the tendency to stretch or warm up muscles and joints before activity are also factors that can stave off injury or pain.

Smoking and pregnancy are also contributing factors to back pain.

As an Army physician, Swasey said he would see soldiers soon after their injuries and because of what he believes was a quick application of treatment, 90 percent of them were back working, pain-free, within a week.

While he is open to using medication to treat pain in patients, Swasey said he is careful, not only to avoid addiction, but a bigger problem of unwanted side effects, sometimes leading to impairment of normal breathing patterns and even death.

Sleep issues are important to him as a doctor, as he believes they can lead to back pain without an inciting event, such as throwing it out during various physical activity.

Research is only just starting to link the two, but Swasey said it is apparent in what he sees in his office on a regular basis.

"If your pain is bad enough that it's impairing what you need to do in life, you need to be seen," he said. "It used to be that we would let it get better on its own, but in my experience, the sooner you get the appropriate treatment the better."

The solution might be simple, but seeking medical attention, he said, could also help prevent the recurrence of back pain, which is common in people who've had it before.

Saturday: Living with back pain

Hotline Saturday

The Deseret News/Intermountain Healthcare Hotline focuses on back pain and advances in treatment options. From 10 a.m. to noon Saturday, Dr. Scott Swasey, a specialist with Intermountain Medical Center's Physical Medicine and Rehabilitation Clinic, and Intermountain WorkMed physical therapist Brad Dalton will answer questions. Call 800-925-8177 or post questions during that time on the Deseret News' Facebook page, www.facebook.com/desnews.

E-mail: wleonard@desnews.com Twitter: wendyleonards

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