SALT LAKE CITY — There's no "quick fix" or "key you can turn" to cure back and neck problems. It's all about management, with a likelihood that pain will flare or recur at some point.

"It's about managing it and dealing with it," not letting it have control, said Kaye Meidinger, a nurse practitioner at TOSH — The Orthopedic Specialty Hospital's Neck and Back Center, during Saturday's Deseret News/Intermountain Healthcare Health Hotline on neck and back pain.

For two hours, Meidinger and physical therapist Karin Westlen-Boyer fielded dozens of calls and also answered questions posted on the Deseret News' Facebook page. Both work at the center, which provides triage for neck and back pain, helping people figure out what kind of treatment they need.

Amid questions about using magnets and acupuncture and manipulation to solve back and neck pain, Westlen-Boyer cited the book, "Back School," which says there are only three types of proven treatments: aerobic physical conditioning, education and, under specific guidelines, surgery. Only 1 percent to 3 percent of back-pain sufferers need surgery, she noted.

While many people use magnets, herbal treatments, acupuncture, corsets and spinal manipulation, studies don't support consistent effective results, according to Meidinger and Westlen-Boyer.

Staying active is one of the most important aspects of managing back and neck pain. It's instinctive in some cases to hunker down and be still, but motion and activity actually help easy pain and promote healing, said Meidinger, who suggests finding something that's physical and enjoyable, so that you will stick with it. It could be walking or aerobics, for instance. If you choose something like yoga or pilates, it's a good idea to learn to do it correctly by taking a class, she said.

Several callers were especially worried about back surgery because they said friends had back surgery in the past and "are worse than ever." Back surgery is very effective in cases where it's needed, she said, but it's not a quick fix, either. People have to maintain the stability of their spine, condition the muscle and strengthen their core. Without that, no treatment is truly effective. And it takes effort on a patient's part to get and keep the best results.

Two calls were particularly worrisome, indicating that the individuals might have some type of nerve root impingement, based on their symptoms. That can be marked by pain that travels down one extremity. It can progress to worse, Meidinger said, so that the extremity becomes weaker. A hand, for instance, might lost its grasp or it can become difficult to pick up a foot. "That's a red flag and we like to get on top of it," said Meidinger.

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Patients often express frustration because it's not always clear what causes back pain and much of it may never resolve. "It's good to exclude a serious problem and that's where an evaluation comes in," said Meidinger, who noted that tumors, abscesses and infections can cause pain but are much less common than structural issues and strains. Once you rule those out, it's still possible a cause of pain won't be clear. But you don't necessarily need to know where it's coming from or how it started to get effective treatment.

The hotline tackles a different health topic the second Saturday of each month.

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