Weight control, exercise and anti-inflammatory pain medications form the foundation of recovery from most back pain, according to back specialists who answered questions during Saturday's Deseret News/Intermountain Healthcare Hotline.

Dr. Reed Fogg and Dr. Terry Sawchuk answered dozens of calls during the monthly two-hour hotline, responding to questions that ranged from coping with aches and pains associated with aging to what to make of diagnostic studies, when injections are helpful and whether decompression works.

"A lot of calls are from senior citizens who are feeling aches and pains that, unfortunately, simply come with time," said Fogg, director of the Intermountain Spine Institute at The Orthopedic Specialty Hospital. When age is the primary cause of back pain, it's unrealistic to expect total resolution, he said.

That doesn't mean that improvement is not possible, and that's where being thin, fit and taking the appropriate medications come into play.

"As fantastic as (people who treat backs) are with imaging, injections, artificial disks, etc., it's a sad fact that there's not a fix for everyone," said Sawchuk, also of the institute, who is board-certified in physical medicine and rehabilitation, with an emphasis in interventional physiatry.

For many, it becomes an issue of managing pain.

Fogg said he likes swimming as a form of therapy for back pain because it's low-impact, builds strength and uses a complete range of motion. Unfortunately, "Americans do not like to swim, particularly American women" who don't want to get into a swimsuit or have their hair messed up, he said.

He's not talking about doing 20 laps of the Australian crawl, he said, but rather water aerobics and arthritis exercises in a warm pool —at least 80 degrees."It has great benefits, but most people won't do it over a prolonged period."

People are more likely to walk or ride a recumbent bike, he said, also good exercises.

Sawchuk told a couple of callers to consider a large exercise ball, which they can use to stretch their backs. He also noted that activity modification is important, although that may not be what patients want to hear. The sad fact, he said, is that as you get older, you can't always do what you did in your 20s.

To get the right exercises, Fogg and Sawchuk recommend a program of body mechanics and conditioning.

Someone who is considering an injection or surgery needs to have a specific diagnosis, and that involves tests including an MRI and others, Fogg said.

Several callers asked them about chiropractors to treat back pain. "They have a place," Sawchuk said, but he questions any care provider who asks someone to come 56 times, something one caller reported. If, after three or four visits, it's helping, a few more visits might be appropriate, he said.

Both doctors told callers that if they're not getting relief, seeking a second opinion is appropriate.

The hotline tackles a different topic the second Saturday of each month. This month, answers to some of the questions that were submitted by e-mail will be published at www.deseretnews.com on Thursday morning.

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