Chronic back pain is not a disorder but a symptom of other medical problems that requires a detailed assessment and treatment plan to address the root cause and avoid repeated sickness absenteeism from work and disability, says a pain management expert at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health.
The 2019 Global Burden of Disease Study, published last year, estimates that low back pain is among the top 10 diseases and injuries that account for the highest number of disability-adjusted life years (DALY) worldwide. This debilitating pain affects more than 540 million people globally, but is largely treated improperly according to experts. It is one of the top reasons for hospitalization and the second leading cause of missed work in many Western countries.
“Back pain is the most common reason patients come to Cleveland Clinic Abu Dhabi’s pain management clinic. At some point in life, everyone will experience some degree of back pain. While the acute pain can be caused by a sudden injury to the muscles and ligaments supporting the back and goes away after a few days of care, a chronic condition needs a more intensive pain management plan,” says Dr. Reda Tolba, the Department Chair of the Pain Management Department in the Anesthesiology Institute at Cleveland Clinic Abu Dhabi.
Dr. Tolba explains that chronic back pain can be a cumulative response to other conditions, such as arthritis of the spine, sacroiliac joint dysfunction, herniated disc, myofascial pain, and even a patient’s lifestyle. A proper diagnosis can be achieved by assessing the patient’s medical history, a physical exam, and investigative studies, such as x-rays, MRI or CT scans, if necessary.
“When patients come to us, they’ve already spent years suffering from back pain that has affected their normal day-to-day activities and kept them away from work for an extended period of time. Patients are usually seen by a primary care or emergency medicine physician for an initial assessment and are given symptomatic treatments such as over-the-counter anti-inflammatory medications and painkillers. They only see a pain medicine physician much later when the pain gets worse.”
He says that there needs to be more awareness among physicians for proper and timely referral to pain specialists to avoid the burden of lower back pain on patients, the economy and wider healthcare system.
“During my time in the United States, I saw a lot of patients who would file for disability because they ignored issues such as herniated discs exacerbated by their physical jobs or other neurological symptoms that were so severe that they couldn’t go into work anymore. It has become one of the most common causes of disability worldwide.”
At Cleveland Clinic Abu Dhabi, patients with back pain are offered a range of management plans, which involve innovative cutting-edge procedures to help patients suffering from excruciating pain.
Those procedures are in conjunction with physical therapy and a diet plan to address underlying lifestyle issues. Patients are also educated on proper ergonomics and how to lift weights to avoid injuries, and are given at-home exercises to strengthen their core to help with their chronic low back pain.
“Patients can have long periods of pain relief as long as they follow the plan and see their specialist regularly. Our aim is to not only help reduce their pain but maximize their functional performance in daily life and productivity at work,” says Dr. Tolba.