Monday, July 10, 2000

'Oh, My Achin' Back': Top 10 Professions Most at Risk to Low Back Pain
Low Back Pain Affects 20-Million Americans Annually; New Treatment Offers Relief and Mobility

(ARA) - What do truck drivers and heavy equipment mechanics have in common with doctors, dentists and nurses?

If you answered that they all have to work with some pretty tough customers, you may be only partially right. At least one other thing they have in common is ... low back pain.

According to the American Journal of Public Health, truck driving tops the list of the ten jobs with the highest prevalence of low back pain due to an injury at work. Following close behind are 2.) construction equipment and heavy machinery operators; 3.) construction workers; 4.) janitorial and building maintenance workers; 5.) firefighters; 6.) police officers; 7.) heavy equipment mechanics; 8.) health care therapists; 9.) physicians, dentists and nurses; and 10.) people involved in agriculture, forestry and commercial fishing.

However, you don't have to be a truck driver to experience low back pain. It can affect anybody, at any age, in any profession, from those who spend most of their day working in an office setting to professional golfers, such as Jason Zuback, the 29-year-old Canadian who is the four-time World Long Drive Champion (see Golfweek, Oct. 30, 1999). In fact, low back pain is the most common work-related medical problem in the United States and the second most common reason for doctor visits among U.S. citizens, according to the National Center for Health Statistics. It affects more than 20 million Americans and is the leading cause of disability among people ages 19 - 45. It hits the bottom line fairly hard, too: low back is the No. 1 leading cause of missed work days, costing Americans $60 billion per year in treatments and American businesses about $15 billion annually. It's estimated that at least 80 percent of all Americans will experience some form of low back pain at some point in their lives.

Many Causes of Lower Back Pain

A healthy spine protects the spinal cord and supports the body while allowing it to move freely. The vertebrae and the discs between them are aligned in three natural curves that are normally kept in balance by the muscles surrounding the spine. But because of various factors, including injury, the natural aging process or premature degeneration, certain spinal problems can cause the discs or vertebrae to impinge upon the spinal cord and its nerve roots, producing symptoms such as pain, stiffness, tingling and numbness. Two common types of physiological problems leading to low back pain are muscle and joint problems. Muscle-related low back pain comes in either spasms or strains that, while easily treatable, can also be symptoms of joint problems such as disc degeneration, disc herniation or spinal stenosis.

"The typical backache lasts two to three days and 80 percent of lower back pain cases clear up in two weeks," notes Dr. John Sherman, M.D., a Minneapolis-based orthopaedic surgeon. "Most cases can easily be managed with an over-the-counter, non-prescription pain reliever or anti-inflammatory (e.g., Tylenol, Aleve, Motrin or Advil) and a short term decline in activities."

"The type of cases that concern me and other orthopaedic surgeons," Dr. Sherman adds, "are those that last longer than six weeks, are generating a great deal of pain and truly interrupt day-to-day function."

Hope for Chronic Back Sufferers

Sometimes, low back injury can occur as a result of something as simple as a little fall or an innocent twist. Even such minor causes can lead to devastating results. But now there is hope for some back pain sufferers through a new, non-surgical treatment that's gaining favor even among skeptical orthopaedic surgeons.

Consider the case of Walter Cobb, 57, a truck driver who used to criss-cross the country for weeks at a time in an 18-wheeler for J & C Trucking, Forest Lake, Minn. Years of chronic low back pain and three back surgeries later, Cobb doesn't cruise the nation's highways any more -- doctor's orders. In January 1997, Cobb fell and injured his back again, which placed him the uncomfortable position of a fourth back surgery. However, before going under the knife, his doctor prescribed the Orthotrac, a new, non-invasive (non-surgical) back pain treatment. Ever since then, Cobb has kept on truckin'. Cobb credits the vest, which he wears several times daily, for allowing him to continue his 35-year career as a truck driver. Today, with the aid of his Orthotrac, Cobb hauls automobile parts for Ford Motor Company's St. Paul Division with Rush Trucking, a St. Paul, Minn.-based trucking firm.

"I have a love for the road," says Cobb, "as does my wife, Patricia, who also is a truck driver. The Orthotrac lets me stay close to the trucks and to the road."

Most orthopaedic surgeons will acknowledge that there are many ways to treat chronic lower back pain, ranging from traditional options such a epidural steroid injections, physical and traction therapy and surgery to non-traditional alternatives such as acupuncture or chiropractic adjustments.

As a relatively new alternative, the Orthotrac may serve as a happy medium between the traditional and non-traditional treatments. While it may not completely eliminate the need for surgery, it often allows the surgical option to be put off, sometimes indefinitely. And while treatments such as acupuncture remain suspect, the Orthotrac Vest is receiving the respect and endorsement of a growing number of orthopaedic surgeons, in part because of the numerous studies that have been commissioned to evaluate its effectiveness and its approval by a number of leading health plans.

The Orthotrac is an ambulatory (allows movement) treatment for patients who aren't responding to low back pain. Developed by Kinesis Medical, Inc. (, the Orthotrac is the first non-surgical treatment that delivers self-administered spinal off-loading. Custom fit, with individual measurements taken to offer the most accurate treatment possible, the vest's pneumatic lifting technology transfers weight from the patient's spine to the hips. When inflated, the vest reduces the intervertebral compression that may be causing back pain. The vest's lightweight fabric allows patients to be mobile during the course of their treatment. Patients can even participate in prescribed exercise routines and return-to-work conditioning programs while wearing the vest.

According to Kevin Nickels, president of Kinesis Medical, the treatment device creates a low level of disc decompression that reduces pain and improves mobility. In a way, it's similar to pool therapy, but it allows a patient to be more mobile.

"The Orthotrac gives spine and orthopaedic surgeons another tool for managing patients who haven't experienced relief from other therapies," says Nickels. "It's the first non-surgical treatment that delivers self-administered, spinal off-loading."

"A typical patient wears the vest two to three times a day for up to an hour at a time," says Dr. Vito Loguidice, a spine surgeon located in Bethlehem, Pa. "Many patients begin seeing results within days of beginning treatment and over the course of a few months, see a significant improvement in their quality of life."

When the Orthotrac Vest is worn several times a day, per a doctor's prescription, it off-loads up to 50 percent of a patient's body weight. The vest is worn outside of a patient's clothing with two belts anchoring it at the base of the rib cage and on the hips. A hand pump pneumatically inflates lifting mechanisms in the front, rear and lumbar regions to designated pressure levels prescribed by a physician or physical therapist. Patients are instructed to wear the vest two to four times a day for 20 - 60 minutes.

According to Kinesis Medical's Nickels, more than 1,500 people within the past three years have been prescribed the Orthotrac Vest, including homemakers, nurses, corporate managers and truck drivers.

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