Skip to main content
SpringerLink
Log in

Rational Evaluation and Management of the Patient with Spinal Pain

  • Chapter
Advanced Concepts in Lumbar Degenerative Disk Disease

  • 2093 Accesses

Abstract

Low back pain is a common adult complaint throughout the developed world. The majority of acute low back pain episodes will relent spontaneously. Evaluation is not needed immediately if there are no red flags. A small number of patients with acute disk herniation will require surgery based upon severity of pain and real or impending neurological deficits. Many can be relieved of radicular pain by perineural steroid injection and/or a short course of oral steroids. Rapid mobilization and return to function are helpful.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Long DM. Electrical stimulation for relief of pain from chronic nerve injury. J Neurosurg. 1973;39(6):718–22.

    Article  CAS  PubMed  Google Scholar 

  2. Long DM, Hagfors N. Electrical stimulation in the nervous system: the current status of electrical stimulation of the nervous system for relief of pain. Pain. 1975;1:109–23.

    Article  CAS  PubMed  Google Scholar 

  3. Long DM, BenDebba M. Diagnosis and management of low back pain, chapter 51. In: Asbury AK, McKhann GM, McDonald WI, Goadsby PJ, McArthur JC, editors. Diseases of the nervous system. Clinical neuroscience and therapeutic principles. 3rd ed. Cambridge, UK: Cambridge University Press; 2002. p. 760–70.

    Google Scholar 

  4. BenDebba M, Dizerega MD, Long DM. The lumbar spine outcomes questionnaire: its development and psychometric properties. Spine J. 2007;7:118–32.

    Article  PubMed  Google Scholar 

  5. Long DM. Chronic back pain. In: Wall PD, Melzack R, editors. Textbook of pain. 4th ed. Edinburgh/New York: Churchill Livingstone; 1999. p. 539–58.

    Google Scholar 

  6. Long DM. The development of the comprehensive pain treatment program at Johns Hopkins. In: Cohen MJM, Campbell JN, editors. Pain treatment centers at a crossroads: a practical and conceptual reappraisal. Progress in pain research and management, vol. 7. Seattle: IASP Press; 1996. p. 3–24.

    Google Scholar 

  7. Long DM, BenDebba M, Torgerson WS, Boyd RJ, Dawson EG, Hardy RW, Robertson JT, Syport GW, Watts C. Persistent back pain and sciatica in the United States: patient characteristics. J Spinal Disord. 1996;9(1):40–58. Philadelphia: Lippincott-Raven Publishers.

    Article  CAS  PubMed  Google Scholar 

  8. Ackerman SJ, Steinberg EP, Bryan RN, Ben Debba M, Long DM. Patient characteristics associated with diagnostic imaging evaluation of persistent low back problems. Spine. 1997;22(14):1634–40.

    Article  CAS  PubMed  Google Scholar 

  9. Hendler NH, Mollett A, Viernstein M, Schroeder D, Rybock J, Campbell J, Levin S, Long DM. A comparison between the MMPI and the “Hendler Back Pain Test” for validating the complaint of chronic back pain in men. J Neurol Orthop Med Surg. 1985;6(4):333–7.

    Google Scholar 

  10. Lora J, Long DM. So-called facet denervation in the management of intractable back pain. Spine. 1976;1(2):121–6.

    Article  Google Scholar 

  11. Bogduk N, Long DM. Percutaneous lumbar medial branch neurotomy. A modification of facet denervation. Spine. 1980;5(2):193–200.

    Article  CAS  PubMed  Google Scholar 

  12. Long DM. Pain of spinal origin, chapter 126. In: Youmans JR, editor. Neurological surgery, vol. 6. 6th ed. Philadelphia: W. B. Saunders Publishing Co; 1982. p. 3613–26.

    Google Scholar 

  13. Long DM. Surgical treatment for back and neck pain. In: Wall PD, McMahon SB, Koltzenbarg M, editors. Wall and Melzack’s textbook of pain. Philadelphia: Elsevier/Churchill Livingstone; 2006.

    Google Scholar 

  14. Long DM. Effectiveness of therapies currently employed for persistent low back and leg pain. Commentary Effectiveness of therapies currently employed for persistent low back and leg pain. Commentary. Pain Forum. 1995;4(2):122–5.

    Article  Google Scholar 

  15. Long DM. Chronic back pain, chapter 5. In: Wall, Melzack, editors. Handbook of pain management: a clinical companion to wall and Melzack textbook of pain. Churchill Livingstone: Elsevier; 2003. p. 67–76.

    Chapter  Google Scholar 

  16. Long DM, Zeidman SM. Outcome of low back pain therapy. In: Hadley MN, editor. Perspectives in neurological surgery, vol. 5, no. 1. St. Louis: Qualit, Medical Publishing; 1994. p. 41–51.

    Google Scholar 

  17. Long DM. Evaluation and treatment of the “multiple surgery” low-back cripple. Contemporary. Neurosurgery. 1979;17:1–6.

    Google Scholar 

  18. Long DM. Failed back syndrome: etiology, assessment and treatment—chapter 27. In: Burchiel K, editor. Surgical management of pain. New York: Thieme Medical Publishers, Inc; 2002. p. 354–64.

    Google Scholar 

  19. Zeldman SM, Long DM. Failed back surgery syndrome, chapter 43. In: Menezes AH, Sonntag VKH, editors. Principles of spinal surgery, vol. 1. New York: McGraw-Hill Publishers; 1996. p. 657–79.

    Google Scholar 

  20. Long DM. Failed back syndrome. In: Kostulk JP, editor. SPINE failed spinal surgery: state of the art reviews-vol. 11, no. 3. Philadelphia: Hanley & Bellus; 1997. p. 439–52.

    Google Scholar 

  21. Long DM, McAfee PC, editors. Atlas of spinal surgery. Baltimore: Williams and Wilkins; 1992.

    Google Scholar 

  22. BenDebba M, van Alphen HA, Long DM. Association between peridural scar and activity-related pain after lumbar discectomy. Neurol Res. 1999;21(Supp. 1):537–42.

    Google Scholar 

  23. Long DM. External electrical stimulation as a treatment of chronic pain. Minn Med. 1974;57:195–8.

    CAS  PubMed  Google Scholar 

  24. Campbell JN, Long DM. Peripheral nerve stimulation in the treatment of intractable pain. J Neurosurg. 1976;45:692–9.

    Article  CAS  PubMed  Google Scholar 

  25. Long DM. Use of peripheral and spinal cord stimulation in the relief of chronic pain. In: Bonica JJ, Albe-Fessard, editors. Advances in pain research and therapy. New York: Raven Press; 1976. p. 395–403.

    Google Scholar 

  26. Long DM. Electrical stimulation for the control of pain. Arch Surg. 1977;112:884–8.

    Article  CAS  PubMed  Google Scholar 

  27. Long DM. Uses of percutaneous electrical stimulation of the nervous system. Med Prog Technol. 1977;5:47–50.

    CAS  PubMed  Google Scholar 

  28. North RB, Fischell TA, Long DM. Chronic dorsal column stimulation via percutaneously inserted epidural electrodes: preliminary results in 31 patients. Appl Neurophysiol. 1977/1978;40:184–91.

    Google Scholar 

  29. Long DM. Electrical stimulation of the nervous system for pain control. Contemporary Clin Neurophysiol. 1978;(EEG Suppl. No. 34):343–48.

    Google Scholar 

  30. Long DM, Erickson D, Campbell J, North R. Electrical stimulation of the spinal cord and peripheral nerves for pain control. A 10-year experience. Appl Neurophysiol. 1981;44:207–17.

    CAS  PubMed  Google Scholar 

  31. Erickson DL, Long DM. Ten-year follow-up or dorsal column stimulation. In: Bonica JJ, editor. Advances in pain research and therapy, vol. 5. New York: Raven; 1982. p. 583–9.

    Google Scholar 

  32. North RB, Kidd DH, Zahurak M, James CS, Long DM. Spinal cord stimulation for chronic, intractable pain: experience over two decades. Neurosurgery. 1993;32(3):384–95.

    Article  CAS  PubMed  Google Scholar 

  33. Long DM. Chronic pain syndrome. In: Long DM, editor. Current therapy in neurological surgery 1985–1986. Toronto: B C. Decker Publisher; 1985. p. 208–9. St. Louis/Toronto/London: C. V. Mosby Company.

    Google Scholar 

  34. Long DM. Contemporary diagnosis and management of pain. 3rd ed. Newtown: Handbooks in Health Care Co., a Division of Associates in Medical Marketing Co; 2005.

    Google Scholar 

  35. Long DM. Rehabilitation of the patient with persistent pain. In: Illis LS, editor. Neurological rehabilitation. 2nd ed. Oxford: Blackwell Scientific Publishers; 1994. p. 394–408.

    Google Scholar 

  36. Bogduk N, Long DM. The anatomy of the so-called “articular nerves” and their relationship to facet denervation in the treatment of low-back pain. J Neurosurg. 1979;51:172–7.

    Article  CAS  PubMed  Google Scholar 

  37. Vrtovec T, Janssen MMA, Likar B, Castelein RM, Viergever MA, Pernus F. A review of methods for evaluating the quantitative parameters of sagittal pelvic alignment. Spine J. 2012;12:433–46.

    Article  PubMed  Google Scholar 

  38. Schroeder M, Viezens L, Schaefer C, Friedrichs B, Algenstaedt P, Ruther W, Wiesner L, Hansen-Algenstaedt N. Chemokine profile of disc degeneration with acute or chronic pain. Laboratory investigation. J Neurosurg Spine. 2013;18:496–503.

    Article  PubMed  Google Scholar 

  39. Aoki Y, Rydevik B, Kikuchi S, Olmarker K. Local application of disc-related cytokines on spinal nerve roots. Spine (Phila PA 1976). 2002;27:1614–7.

    Article  Google Scholar 

  40. Burke JG, Watson RW, McCormack D, Dowling FE, Walsh MG, Fitzpatrick JM. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002;84:196–201.

    Article  CAS  PubMed  Google Scholar 

  41. DePalma M. Biologic treatments for discogenic low back pain. SpineLine. 2012;3:19–26.

    Google Scholar 

  42. Nagae M, Ikeda T, Mikami Y, Hase H, Ozawa H, Matsuda K, Sakamoto H, Tabata Y, Kawata M, Kubo T. Intervertebral disc regeneration using a platelet-rich plasma and biodegradable gelatine hydrogel microspheres. Tissue Eng. 2007;13(1):147–58.

    Article  CAS  PubMed  Google Scholar 

  43. Meisel HJ, Siodla V, Ganey T, et al. Clinical experience in cell-based therapeutics: disc chondrocyte transplantation: a treatment for degenerated or damaged intervertebral disc. Biomol Eng. 2007;24:5–21.

    Article  CAS  PubMed  Google Scholar 

  44. Steck E, Bertram H, Abel R, et al. Induction of intervertebral disc-like cells from adult mesenchymal stem cells. Stem Cells. 2005;23:403–11.

    Article  CAS  PubMed  Google Scholar 

  45. Yoshikawa T, Ueda Y, Miyazaki K, et al. Disc regeneration therapy using marrow mesenchymal cell transplantation: a report of two case studies. Spine. 2010;35:E475–80.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Donlin M. Long MD, PhD

Authors
  1. Donlin M. Long MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donlin M. Long MD, PhD .

Editor information

Editors and Affiliations

  1. Neurological and Spine Surgery, Hospital Samaritano, São Paulo, São Paulo, Brazil

    João Luiz Pinheiro-Franco

  2. Rothman Institute, Thomas Jefferson University Medical Center, Philadelphia, Pennsylvania, USA

    Alexander R. Vaccaro

  3. Cleveland Clinic Neurological Surgery, Cleveland, Ohio, USA

    Edward C. Benzel

  4. Schön Klinik München Harlaching FG Wirbelsäulenchirurgie, München, Germany

    H. Michael Mayer

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Long, D.M. (2016). Rational Evaluation and Management of the Patient with Spinal Pain. In: Pinheiro-Franco, J., Vaccaro, A., Benzel, E., Mayer, H. (eds) Advanced Concepts in Lumbar Degenerative Disk Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47756-4_50

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-47756-4_50

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47755-7

  • Online ISBN: 978-3-662-47756-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation