Back Pain

What is the most effective NSAID for back pain?

DEAR DOCTOR K: I have frequent back pain. I usually take acetaminophen (the Tylenol brand), but I hear it may not be effective for back pain. Is there anything to that?

DEAR READER: If you'd asked me that question even a year ago, I would have said, "Acetaminophen works fine for most people." Lots of people are bothered by back pain. When it strikes, all you want is relief -- and fast. Many folks turn to over-the-counter pain relievers like acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDs (ibuprofen, naproxen and aspirin).

What are the surgical options for a herniated disk?

DEAR DOCTOR K: I have a herniated disk that's been bothering me for more than a year. I've tried exercise, medication and complementary therapies. None have helped. What are my surgical options?

DEAR READER: Let's start with a brief anatomy lesson. The human spine consists of a column of interlocking bones called vertebrae. They surround and protect the spinal cord. Vertebrae are stacked on top of each other. In between each pair of vertebrae is a little shock-absorbing cushion called an intervertebral disk. Intervertebral disks -- think of miniature jelly doughnuts -- prevent the vertebrae from scraping against each other. A normal disk has a jelly-like center (the nucleus) and a tough outer covering.

What type of mattress helps with lower back pain?

DEAR DOCTOR K: I have chronic low back pain. What type of mattress should I use?

DEAR READER: Considering that we spend roughly a third of our lives lying in bed, this is a very good question. And you'd think medical science would have a very good answer. I asked my colleague, Dr. Jeffrey Katz, professor of medicine and orthopedic surgery at Harvard Medical School, for his thoughts. He noted that there's not a great deal of research on this topic, but a few studies offer some guidance.

What is the best treatment option for scoliosis?

DEAR DOCTOR K: My granddaughter has scoliosis. What is the best treatment option for this condition?

DEAR READER: For readers who may not be familiar with the condition, I'll start by explaining what scoliosis is. Normally, when you look at a person's spine, it appears straight. With scoliosis, the spine typically curves out to one side and then back again. Or it may have two bowed-out areas, resembling an S shape. Here you'll find an illustration of a normal spine and a spine curved by scoliosis:

How soon can I resume normal activities after an episode of low back pain?

DEAR DOCTOR K: I'm recovering from an episode of low back pain. How quickly (or slowly) should I resume my normal activities? I don't want to reinjure my back.

DEAR READER: You're right: It's a balancing act. Too rapid a return may precipitate a relapse, but too timid a return can delay -- or even prevent -- recovery. I can't give you a definitive answer because I don't know the details of your condition. But here's some general advice.

What are the best ergonomics to help reduce my neck pain while at my desk?

DEAR DOCTOR K: I spend most of my day at my desk. Can you describe the correct ergonomics to help reduce my neck pain?

DEAR READER: I'm glad you asked, because I've spent all of this day writing my columns, and my neck hurts. I'm not very good at following the advice I'm about to give you. For readers not familiar with the term, "ergonomics" is the science of using our bodies (primarily bones and muscles) for a particular task in the safest and most efficient way. It teaches us about how best to arrange our homes and workplaces.

What are exercises that will strengthen my lower back?

DEAR DOCTOR K: My lower back has been giving me trouble. Could you describe some exercises to strengthen it?

DEAR READER: If misery loves company, you'll be glad to hear that there are many people who have back problems. One large survey conducted by the government found that about one out of every four adults had suffered from back pain lasting at least a whole day in the previous three months.

Should I go to a chiropractor for my lower back pain?

DEAR DOCTOR K: I suffer from low back pain, and I'm thinking of visiting a chiropractor for spinal manipulation treatments. What do you think?

DEAR READER: Spinal manipulation treatments are performed by chiropractors, osteopaths, and some massage and physical therapists. More than one of my patients has tried this treatment for back pain. They usually don't like to tell me about it, because they think I'll disapprove. Actually, I think there is evidence from scientific studies that chiropractic therapy for short-term or recurrent pain may be at least as effective as the treatments that I have to offer.

How can I stop having neck pain from using my tablet computer?

DEAR DOCTOR K: I love my tablet computer, but my neck hurts every time I use it. Any suggestions?

DEAR READER: Using a tablet computer shouldn't be a pain in the neck, but for all too many people, it is. Why? Widely popular tablets such as the iPad, Nook, Kindle Fire, Xoom and others are so light and easy to handle that you can hold one on your lap or in your hand.

Why do people lose height and develop a stooped posture as they get older?

DEAR DOCTOR K: Why do so many people lose height and develop a stooped posture as they get older?

DEAR READER: You may be surprised by the answer. In many older people, loss of height and stooped posture results from fractures of the spine. When you think of a bone fracture, you probably picture a long bone being snapped like a twig, as with a broken arm or leg.