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Conservative and Surgical Approaches for Acute and Chronic Back Pain  Donald S. Corenman, M.D., D.C. Steadman Hawkins Clinic
Spinal Function ,[object Object],[object Object],[object Object],[object Object]
Circulatory Changes in the Disc ,[object Object],[object Object],[object Object],[object Object]
Discal Changes with Aging ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanical Stress with Flexion on Lumbar Discs ,[object Object],[object Object],[object Object]
Annular Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Annular/Discal Biomechanics ,[object Object],[object Object],[object Object]
The Devil’s in the Details ,[object Object],[object Object],[object Object]
Annular Tears ,[object Object],[object Object],[object Object]
Pathophysiology of the Facets ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
So- where does the pain come from????????
Smyth and Wright, JBJS(B) 40A intraoperative connection of nylon threads to spinal structures with post-operative stimulation  ,[object Object],[object Object],[object Object],[object Object]
Kuslich, OCNA April 91 pain response to tissue stimulation under local anesthesia ,[object Object],[object Object],[object Object]
Kuslich,  OCNA  April 91 pain response to tissue stimulation under local anesthesia ,[object Object],[object Object],[object Object]
Posterior Annular Nociceptors  ,[object Object],[object Object],[object Object],[object Object]
Nociceptor Nerve Injury ,[object Object],[object Object],[object Object]
Arachidonic Acid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Why do we need pain receptors in the first place? ,[object Object],[object Object],[object Object]
Sources of Lower Back Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
General Indications for Surgery ,[object Object],[object Object],[object Object]
Physical Therapy to Modify Structure and Behavior ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oral Chemical Modulation of Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidural and Facet Steroids ,[object Object],[object Object],[object Object]
Percutaneous Spinal Treatments ,[object Object],[object Object],[object Object]
Surgical Treatment- Decompression ,[object Object],[object Object],[object Object]
Surgical Treatment- Fusion ,[object Object],[object Object],[object Object],[object Object],[object Object]
How to Treat Low Back Pain in 15 Seconds ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ The lower back is at the crossroads where the psyche meets the soma” Voltaire Thank You

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Chronic Back Pain | Conservative Treatment for Back Pain | Surgical Treatment for Back Pain

  • 1. Conservative and Surgical Approaches for Acute and Chronic Back Pain Donald S. Corenman, M.D., D.C. Steadman Hawkins Clinic
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  • 28. “ The lower back is at the crossroads where the psyche meets the soma” Voltaire Thank You