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End Your Back Pain Like an expensive but temperamental sports car, the human spin is beautifully designed and maddeningly u

admin2013-06-02  34
问题                                       End Your Back Pain
     Like an expensive but temperamental sports car, the human spin is beautifully designed and maddeningly unreliable. If you are a living, breathing human being, you have probably suffered the agony of back pain. And as long as people continue to lead overweight, sedentary and stressful lives, the number of sufferers is unlikely to go anywhere other than up.
     As it does, armies of new back-pain sufferers, many desperate and even disabled, will seek relief. When they do, they’ll quickly discover just how complicated their problem really is, with its mystifying mix of physical symptoms and psychological underpinnings. The reality is that the agony will often go away on its own — impossible as that may seem when you are writhing (痛苦扭曲) on the kitchen floor. The Great Pain Mystery
     Back pain can originate anywhere in the elaborate spinal architecture. Degenerated discs (椎间盘), which many lead to herniation (突出) and compressed nerves, are a common problem. Then there those wrenching pain provoked by muscle injuries, which can drop grown men to the floor. What’s most mysterious about back problems is the frequent disconnect between anatomical defects and pain. Unlike blood pressure and cholesterol (胆固醇), which could be measured with arm cuffs and blood tests, lower-back pain has no objective way — the volume of tears? the intensity of a grimace? — to be gauged.
     Many times, the precise cause of pain remains unknown. Imaging tests found that two people with herniated discs can lead radically different lives: One spends his days popping painkillers, the other waltzes through life. In a well-known study, researchers checked 98 healthy people: Two-thirds had abnormal discs even though none complained of pain. The real issue is why some people have a mild backache and some have really crippling pain. In another research, experts compared a group of patients who reported back pain with a control group who did not. Close to two-thirds if the pain patients had cracks in their discs, so-called high-intensity zones, or HIZs. But so did 24 percent of the non-complainers.
     The answer has as much to do with the mind as with the body. In the HIZ study, the best predictor of pain was not how bad the defect looked, but the patient’s psychological distress. Depression and anxiety have long been linked to pain; a recent Canadian study found that people who suffer from severe depression are four times more likely to develop intense or disabling neck or low-back pain. At New York’s Hospital for Special Surgery, psychiatrist Gregory Lutz says he often sees men who have two things in common: crippling sciatica (坐骨神经痛) and an upcoming wedding date. The problem in their back, possibly a degenerated or herniated disc, likely already existed, says Dr. Lutz, but was intensified by the pre-marriage jitters.
Spine Surgery Breakthrough
     Pain is pain, and many want a quick fix and that means surgery. Spinal-fusion surgery, one of the most invasive and costly forms of therapy (about ＄42,000) has more than doubled in the US since 1993, to about 350,000 in 2003. Discectomy, which is done less invasively, has also spiked to 342,000 surgeries per year. But these procedures don’t work for everyone.
     The increase in all spinal surgery has been promoted in part by technical advances promising better outcomes. Perhaps the most intriguing new development is the artificial cobalt-chrome disc. In October 2004, the US Food and Drug Administration (FDA) approved the first such disc, the Charite, for patients with degenerative disc disease. The three-piece device has a sliding medical-grade plastic core sandwiched between two metal plates, which allows the spine to move. It is believed that, such discs, like knee replacements, will give patients more mobility than traditional fusion surgery. And they will get out of bed a lot sooner too. The key is to be very specific and very careful about patient selection. Not everyone who has disc degeneration should have an operation.
Alternative Treatments
     Doctors, worried that too many patients seem willing to go under the knife, are now looking for simpler, more effective ways to treat one of the most vexing problems in medicine. For more and more people with back pain, alternative therapies are the way to go.
     Chiropractic care (指压疗法), the most popular nonsurgical back therapy, is booming, with 60,000 chiropractors practising in the US today. Some happy clients visit their chiropractors more often than their hair stylists. Experts generally agree that the treatment, which involves manipulation of the joints and tissues of the spine, is safe for the lower back. It provides modest benefits equivalent to those of conventional treatments.
     Massage has an increasing number of proponents, and research shows it can help knead ont (揉掉) persistent pain. Steven Smith, a physical therapist at the Schuldt Performance uses massage on back-pain sufferers to loosen up muscles and increase blood flow. It’s not exactly a spa-like experience, though. "You’ve got to get in there deep to break the pain."
     Acupuncture (针灸) is also popular. The first large trial of the practice is now conducted at New York’s Integrative Care Center, where therapist push the tiny needles into the patients. Acupuncture seems to stimulate the release of feel-good endorphins, has a cumulative effect. Patients describe a lingering euphoria, a nice happy state whether you’ve got a back problem or not.
An Integrative Approach
     Jordan, a long-term back-pain sufferer, tried every wacky thing out there. "Faith healing, hanging from the ceiling, clicking my heels together and wishing I was home, you name it, I’ve done it." Last year, feeling especially distressed, he tried biofeedback, a technique that trains him to distance himself from the pain. "I never get rid of the pain, but these treatments provide some relief." says Jordan.
     If patients’ attitudes can help the pain, can more creative thinking among the experts improve the odds of beating it? Dr. Eisenberg, head of Harvard Medical School’s Osher Institute, is spearheading an National Institutes of Health-funded pilot program to find out. A diverse group of 25 specialists meet regularly to educate one another on how they diagnose and treat back pain. They intend to see if there is a more efficient, multi-disciplinary way to attack the problem, and to make it cost-effective too.
     No wonder there’s a flood of interest in alternative medicine. Even New York’s Hospital for Special Surgery opened a complementary-medicine center four years ago. Now about 13,000 patients a year, many with bad back, see its rehab specialists, massage therapists and chiropractors, as well as taking yoga and tai chi classes any noninvasive approach they can find to relieve the pain.
Can Rage Ruin Your Back?
     Dr. Sarno, a professor at New York University School of Medicine, believes almost all back pain is rooted in bottled-up feelings. Samo explains how repressed rage and anxiety can stress the body, eventually manifesting itself as muscle spasm (抽搐), nerve dysfunction, numbness and pain. Recovery begins with recognition the connection between the body and the mind. "Pain is created by the brain to make sure the rage doesn’t come out." says Sarno. But skeptics say Samo is offering a placebo (安慰剂), which could miss the true cause of the pain.
     After centuries of agony, humanity could certainly use some relief. But more important than the success of any treatment is the good news that back-pain sufferers and doctors are embracing bold new ways to think about the most exquisite and frustrating work of art: the spine.
What’s so mysterious about back problems?
选项 A、The impossibility to measure the intensity of the pain.
B、The unknown origin of the pain.
C、The disconnect between spine defects and pain.
D、The low percentage of people with abnormal discs among the healthy.
答案C
解析 参见“The Great Pain Mystery”部分第一段第四句：What’s most mysterious about back problems is the frequent disconnection between anatomical defects and pain．
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