What else can be done about low-back pain, apart from surgery and manipulation?
J.Y.M.: Anti-inflammatories, either systemic or by infiltration, are excellent in some forms of pain. Since they work, it is clear to me that one cannot say that nonspecific backache is invariably mechanical in origin. Obviously, it frequently will be mechanical, but in many cases the backache will be due to inflammation, either of the disc or of the facet joints. If it is an inflammation, then there are pharmacological treatments available; if it is mechanical, manipulation may be an option. There are other mechanical treatments, such as braces or physiotherapy; and, obviously, surgery, as a last resort. I tend to use braces in conjunction with anti-inflammatories. M.O.: It looks as if infiltrations are being done a lot more… J.Y.M.: Yes, they are still used a lot; and why shouldn’t they? When I read in the literature that infiltrations don’t work, I am not convinced. What is wrong, though, is to go on using infiltrations in cases where they have been found not to work. M.O.: Where
