Tahoe docs offer solutions for low back pain

By Kathryn Reed

Two doctors with different approaches to low pain spelled out options for people last week during a lecture at Lake Tahoe Community College.

Michael Fry and Peter Costa are part of Barton Health’s team. Fry is an orthopedic surgeon focusing on the spine and sports medicine. Costa is a physiatrist, specializing in physical medicine and rehabilitation.

About 75 percent of adults will have low back pain at some point. It doesn’t mean it will be serious or require surgery. But according to stats presented at the Sept. 19 lecture, low back pain is the No. 2 reason people visit their primary care physician. In the United States, 25 million people miss at least one day of work each year because of low back pain. The direct health care cost of low back pain is $25 billion a year.

Peter Costa, a doctor with Barton Health, talks about his approach to low back pain. Photo/Kathryn Reed

Some of the causes are hereditary. Smoking is a contributor because the nicotine reduces the flow of blood and discs in the back naturally lack a good supply of blood.

Sitting hunched over – like many people do at a computer – is a huge stressor on the low back. Or sitting like many of the nearly 70 people did at the talk in the college desks is another example of how posture is key.

“While we sit here all of our discs are degenerating,” Costa said. “As a disc degenerates, it gets sloppy in there. That’s when you get instability.”

Yet at the same time bending forward often decreases the pain because the canals open up and the symptoms go away.

But the problem is not always where the pain is. Kidneys, stomach and liver issues can cause low back pain, as does constipation, urinary tract infections, and uterus and ovary problems.

“You want to make sure you don’t miss a hip problem when you have back pain,” Fry said.

A series of exams and tests are regular protocols with Fry. Pain meds, epidurals and surgery are all possible treatments.

“An operation treats the symptoms of spinal stenosis. Degeneration is ongoing,” Fry said.

He said with surgery one can expect about 85 percent decrease in butt and leg pain and 65 percent decrease in back pain.

For Costa, as a physiatrist, he is treating the whole person and not just where the pain is. It’s a nonsurgical approach to medical care.

“I definitely take an educational approach. I believe the more you know about the problem, the more control you have,” Costa said.

Costa talks to patients about the medications they are on to determine if that could be the source of the pain. He asks about life issues to analyze how stress may be physically affecting a person.

“Epidurals control the pain. They don’t fix the problem,” Costa said.

When the pain comes on the doctors say don’t stay in bed all day. Do some gentle stretches and take anti-inflammatory meds. If pain lasts for a few weeks, see a doctor. And see a doctor immediately, they said, if there is a fever, numbness in the legs or uncontrolled bladder.