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Triano Interview
for American Airlines In-Flight Audio

Dr. John TrianoInterviewer: Back pain may be common, but successful therapies aren't. Conventional treatments for everyday back pain don't stand up to scrutiny. Bedrest makes it worse, and cortisone injections and traction are ineffective. So how can sufferers get relief?

According to reports, last year 20 million back-pain-sufferers found relief by visiting a chiropractor. Orthopedic surgeons and specialists, like the ones at the Texas Back Institute, are still very busy. They handle plenty of patients with chronic spinal pain or pain from accidents. But in a striking change, they see themselves as doctors of last resort.

The institute's John Triano,DC,PhD, is here to discuss chiropractic medicine and its emerging role in conservative care.

Dr. Triano, thank you for being on the show today.

Dr. Triano: Thank you for the opportunity.

Interviewer: Back in 1994, the government convened a panel to review the state of back care. The group included spine researchers, surgeons, orthopedists, psychologists — and one chiropractor — you. What were the group's most significant findings regarding back care?

Dr. Triano: That was a most interesting series of meetings over several years culminating in a 1994 report, and it became very controversial in the orthopedic community, with an awful lot of opposition that developed.

The fact is that the science of spine care led the group of multiple disciplines that you mentioned to recognize that some of the simplest methods of care are the most appropriate. The most common mistake that people make when they have a back problem is that they immediately limit all their activity. What this panel discovered is that the research says that you should continue to go about your normal activities of daily living as best you can. People get well faster when they do that than when they begin severely limiting what they do.

The second thing that they discovered was that common over-the-counter medication is often most effective and contrasts some of the ‘heavy-hitters' and narcotics that you get under prescription. So, simple, over-the-counter acetamenophin, Advil, Aleve — those things work as well for most patients as running to the doctor and getting medication.

The third thing that they discovered is that getting to someone who does spinal manipulation (chiropractors do most of that in the United States) — a form of treatment that improves function and reduces pain faster than most other forms.

Interviewer: Research has shown that chiropractic can relieve pain in the lower back. Where else is chiropractic treatment beneficial?

Dr. Triano: Most people do think of chiropractic in terms of helping lower back pain. However, chiropractic is a discipline, and what we do is take care of musculoskeletal or muscle, bone and joint complaints. So you could think of chiropractic for back, leg, neck, arm pain and headaches.

Interviewer: Over the last decade, more multidisciplinary practices have developed where medical and chiropractic health care providers work side-by-side to help patients with complicated problems. How does the interdisciplinary approach help these cases?

Dr. Triano: This is really an exciting and often unrecognized area in the treatment of spine problems. The fact is, complex cases develop many collateral, or parallel forms and sources of pain. And when you bring them to one doctor, he or she is usually not capable of handling all of them. By putting multiple disciplines together, you bring the skills of the chiropractor for manipulation science; and the skills of the medical doctor with medication; and the skills of psychologist; and the rehabilitation specialist all to one place. That helps patients who need more than one approach.

Interviewer: John Triano,DC,PhD, is the director of the chiropractic division of the Texas Back Institute in Plano.


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