Anatomy Guide: Low Back Disorders
From: WebMD; 2004; 6 pages - See animations online Here
This web page presents an animated display of the pathophysiology of 6 low back disorders. Each animation offers a good depiction of how physiological changes in the body cause the pain experienced by the patient. Each disorder is described in one paragraph of text and an animation displays the changes in normal physiology for the following 6 disorders: herniated disc, spinal stenosis, osteoporosis, osteoarthritis, ankylosing spondylitis, and spondylisthesis. To see the animation, click the button marked 'Click for Animation', then, when the animation begins, click on the 'View Labels' button to display anatomical landmarks. Access checked August 22, 2007.

Ankylosing spondylitis
Spondylitis.org
The Spondylitis Association of America is a national non-profit organization dedicated to helping improve the lives of people living with ankylosing spondylitis. The site also includes a message board and access to publications and news. www.spondylitis.org

Arthritis
American College of Rheumatology
The ACR is a professional organization dedicated to curing arthritis and related disorders. The site includes a geographic member directory, condition fact sheets, and links to economic aid programs, clinical trials, and publications. www.rheumatology.org

Arthritis Foundation
This web site has patient information on arthritis and a drug guide that gives general information on arthritis-related drugs. www.arthritis.org

Back Exercises
A healthcare provider should be consulted before beginning an exercise program for back pain. The following resources provide instructions and/or demonstrations of back exercises that may be beneficial in healing or preventing back pain.
From: MedlinePlus Patient Education Institute; Updated in 2005; 69 slides.
http://www.nlm.nih.gov/medlineplus/tutorials/backexercises/htm/_no_50_no_0.htm
This easy-to-follow audio-visual slide program begins with an explanation of the benefits of back exercise and emphasizes that regular stretching and strengthening exercises can prevent back pain.

Back pain
Back pain is the #2 problem that brings people into the doctor's office. Many spinal conditions cause back pain, but muscles sprains and strains can cause it, too. In the SpineUniverse Back Pain Condition Center, learn what treatments may bring relief and even what exercises to dbo for immediate help.
http://www.spineuniverse.com/back-pain/condition-center/

Choosing Pain Medicine for Osteoarthritis: A Guide for Consumers
From: U.S. Agency for Healthcare Research and Quality; January 2007; 10 pages.
PDF available here for download: Pain_Meds_Osteoarth_Pts.pdf
This booklet helps consumers -- patients and their caregivers -- work with their doctors or nurses in choosing pain-relief medications for osteoarthritis. It is based on a detailed review of 350 research reports on this subject. The guide describes the different kinds of pain relievers and gives information about the trade-offs between pain relief, risks of problems, and the price of the medications. Access checked August 22, 2007.

Chronic pain
American Academy of Pain Management
A nonprofit, multidisciplinary, physician-based pain society, the Academy provides credentialing to practitioners in the area of pain management. The patient resources on the site include a doctor directory and patient bill of rights information. www.aapainmanage.org

American Pain Foundation
This is the patient advocacy arm of the American Pain Society, and this site contains advocacy information as well as articles on back pain and back problems. www.painfoundation.org

American Pain Society
This society consists of member scientists, practicing clinicians, policy analysts, and others aiming to advance pain-related research, education, treatment and professional practice. The site has a pain treatment center finder. www.ampainsoc.org

National Foundation for the Treatment of Pain
A not-for-profit organization dedicated to providing support for patients with intractable pain, their families, friends and the physicians who treat them. The site includes patient articles and advocacy information. www.paincare.org

The National Pain Foundation
This site provides education and support resources for people in pain, their families, and health care providers. It has information about different types of pain conditions and also has an online community. www.NationalPainFoundation.org

Pain.com
A web site supported by the Dannemiller Memorial Educational Foundation with consumer information on pain, including articles, ask a doctor, book store and message board. www.pain.com

Clinical trials
National Institutes of Health Clinical Trials
An NIH website that provides patients, family members and members of the public current information about clinical research studies. www.clinicaltrials.gov

Discussion Guide to Talk to Your Healthcare Provider About Your Pain Relief Needs
From: Making Sense of Pain Relief; 2005; 2 pages.
http://www.makingsenseofpainrelief.org/information/DiscussionGuide.pdf.
This guide answers 8 questions about pain medications and risk.

Exercise and Your Arthritis
From: The Arthritis Foundation; 2003; 12 pages.
http://www.arthritis.org/conditions/onlinebrochures/Exercise.pdf
This handout is a very practical guide to help people with arthritis begin and maintain an exercise program. The benefits of staying active are presented and practice tips are offered to help the exerciser stay comfortable before, during, and after activity. Definitions and descriptions are provided for four categories of exercise: 1) range-of-motion.

Fibromyalgia
National Fibromyalgia Association
Formed with the goal of improving the lives of those affected by fibromyalgia. Includes patient education and a newsletter. www.fmaware.org

Neuropathic pain —The Neuropathy Association
An organization designed to support and educate individuals with chronic pain from peripheral neuropathy. www.neuropathy.org/

Handout on Health: Rheumatoid Arthritis
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; revised May 2004; 48 pages.
http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/rheumatoid_arthritis_hoh.pdf
http://www.niams.nih.gov/Health_Info/Rheumatic_Disease/default.asp
The pain and inflammation associated with Rheumatoid Arthritis, an autoimmune disease, are manifested differently from one patient to another. This booklet describes these differences and is helpful for patients, as well as family members and friends. Copies of this booklet are available at no charge from NIAMS Handout on Health: Back Pain From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; September 2005; 44 pages. http://www.pain-topics.org/pdf/BackPain_NIH_Sept2005.pdf. http://www.niams.nih.gov/Health_Info/Back_Pain/. This booklet is for patients with back pain, as well as family members, friends, and others who want to learn more about it. In straightforward language, the booklet describes causes, diagnoses, and treatments, and research efforts seeking to learn more about back pain, many of which are supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the Department of Health and Human Services' National Institutes of Health (NIH). Patients having further questions after reading this booklet, can discuss them with their healthcare providers. Topics covered include: How common is back pain and what are the causes? When should a doctor be seen for the pain? How is back pain treated? Copies of this booklet are available at no charge from NIAMS and may be ordered at the website noted above. Access checked October 30, 2007.

Information From Your Family Doctor. Low Back Pain
From: American Academy of Family Physicians (AAFP); 2007; 3 pages
See HTML article online at: http://www.aafp.org/afp/20070415/1190ph.html.
This question-and-answer sheet from the American Family Physician provides a good summary of the basic issues related to low back pain. In addition to a general discussion on the causes of back pain, 2 drawings can serve as an aid to an improved understanding of the physiology involved. Several tips and techniques for pain relief and the prevention of back injury are offered. Access checked August 22, 2007.

Lower Back Pain: Self-Care Flow Chart
From: American Academy of Family Physicians (AAFP); 1996; 1 page.
http://familydoctor.org/online/famdocen/home/tools/symptom/531.printerview.html
Back pain is common, but its causes range from minor strains to serious disorders and injuries. This self-care flow chart from AAFP helps to guide patients through a series of yes-&-no questions about their symptoms to assist them in decision-making related to seeking medical help. It is meant to help educate the patient with low back pain and not to serve as the sole tool in the decision-making process.

Low Back Pain Exercise Guide
From: American Academy of Orthopaedic Surgeons; 2000; 6 pages.
http://www.orthoinfo.org/booklet/view_exercise.cfm?Thread_ID=18&topcategory=Spine
To meet the needs of patients at various levels of recovery and ability, this handout provides basic descriptions and drawings to instruct patients in performing 15 back strengthening exercises at 3 different levels

Low Back Pain Fact Sheet
From: National Institute of Neurological Disorders and Stroke (NINDS); Updated in 2007; 8 pages.
http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
This factsheet covers back pain basics, including a description of the anatomy of the back and a brief definition of acute versus chronic pain. The causes of low back pain plus the names and descriptions of conditions that cause it are discussed. Explanations of the methods used for a thorough diagnosis, including a description of all tests that could be prescribed, are presented. Potential treatments, from self-care to surgery, are described and tips for prevention and back-strengthening are offered. Access checked August 22, 2007.

Managing Arthritis Pain — Hot and Cold Treatments
From: University of Washington Medicine; 2005; 2 pages.
See HTML article online at: Click Here
Patients are frequently confused about the use of heat or cold packs for pain relief. This information sheet provides tips on how to use both effectively, including the rationale behind using one or the other. The article includes safety tips when using heat or cold therapy. Access checked August 22, 2007.

National Osteoporosis Foundation
http://www.nof.org/

Neck Pain
From: American College of Rheumatology; 2006; 4 pages
http://www.rheumatology.org/public/factsheets/neckpain.asp
This patient fact sheet provides a good summary of basic important facts about neck pain. Diagnostic techniques and causes of neck pain are discussed; specific description of spinal stenosis, osteoarthritis, and intervertebral disc herniation are included.

NIH Pain Consortium — Pain Information Index
From: National Institutes of Health; provides multiple links to NIH pain management topics.
See HTML options online at: http://painconsortium.nih.gov/pain_index.html.
This NIH website provides an A-Z listing of pain-related conditions as well as treatments and topics related to the management of pain.

Options for Managing Pain
From: Making Sense of Pain Relief; 2005; 15 pages.
http://www.makingsenseofpainrelief.org/information/ConsumerGuide.pdf.
http://www.makingsenseofpainrelief.org/managingpain/default.asp.
Chronic pain can require the long-term use of potent medications and some patients would like to become better informed of their pain management options. This consumer guide provides credible online resources to assist your patient in researching topics related to pain treatment from reliable, patient-friendly sources

Other sites of interest
Medical Breakthroughs
This site covers the latest medical breakthroughs as well as discussion groups, a weekly newsletter and links to other health related sites. www.ivanhoe.com

About.com: Orthopedics
Includes a broad range of articles about common orthopedic conditions and treatment, written by an orthopedic surgeon, Dr. Jonathan Cluett, MD. orthopedics.about.com

Medicow
A health search engine that keeps searching on topic and provides relevant descriptions. http://www.medicow.com/home.php

Degenerative disc disease (DDD) usually affects older people because it's caused by the effects of aging on the spine. The intervertebral discs can become stiff and rigid, causing pain and other symptoms. However, there are many treatments, including physical therapy, medications, exercise, and surgery.
http://www.spineuniverse.com/degenerative-disc-disease/condition-center/

SpineUniverse has the most thorough, and easy-to-understand information on spinal stenosis-a condition that can cause you a lot of neck and back pain. Learn what causes this narrowing of the areas around your spinal cord and nerve roots, plus delve into treatment options and what to expect if you need to have surgery
http://www.spineuniverse.com/spinal-stenosis/condition-center/

Series of articles on adult scoliosis
http://www.spineuniverse.com/displayarticle.php/article1436.html

The SpineUniverse Professional site has spinal cases, CME and other educational opportunities related to the aging spine.
http://www.spineuniverse.com/professional/

Pain Information Library
From: American Pain Foundation; provides multiple links to APF pain management topics.
A Pain Treatment Topics affiliate organization. HTML article available online at: http://www.painfoundation.org/page.asp?file=Library/Index.htm.
Pain management is complex because there are many pathological causes as well as emotional and cultural factors that influence pain perception and experience. The Pain Information Library was developed to help patients find answers and support for a myriad of pain conditions.

Pain Resource Guide: Getting the Help You Need
From: American Pain Foundation; 2007; 27 pages. A Pain Treatment Topics affiliate organization.
http://www.painfoundation.org/Publications/PainResourceGuide2007.pdf
This booklet is designed to help patients take charge of their pain care. It provides important information about pain, answers to common questions, and helpful tips for getting quality pain care. In easy-to-read fashion, the booklet discusses why pain management is important, how to find effective pain care and pain specialists, and methods used to assess and diagnose pain.

Questions and Answers About Arthritis and Exercise
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases; 2001; 4 pages.
http://www.pueblo.gsa.gov/cic_text/health/qa-arthex/arthex.htm.
Arthritis pain can discourage patients from getting much-needed exercise. This handout provides general information on the importance of regular exercise for people with arthritis and describes three different types of exercise: range-of-motion, muscle strengthening, and aerobic..

Sleep disorders
National Sleep Foundation
This organization's goal is to improve the quality of life for those affected by sleep problems and disorders. The site includes patient education and community resources. www.sleepfoundation.org

Scoliosis
Scoliosis Research Society
The site provides information on scoliosis and treatment, a glossary of scoliosis-related medical terms and a doctor finder, listing members by state without contact information. www.srs.org

Spinal cord injury
American Spinal Injury Association
Spinal cord injury prevention program directory, by state. www.asia-spinalinjury.org

Surgery
Neurosurgery Today
Provides a great description of spinal and neurological disorders and treatment options.

Take Control With Exercise
From: The Arthritis Foundation; 2006; 60-minute audio-visual exercise program.
See the Arthritis Foundation website for DVD ordering information: Click Here.
The DVD can be purchased for US$19.95 by calling the Arthritis Foundation at 800-283-7800 or by visiting the website listed above. A Pain-Topics.org review of this program is provided under the Education/CME Locator, Resource Review section. See: http://www.pain-Topics.org/education_CME_locator/indexbkrv.php#top.

Target Chronic Pain Notebook
From: American Pain Foundation; revised December 2007; 38 pages.
A Pain Treatment Topics affiliate organization.
http://www.painfoundation.org/Publications/TargetNotebook.pdf
http://www.painfoundation.org/page.asp?file=Publications/Target.htm.
A pain notebook is a valuable tool to help patients identify their pain patterns in relationship to their lifestyle (time, location, triggers, intensity, therapy results). The text stresses the overall health benefits of reducing pain levels and that reporting accurate symptoms can greatly improve communication with healthcare providers to help identify the best therapy. This notebook provides examples to show the patient how to chart pain by time and location, as well as the logging of activities or therapy used to relieve pain. Daily log pages are included so the patient can begin using the notebook immediately and additional blank log and worksheet pages are available at the website shown above. Access checked January 21, 2008.

The National Pain Foundation: My Pain
From: National Pain Foundation; provides multiple links to pain management topics.
http://www.nationalpainfoundation.org/MyPain/default.asp.
The goal of this website is patient education and it offers 9 sections on different pain conditions plus a link to clinical trial information. The pain conditions presented include: Arthritis, Back and Neck Pain, Cancer Pain, Complex Regional Pain Syndrome (CRPS), Fibromyalgia, Headache, and Pelvic Pain.

Upper Back Pain
From: Virginia Tech Schiffert Health Center; 2004; 3 pages.
http://www.healthcenter.vt.edu/pdf/MCOrthoRehab-UpperBack.pdf
This factsheet explains that most upper back pain, not due to traumatic injury, is muscle strain that could be the result of improper lifting, bending, or poor posture. The tip sheet includes a list of quick self-treatment options plus guidelines on symptoms that signal the need to see a doctor. Emphasis is placed on the use of exercise for rehabilitation and muscle strengthening after the initial pain has subsided. Access checked August 22, 2007.

What Is Back Pain?
From: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); 2006; 5 pages.
http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.pdf
This easy-to-read factsheet contains a good summary of the causes of back pain as well as options for prevention. A concise checklist of specific symptoms that should alert a patient to see a doctor precedes an explanation of the various types of treatment available for back pain. Access checked October 30, 2007.