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 v