When neurosurgeon Dr. Winston Capel asked members of the Vicksburg Kiwanis Club Tuesday who was experiencing lower back pain, most of the 21 members attending their noon meeting, and some of their guests, raised their hands.

“It’s very common. About 50 percent of you have it, so if you haven’t had it, your time’s coming, ” Capel, a neurospine specialist with River Region Medical Center, said, adding that next to the common cold, lower back pain was the most common disease people complain about.

“One thing about lower back pain as a disease is people frequently seek out medical care. They’re not silent sufferers,” he said. “They want solutions. This is a very expensive disease to society and the direct and indirect costs total $60 billion a year, when you think about all your costs, lost wages and medical care and indemnity.”

People generally experience their first lower back pain between 35 and 45, and more males than females experience it because of industrial work, he said, “but that is changing. Now it’s becoming equal.”

Lower back pain, he said, “is an up and down kind of disease,” adding the most common cause of pain is a degenerated disk.

“The disk is the cushion between the vertebrae, and it is the weak link,” he said. “It’s (in) a very austere environment. A lot of pressure and very little blood supply to the disk. The disk relies on its blood supply from the vertebrae and that blood supply is tenuous, so that disk will frequently — some argue that it is programmed to — degenerate. There are a series of program changes in the disk. One of the byproducts of those changes is increased pain.”

One of the risk factors for disk problems, Capel said, is a person’s genetic history. Other factors include wear and tear on the disk and repetitive trauma and exposure.

“It’s not generally, as commonly taught, that a single event is the cause of back pain, it’s usually a combination of events,” he said.

He added there are five forms of treatment for lower back pain.

• Core strength, or strengthening the abdominal muscles: “Most people who have back pain gravitate toward a pattern of pain awaits, and so they reduce their activity in anticipation of causing pain, and the net result is they become deconditioned and they lose their core strength, and that’s the No. 1 cause of back pain,” he said.

Capel recommended that everyone with back pain should do a core program six out of seven days per week, about 20 minutes per day, “so making that investment core strength will have returns.” They should also lose weight to reduce the stress on the back.

“There is a common association with obesity and back pain, so we recommend everyone with back pain to strengthen their core and lose weight,” he said. “Those are the two most important things you can do.”

• Medication such as anti-inflammatory drugs.

• Changing positions: Capel recommended moving around periodically.

“Static fixed positioning is a risk factor for back pain,” he said. “Truck drivers have more back pain than other occupations because of the sitting position. So if you a history of back pain, change positions frequently.

• Pain medication, but only for short-term relief because of the potential for addiction.

• Surgery, which is rarely indicated for back pain and is usually the last option if other alternatives do not work. If surgery becomes an option, he said, people need to be evaluated to determine if a procedure would be feasible.

There are two options for surgery on a disk, he said, either replace the injured disk with a synthetic one or fuse the vertebrae, which he said is better for pain control.

He said technology involving fusion has enabled surgeons to perform some outpatient procedures that will allow people to be back to work within a week of the surgery.

“Technology has allowed us to perform procedures with less risk and less tissue injury,” he said.