The Changing Face Of Spinal Surgery
Only a small percentage of patients with back pain are candidates for surgery, but for these patients, advances in techniques have made recovery a much easier road, says Boden of The Emory Orthopaedics and Spine Center.
Fifty years ago, a spine fusion meant a two-week hospital stay, a body cast or brace for months, and a minimum of six months away from normal activities. A spinal fusion is performed by fusing the vertebrae together with bone grafts to eliminate motion between two adjacent vertebrae where motion is causing lower back pain.
Today, minimally invasively techniques allow for smaller incisions, less blood loss, and faster recovery time, Boden says. Some spine fusion techniques can be done on an outpatient basis.
Fifty years from now, Boden predicts that disc replacement will be an alternative to spinal fusion. Moreover, gene therapy will be able to prevent or reverse disc degeneration, and genetic research will help discover genetic sources of back pain, he says.
“Gene therapy for disc regeneration may be more than five years off, but less than 20,” he predicts.
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Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From 111 If:
You have back pain and:
- a high temperature
- you’ve lost weight without trying to
- there’s a lump or swelling in your back or your back has changed shape
- the pain does not improve after resting or is worse at night
- the pain is made worse when sneezing, coughing or pooing
- the pain is coming from the top of your back , rather than your lower back
Stretch Your Back Throughout The Day
Another easy way to keep pain at bay is to stretch the muscles in the back of the body that get tight from sitting and carrying out everyday activities. The seated childs pose is another move that is easy to do at your desk while youre listening to a meeting or when you need a one-minute break. Sit on the edge of your chair, making sure that your upper thighs are supported by the chair. Position your feet as wide as your knees and your knees as wide as your hips. Lean forward, allowing your torso to hang forward over your legs. Allow your arms and hands to fall naturally to the ground on either side of your feet. Relax your head and neck to release tension in the neck, shoulders and back. Focus on steady, even breaths while maintaining a rounded spine. Hold for 5 slow, deep breaths.
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How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
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Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
Stretch Your Hamstrings Twice Daily
One often overlooked contributor to lower back pain is tight hamstrings. If your hamstring muscleslocated in the back of your thighsare too tight hamstrings your lower back and sacroiliac joints will be stressed, leading to more pain. Hamstring stretching should be done carefully and at least twice per day for 15-30 seconds each time.
There are many gentle stretching exercises that should not hurt.
Watch:Wall Hamstring Stretch for Low Back Pain Relief Video
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Chronic Low Back Pain
Chronic low back pain is a common condition. It is defined by low back pain lasting more than six weeks. Unfortunately, a clear cause can only be found in twenty percent of cases. The rest of the time, it is believed to be due to strain on the bones and muscles of the back from heavy lifting, prolonged sitting, or bad posture.
For back pain persisting longer than six weeks, it is recommended to make an appointment with a physician. Treatments may include a program of back exercises, as well as pain medicine such as ibuprofen and acetaminophen . It is also recommended to stay active and carry on with the things you usually do as much as possible, to help you recover faster. Sitting or lying still for long periods can actually make the pain worse. Your joints may become stiff which will make it harder and more painful to move your back.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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Why Seeing A Nurse Practitioner May Be The Best Course Of Action For Sciatic Pain
Sciatic pain is a common condition that can cause a great deal of discomfort. While there are many over-the-counter and prescription medications that can help to ease the pain, some people may not find relief with these treatments. For these individuals, seeing a nurse practitioner may be the best course of action. Nurse practitioners are trained to diagnose and treat a wide variety of conditions, including sciatic pain. They can provide recommendations for pain relief, as well as help to manage any underlying conditions that may be contributing to the pain. In some cases, they may also refer patients to other specialists, such as pain management specialists, for more intensive treatment. If you are suffering from sciatic pain, making an appointment to see a nurse practitioner can be a good first step in finding relief.
If you have any new or worsening sciatica symptoms, you should see a physician in the Bay Area. If you have sudden or severe symptoms in both legs or if you lose bladder or bowel control, you should seek urgent medical attention. A severe nerve compression can be found in this case, and surgery must be performed immediately.
Avoid Rushing Into The 2 Most Common Mistakes For Treatment
MISTAKE #1. Do not to rush into basic strengthening exercises such as sit-ups, crunches or lower back extensions. This may help for some, but in most cases, these areas are already tight, short and strong.Tightness and overly strong muscle conditioning is usually the case with the lower back and hamstrings.
MISTAKE #2.Simply resting and returning to your daily whatever. Werent you doing this JUST BEFORE it happened? No, my friend. There needs to be a plan and you are here for actual solutions right?
Observe the degree of your pelvic tilt. The three common positions are neutral, anterior and posterior. An excessive angle can trigger another spasm.
Exercises such as sit-ups and crunches can help but should not be done first as they are considered as isolation type exercises. They do not condition the core muscle groups to protect you. If you are in need of some specific exercises, begin with these 10 exercises.
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Mechanical Low Back Pain Without Sciatica
About 80 percent of people will experience mechanical back pain. Mechanical means that the pain comes from the spine or its supporting structures. Sometimes, people experience sciatica with their low back pain. Sciatica is a general term to describe pain that travels from the back into the leg. Most of the time, it is unclear to doctors what exactly causes the episode of low back pain. However, it is most often due to a muscle strain, or an injured tendon or ligament. A slipped or herniated disc is also a possible cause. Fortunately, in any of these cases, initial treatment is the same. Pain usually goes away within 4-6 weeks, often sooner.
Lower Back Pain Treatment Options
, according to the National Institute of Neurological Disorders and Stroke . Discomfort in the lower back can be chronic or ongoing. It can also be a sudden and brief condition known as acute pain.
Causes of lower back pain include:
- spinal abnormalities, such as a slipped disc or spinal stenosis
Treatment options for lower back pain range widely according to the cause of the condition. Read on to learn more.
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Low Back Pain Shouldn’t Sideline You
Explore the common but under treated and misunderstood issues that accompany chronic back pain in our Back Pain Series. Part 1 explains the latest treatments that could relieve that aching back.
Many Penn State alumni fondly remember David K., now 34, as the student who crawled to class. Mired by back pain throughout his four years of college, David saw tons of doctors from top neurosurgeons to psychologists for the pain. Instead of listening to the popular college music of his day like REM, he listened to the soothing sounds of pain expert John E. Sarno, MD, on cassette tapes called Mind Over Back Pain when he drove his Mustang around the college campus.
“If you don’t have chronic back pain, you can’t possibly imagine what it feels like,” he says. “It’s unbearable — literally.” He says that there were many times he couldn’t walk and would have to crawl from his fraternity house all the way to class so he would not miss a midterm or final exam. “My fraternity brothers made a lot of fun of me,” he says. “Still do.”
About 80% of Americans — or four in five — experience low back pain at some point in their lives and understand David’s plight all too well. Many people with chronic low back pain are working age and for them, back pain is the most frequent case of lost productivity. Treatment for back pain costs roughly $100 billion a year, according to the American Academy of Orthopaedic Surgeons in Rosemont, Ill.
Your Spine Is Under Pressure
Most people are unaware of the general geography of their organs, and you may be surprised to discover that the womb sits near the spine. In preparation for pregnancy, each time you have a period your womb becomes engorged, and this can push against the dense network of nerves surrounding your spine. This can result in back pain, neck pain and headaches.
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Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
When To Contact A Medical Professional
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also call if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
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What Can A Neurologist Do For Sciatica
A neurologist is a medical doctor who specializes in the diagnosis and treatment of disorders of the nervous system. The nervous system includes the brain, the spinal cord, and the nerves that travel throughout the body. Sciatica is a condition that can be caused by a number of different underlying problems with the nervous system. A neurologist can help to identify the cause of the sciatica and develop a treatment plan to address the underlying problem. In many cases, this will involve a combination of medication, physical therapy, and lifestyle changes.
When wrenching a Sciatica, it can be difficult to untangle the knot. Because there are so many possible causes, starting from the beginning would be foolish. A neurologist may be able to determine the cause of nerve pain. An orthopedic doctor may be able to determine that a surgical procedure is required to alleviate the pressure on your sciatic nerve. If an orthopedic doctor recommends surgery for you, you should seek another opinion from him or her. If you have sciatic pain, you may be able to find a non-surgical treatment. If the reason for muscle weakness or tightness is the result of a muscular condition, the cause can be treated by a Chiropractor.
Ask About Prescription Medications
If your back pain hasnt resolved itself within four to six weeks, make an appointment with your doctor, who will examine your back and ask you to sit, stand, bend, walk, and lift your legs to see how your pain is affecting your mobility. Youll likely be asked to rate your pain on a scale of one to 10, and they may do imaging tests, like an X-ray or MRI. Then, he or she may recommend one of the following prescribed therapies:
- Muscle relaxants: Medications like cyclobenzaprine or baclofen can help relieve painful back spasms. If you go this route, just know that side effects can include fatigue and dizziness.
- Topical pain medications: These creams and ointments, like Voltaren gel, are meant to be rubbed directly on to the area thats hurting you.
- Cortisone shots: If other treatment measures fail, your doctor may recommend an injection of cortisone, a potent anti-inflammatory. There are risks, including thinning of nearby bone, and relief typically lasts just a few months, tops.
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Why Do I Have Cramps But No Period
Pelvic pain similar to a menstrual period can happen at times when no period is due or can occur because of conditions other than the monthly cycle. Sometimes it is hard to tell the exact reason for cramps that feel like a menstrual period.
The following diseases and conditions are examples of situations that can cause pain or cramps when not on your period.
Chronic Low Back Pain Of No Specific Origin
Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. “Chronic” means the pain has lasted for twelve weeks or longer, and “no specific origin” means the pain cannot be traced to any specific cause, incident, or injury.
Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.
Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.
Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.
Rarity: Common
Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation
Symptoms that always occur with chronic low back pain of no specific origin: lower back pain
Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury
Urgency: Primary care doctor
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