Back Pain: Don’t Let History Repeat Itself!

History doesn’t have to repeat itself, right? If you are suffering from back pain, find out if other family members are suffering from back pain, too. Surprisingly, back pain issues can run in the family – especially a herniated disc. Research shows that those who suffer from a herniated disc are four times more likely to face a similar problem if another family has suffered a pain-related issue, too.

Do you know your family’s health history?

It’s always good to know your family’s health history when it comes to significant medical issues. You should at least be aware of health problems in your immediate family: Parents and siblings. The further out on the family tree you can get, however, the more forewarned you’ll be — grandparents, your parents’ siblings, and your cousins can also provide telling info. It’s not important to track every cough and cold; you just want to know about major illnesses and chronic conditions.

What are your choices?

What disease or health problem are you tracking? Is it back pain or something similar? Find out what’s available to you. If you know, for example, that you have a parent and a grandparent who suffer from chronic back pain, it’s important to rule out non-genetic elements that could be the root of the problem. For example, working at a physically demanding job isn’t something that’s hereditary (well, maybe unless you inherit the family farm). Other health issues that can contribute to back pain, like obesity, can be addressed with preventative measures. Learning about health problems that “run in the family” can help you determine whether there are other factors you have that may increase your chances of developing one of these problems.

Again, let’s not allow history to repeat itself. When you consult with Dr. Solomon Kamson, talk to him about your family tree when it comes to illness and chronic pain. Osteoporosis, arthritis, or even a bum knee is important to bring up as well. Knowing what health issues you may be more likely to face — even if they aren’t causing you trouble now — can help to determine a course of action that will better help you to find relief from pain.

Why Does Everyone Keep Telling You to Try Yoga?

Yoga is one of those trendy sports that it seems like everyone is trying and, of course, recommending to you. But if you’re the type to avoid trends or at least to approach them with a cautious skepticism, you may have ignored these recommendations or felt unsure about how true their claims were.

If you’ve been experiencing minor levels of back pain, Dr. Sol Kamson, a doctor of spinal health, says that you may have good reason to listen to your friends who recommend yoga. While yoga is not a good substitute for cardiovascular exercise or weight training, it can be highly therapeutic for people who have specifically been dealing with pain in the back, neck, and shoulders. What are the specific benefits of yoga for people with back pain? And what can you do to take the best advantage of these benefits?

The Benefits of Yoga for Back Pain
When you learn to practice yoga, you are really learning how to stretch your muscles. If you are able to get to a more complicated level of yoga, you will also be able to work on some muscle strengthening. For most people, it’s beneficial to do actual weight training in addition to yoga rather than to count on yoga for strength.

Stretching is a great way to relieve pain in the back. When you feel pain in your muscles, it is likely either from overworking them or from underworking them. Both can cause the accumulation of stress in the muscles. When you stretch those muscles out, you help to relieve some of that stress. After an extended period of learning and practicing yoga, you can start to maintain a consistent level of flexibility in your muscles, which will decrease your likelihood of future pain.

How to Take Advantage of the Benefits
In order to take advantage of the potential benefits of yoga, you need to make sure you are practicing it in a way that specifically targets the muscle groups that are causing you trouble. Dr. Kamson reminds patients that they should be sure to visit a doctor before trying out yoga to make sure that they are healthy enough for exercise and to make sure that there is not an underlying condition behind your back pain that could be worsened by exercise (as in the case of certain types of injuries). It’s important to find a yoga teacher who has experience working with people suffering from back pain and who understands your physical limitations.

To really get the full benefit of yoga, you will want to make sure that you don’t limit yourself to only working on those muscle groups that are directly causing you pain. Sometimes it can be difficult to target the specific location of a pain, which may mean you will need to exercise multiple muscle groups to actually get at the source. It’s also important not to push yourself too far, too fast. Gentle yoga is often best for people who are suffering from chronic pain.

Why Do Your Neck and Back Crack?

When a joint is hurting, you might be inclined to frequent joint cracking. When the back, neck, or other jointed areas are causing for pain, and the experience of cracking these joints can provide a feeling of relief, even if it is only temporary. Many people worry about the safety of cracking their joints. The short answer is, no, don’t risk it. The long answer is, yes, within reasonable limits it’s okay to crack your joints.

lower back painFirst, some basic points. What is actually happening when you crack your neck or back? When you manipulate your spine by rolling your head around, twisting or arching your back, or having it manually manipulated by another person, the relief you are experiencing comes from stretching out the muscles that support your spine. The cracking noise you hear, while related to the manipulation, is not responsible for the pain relief. It is simply the sound of the fluids or gases between your spinal joints being put under pressure. While stretching can be beneficial for people experiencing back pain, it’s not necessarily true that actually cracking your back can relieve pain.

Why do some people believe that it can be harmful to crack your spine? There are two major reasons behind this concern. The first is that there is a rare but very real risk of causing damage, because your spine is a central connector for a vast network of muscles, veins, ligaments, tendons, and nerves. These are all interconnected, and any damage to one part that you accidentally cause through spinal manipulation can have serious consequences.

The other concern is that you can ultimately put a lot of strain on your muscles and bones through frequent manipulation. While this is a lesser risk for younger people with stronger bones and muscles, for older people, it’s much easier to accidentally cause a serious injury. This can be brought on by some action that may feel relatively minor at the time, especially if it is a sudden and jerking motion. Even for younger people, frequent manipulation can lead to long-term wear on the muscles, ultimately decreasing flexibility and elasticity.

What does this mean for you if you have gotten accustomed to finding some pain relief through cracking your neck or back? The main thing to takeaway from this is that there is no actual connection between cracking your joints and feeling pain relief. The pain relief is actually coming from the experience of stretching the muscles. Many doctors who caution against cracking one’s own back note that you can get the same type and degree of pain relief from regular exercise and flexibility training (for example, gentle yoga).

Dr. Kamson would also like to remind patients who are experiencing back pain that it isn’t a good idea to try to take your pain management into your own hands, especially if you aren’t sure about the source of the pain or the potential complications of the methods you are using to try to fix the pain. It’s important to make sure you aren’t causing more damage than good, and that you aren’t ignoring a treatable underlying issue.

Can’t “Stand” Your Back Pain?

Standing for eight hours a day can be a pain in more ways than one. People who work in jobs requiring them to stand for hours on end often suffer from debilitating back pain caused by this strain. Most people can’t just up and quit, but luckily there are a few things that will help relieve or even eliminate the pain. Start with proper posture, add in some quick exercises and stretches, and always take the proper precautions. When in doubt, check with a spine specialist like Dr. Solomon Kamson to learn the best ways to prevent or ease back pain.

Proper posture will go a long way toward relieving back pain. Slouching puts undue pressure on your spine and strain on your muscles. This pressure can constrict the nerves and blood vessels, causing pain. Proper posture means keeping your body parts in proper alignment. Somebody standing with proper posture should have a straight line from ears to ankles. This may seem uncomfortable at first, but as your body adjusts to the proper positioning, it should become much easier and more natural.

There are a few very simple exercises that can be accomplished while standing to help relieve pain. Instead of standing with both feet side by side, place one foot in front of the other for a few minutes, then alternate. Try shifting your weight from time to time, and never lock your knees. You can rock up on your toes, then back down to help stretch the muscles. Be sure to walk around throughout the day during breaks to stretch out your muscles and get the blood flowing.

Stretching is a good way to relieve sore muscles and stimulate the nerves. One good stretch to try while standing in one spot is lifting one ankle up behind you and holding it with your hand to stretch the muscles in your thighs. You can also place a short stool or book in front of you and alternate placing one foot on it. This will allow you to move the muscles around and stretch your hamstrings.

Sometimes, precautions are worth as much as or more than treatment when dealing with lower back pain. If you are going to be standing in the same place all day long, try placing a mat under your area to cushion your feet. Concrete and even carpet, can be very hard on the soles of your feet and lead to back pain. Be sure to wear comfortable shoes with good arch support designed for standing. If your dress code requires dress shoes, then use flats with added arch support.

These quick and easy ways of alleviating and treating back pain could mean the difference between smiling all day and hurting all night. Spine doctors like Dr. Kamson recommend that people who stand all day should utilize these simple steps, even if they do not suffer from back pain. Proactive preventative measures to prevent a back pain crisis are much better than reactive measures after the damage to the spine has been done.

Hear Testimonials From Some of My Patients

Here are some success stories from patients I have helped with minimally invasive spine surgery.

Andrea-Snyder Nelson had this to say about her procedure at Spine Institute Northwest:

” I didn’t think it would be this good, honestly. From what I’ve read online and from experience, I thought it would be that I would still need some sort of oral pain medication. I t seems like the majority of patients still need some sort of pain medication, so to be where I am, I’m pretty impressed.”

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Spine Surgery: Out with the Old, In with the New

For more than forty years traditional back surgeries have continued to destroy the spine’s vital structures while all along trying to rectify the original problem. These destructive methods would often end up causing other back problems, as well as lengthy recovery times. A big issue with these procedures is that to gain access to the affected area of the spine muscles are dissected, tendons damaged, ligaments removed, and muscles scarred. The end results of this are a weakening of the spine, and possibly causing the nerves to be exposed to scar tissue, which can lead to more issues with the back.

Although there are some situations when traditional back surgery is still necessary, in most cases a minimally invasive surgical procedure can be performed with very little trauma to the back. The great benefit of these procedures is the very small amount of damage to the muscles, ligaments, tendons, joints, and bones. With such a small incision for the procedures, the surrounding tissues also experience very little harm. These small incisions allow the spine to be accessed through tubular channels, and viewed through a camera. Most procedures only require an incision of less than one inch, while traditional surgeries can be up to six inches.

Traditionally the muscle fibers would have to be cut, but with minimally invasive procedures they can be separated and returned to their natural positions. This allows the patient to experience less pain after the procedure, and very little scarring. If your procedure requires rods, screws, or clamps to be implanted to help stabilize the spine, they can also be inserted through these small incisions. To help limit the risk of damage, microscopes and endoscopes are used to provide a great visualization of the entire procedure.

As new minimally invasive techniques are constantly being developed, more and more procedures are being utilized to treat a wide range of back issues. When damaged discs need to be replaced it is possible to remove and replace them with the interbody device through an incision. Artificial discs can be replaced through abdominal incisions, which also results in very little damage. Although there are a number of disorders in the spine that causes chronic pain, the more common procedures treat herniated discs, fractures, degenerative spinal disease, scoliosis, and stenosis. Other causes include tumors, spondylosis, pseudoarthritis, kyphosis, osteomyelitis, spinal instability, post-laminectomy, or other injuries of the spine.

The goal at the Spine Institute Northwest is to utilize the most current minimally invasive procedures to give patients relief from pain, while causing the least amount of damage. Several procedures that are used to treat a wide variety of spinal issues include; Endoscopically Assisted Spinal Decompression, Lumbar Interbody Fusion and Facet Fixation, and Endoscopic Assisted Nerve Excision. These outpatient treatments generally take less than 2 hours, with a recovery time of about an hour. Because there is very little damage done with these procedures, patients recover quickly, experience little pain, and often return to work within a day or two. Patients that have lived with chronic back pain for years are amazed at how quickly and effective these treatments are, as they return to a pain-free life.

The Management of Back Pain

Recent studies have shown that despite many published guidelines, back pain management varies depending on where you go. Various spinal symptoms and back pain is one of the most common complaints a physician receives. With over 10 percent of visits to a primary care physician being related to the back, the numbers and complaints continue to climb each year. The Harvard Medical School in Boston collected National data and surveys from ambulatory services, hospital facilities, and other medical care facilities. This study was designed to examine the different treatments of back pain from the beginning of 1999 to the end of 2010. Researchers assessed the different types of imaging being used, the use of medications like narcotics and nonsteroidal anti-inflammatory medication, acetaminophen, and referrals for physical therapy.

With treatments for back pain being costly enough, as well as loss in wages from not being able to work, some treatments that aren’t as effective can often times be overused. This can cost even more money with repeated visits for treatments that have little or no effect on the patient. With the collected data, researchers found that close to 24,000 visits to the different medical facilities was because of back and spine problems. Almost 60 percent of the patients were females, and throughout the study period the average patient age increased from 49 years old to 53.

The results of the data were interesting and found that the use of anti-inflammatory drugs and acetaminophen being used at each visit had decreased by 12.4 percent in 2010. The use of narcotics increased by 9.8%, reached just under 30% of patients being treated with narcotics. Throughout the study, referrals for physical therapy remained the same with around 20%. However, physician referrals were found to increase by 7.2%, reaching 14% at the end of the study period. The amount of radiographs held steady at around 17%, while magnetic resonance imaging increased by 4.1% and reached 11.3% for the study period.

Even though there are numerous national guidelines in several different publications, back pain management that is routine increasingly relies on the use of narcotics, diagnostic imaging, and physician referrals. As the costs of healthcare continue to soar and are expected to rise, proper management of back pain can result in not only saving money, but time as well.

A great benefit with minimally invasive surgeries is the affordability of the procedures, and the fact that many patients are able to return to their normal life and work the next day. With proven results in relieving pain, the main goal of the Spine Institute Northwest is to provide the best possible medical care and service to our patients, while focusing on relieving and preventing pain that is often associated with poor pain management. With a commitment to personalized and quality treatment plans for our patients, communication with other health care providers is always important to ensure a team approach so everything that can possibly be done to relieve, prevent, or manage pain is being done.

New Research for Treating Back Pain

A newer research study has suggested that using a type of bio-cellular graft could treat lower back pain. Surgeons have been increasingly using this type of graft to repair tissues that have been damaged. Not everyone in the study that suffered from lower back pain had the same end results. This ranged from receiving complete relief from pain, to no improvement at all.
In this procedure, concentrated forms of the bone marrow are injected into the lumbar discs.

This was in patients that suffer from disc degeneration which usually happens with age as the spinal discs break down. This causes the discs to not be able to absorb as much pressure or impact, and they also become less flexible. Some conservative treatments can fail, and other therapeutic options can be limited for those who suffer from back pain because of degenerative discs. The goal of this procedure is to develop a safe and natural method to help boost the body’s ability in order to heal pain.

The practice of transferring materials within a patient’s own body has continued to evolve further than simply using plasma that is platelet-rich to surround the concentrated cellular bone marrow, and draw cells from the body’s fat. In order to explore the different possibilities with this technique, the research team received data from 22 patients that were treated at the Columbia Interventional Pain Center in Columbia, Missouri. These patients had suffered from lower back pain for an average of 4 years, and have evidence that confirms changes with degenerative discs through MRI’s or CT scans.

The researchers began by harvesting a small amount of iliac bone marrow aspirate, and with the use of a centrifuge obtained the necessary concentrate of bone marrow. This concentrate was then injected into no more than 2 of the annulus of the lumbar disc with the use of a smaller gauged needle. Then it was immediately followed up with a smaller amount of concentrate being injected around the exterior of the annulus.

Between 5-24 months after the treatment, patients had reported different changes in back pain that ranged from feeling complete relief of pain, to no improvement at all. None of the patients had reported the pain worsening, and there were no complications with any of the procedures. Those who did experience relief from pain had also reported a significant improvement in their overall tolerance in activities, or reduced the amount of medication used, or even both.

Continuous research and studies are necessary and important for those who live with constant back and neck pain. As chronic back pain is a common complaint with adults, more and more people are suffering from pain each year, and this is the top reason for missing work each year. This has been a growing concern year after year, and chronic lower back pain has recently been named as the third leading cause of disability-adjusted life years as pain diminishes the overall quality of life.

New Discoveries with Herniated Discs

An award-winning paper published in the health journal Spine has recently raised many questions about just how herniated discs occur. This study that was done by Dr. Rajasekaran and colleagues from the Hanga Hospital in India has been named the winner of the 2013 prize for Lumbar Spine Research through the Society for the Study of the Lumbar Spine.

This study concludes that herniated discs that occur in the lower spine are most often a result of the connecting tissue of the spine and disc separating. Traditionally the cause of herniated discs has always been believed to be caused by the disc rupturing. The results of this study suggest that spinal surgeons should pay more attention to failure with the vertebral end plate junction, and it’s attachment with the discs and spine.

For this study 181 patients were involved who were to have surgery performed due to a herniated lumbar disc. Also known as ruptured discs, this is an all too common cause of lower back pain. The pain is caused when the gel like substance inside the disc leaks out through the tough exterior of the outer disc. The data with these studies included; CT and MRI scans, microscopic studies, x-rays, and surgical observations. Patients that were excluded from this study were those who suffered from a disease that affected multiple discs and patients over 60.

The results for this study found that with 65 percent of the cases, the end plate junction had tore off, also referred to as avulsion. This made avulsion become the most common cause for lumbar disc herniation. These cases found that cartilage and/or a part of the bone that connects the vertebrae to the disc had broken off. Surprisingly with the 181 patients involved, only eleven percent of the cases had the traditional rupture of the outer shell.

Occasionally an avulsion was not able to be seen by x-ray, but it was visible at the time of surgery, and is generally able to be seen with a CT scan. With some cases the avulsion healed itself between the time of the injury to when the surgery was to be performed. However, in some cases narrowing of the spinal canal (known as spinal stenosis), was found to be present. Researchers in this study believe that these failures with an end plate junction have been underrated due to the difficulty of documenting the issues.

In many of these cases there did not seem to be a definite traumatic injury before the herniated disc symptoms appeared, which leads researchers to believe that the process of the herniated disc may take several months to take effect after a fracture. This study has opened the door to develop possible biological and repair strategies, as well as ways to prevent the progression of disc herniation after an initial avulsion. In other words, they may have found a window of time to use some sort of treatment to possibly prevent any more damage being done to the discs.

The Use of Nerve Mapping Technology

New studies and research in the medical field are always being conducted to advance technology, improve diagnosis, treatments, and the healing process. A newer tool that is known as Nerve Mapping Technology is proving to be successful and beneficial. This technology will allow a surgeon to determine if a surgery that has been performed to relieve pressure from compressed nerves is effective or not. These compressed nerves are what generate weakness and pain in the muscles through the nerve. This technique of nerve mapping allows the patients nerves to be located and traced for nerve blocks during procedures like regional anesthesia. Nerve mapping allows anesthesiologist to better determine the best area to insert the needle, prior to beginning the procedure.

A small study at the Henry Ford Hospital involved 42 patients to determine the effectiveness of mechanomyography (MMG) technology when measuring nerve functions, and determining whether or not the nerves are compressed. This technique detects the movement of muscles, and sends real time data and alerts to the surgeon. By measuring the nerves during a surgery, it helps eliminate risks that may require additional surgeries. In the past, patients who were operated on with nerve decompression, doctors wouldn’t know if it was successful until after the patient had recovered. This will allow them to differentiate between the sizes of the nerves, and the severity of compression.

It is estimated that 8 out of 10 people are affected by back pain at some point in their lifetime. Over a quarter of adults in the U.S. have reported having back pain for at least a day within the last three months, and with patients realizing the many benefits of minimally invasive surgeries, these types of procedures are quickly on the rise. This will be an effective tool for monitoring nerve function throughout the surgery. This nerve mapping technique can be used in the upper limb with the musculo-cutaneous, brachial plexus, axillary, median, ulnar, and also radial nerve blocks. In the lower limb it is effective with the; sciatica, popliteal, and femoral nerve block. This tool will also be particularly useful for patients when anatomical marks are gone, or difficult to detect because of contractures, burns, or major limb defects.

In the study at Henry Ford Hospital with 42 patients, researchers tested the threshold of stimulation with 64 nerves. They achieved this with direct contact before and after the decompression. This includes removing a small portion of the bone that is over the nerve root so it is able to heal without any complications. Prior to the decompression, 89 percent of the nerves in the study had an elevated threshold that was higher than normal. After decompression, the median threshold was substantially lower, and 70 percent of the nerves had a threshold that was normal. This new technology will allow surgeons to make quicker and better decisions during the operation because improved testing of the nerves during the operation should result in a quicker recovery time and better outcomes.