Get a Handle on Constant Back Pain
November 29th, 2009 Subscribe To Our Feed
Virtually everybody experiences some back pain every so often. Perhaps you overdid it a little playing soccer, or lifted a few too many heavy things. Your back will almost certainly hurt a bit for a few days.
There are plenty of treatments for occasional back pain: medicated rubs, pain relievers and so forth that can eliminate the pain, at least for a short time. A heating pad might even eliminate your pain if it is a slight case. However if you’re one of the many who are afflicted with persistent back pain, then it will take more than that. In fact, an effective back pain management program is probably something which you’re urgently searching for.
Persistent back pain is frequently a permanent condition. You can do exercises to strengthen your back and lessen the effects of chronic back pain somewhat, yet inevitably there will be another flare up. It’s as if your back is reminding you of your damage and that there is nothing at all you can do to get rid of the pain totally.
If constant back pain was completely restricted to your back, it would be a whole lot easier to live with. Normally, however, muscle spasms, damaged discs and such things have an effect on you far beyond just the immediate area.
An injured disc in the vertebrae that flares up will usually produce pain in the legs and ankles along with the backache. Which leg and ankle will be afflicted with this discomfort hinges on which side your injured disc is protruding on. A protuberance on the left equates to discomfort in the left ankle and leg, and vice versa.
The pain in the leg can be more difficult to put up with than the persistent backache itself. Occasionally the pain in your leg can be much more powerful. Persistent back pain isn’t pleasant in any regard.
It is quite likely that you have observed individuals, whether on television or in real life, complaining of a lack of flexibility caused by chronic back pain. These individuals are not faking it, which is something you know if you experience constant back pain. This is real, and it’s also very painful.
Enduring persistent backache is an unpleasant experience. However, the pain can often be treated with certain therapies. You need to take care of your back in the first place, though, to make certain that the likelihood of enduring persistent back trouble are diminished.
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Fusing or Not Fusing: The Spinal Question
November 29th, 2009 Subscribe To Our Feed
Spinal fusion is one of the most misunderstood spinal surgical procedures. Everyone has heard some kind of frightening story about a distant family member who had back surgery and was never the same afterward. Many patients think a spinal fusion will cause their spine to become completely rigid, and they envision a future of robot-like stiffness with the inability to bend their backs or touch their toes, after surgery. Over the past decade, spinal fusion has also had a less than bright reputation as a treatment for pain. Given the overall perception that fusion of the spine is a delicate surgery with questionable outcomes, patients are quite concerned about proceeding with a fusion. We will help to dispel many of the misconceptions that surround this treatment and why it is important to understand the procedure, when it should be performed and who might benefit from a spinal fusion.
What is Spinal Fusion?
Spinal fusion is a surgical procedure designed to provide stability to an area of the spine that has too much movement or movement that causes pain, tingling, numbness or weakness in the arm or leg. The object of a spinal fusion is to connect the bones (vertebrae) that were previously too mobile and form a connection of bone in the spine that is more rigid.
A History Lesson
Orthopaedic surgeons have long applied casts to broken bones to provide support to fractures and allow the bones to heal. The addition of this external support keeps the bones from moving. Why is this important? When there is too much movement between broken bones or bone fragments, the repair cells are prevented from being able to connect the bone fragments together, so their process of healing will stop.
As orthopaedic surgeons have progressed in the use of technology, plates and screws, called internal fixation devices, are now applied to fractured bones. These rigid internal fixation devices are stronger, and they add more support to the fractured bone. Plates and screws have been able to replace bulky external casting in a large group of fracture types.
The same treatment principles are used by the orthopaedic spine surgeon. There was a time when fusions were supported with external bracing. This external support, provided by casting or rigid bracing, has now been replaced with internal rods and screws. Using these internal supports provides stronger bone connections that decrease motion even more. As a result, the number of successful fusions has increased. The internal support of the spine is stronger, allowing patients to get up and out of bed and walk the day of surgery and to return to their usual activities in 6 weeks. This is a far cry from the days of original spinal fusions that were supported with a cumbersome hard plastic brace or cast, leaving patients with limited mobility or bed rest for many months.
Spine surgeons are now better able to determine which patients will benefit from a spinal fusion. Advanced imaging studies, including MRI and bone scans, as well as the use of diagnostic injections, help today’s spine specialist more accurately diagnose patients whose conditions would benefit from spinal fusion. Advances in surgical techniques and components, including the development of better screws and rods, also have greatly improved patient results. Improved diagnostic and surgical training, including advanced training in spine fellowship programs, has helped spine surgeons interpret and use these advances in technology to obtain better outcomes for patients.
Who Can Benefit from Spinal Fusion?
As with all surgeries, there are proper uses that will result in good outcomes for patients with spinal fusion.
In patients where the spinal bones have begun to slip and cause pressure on the spinal nerves (spondylolisthesis), this excessive movement may need to be stopped to prevent worsening of the nerve pressure. During surgery, these patients will have the bone spurs and disc protrusions removed from around the nerve roots and spinal cord, which may destabilize the bones of the spine and cause the bones to slip. Inserting screws and rods in these bones will prevent the bones from slipping any further after surgery and also may be used for correction of the original slippage.
Use of screws and rods can also provide stability and correction for patients with scoliosis. Scoliosis is the bending of the spine in an abnormal direction. The curve of the spine may increase with time or may be painful as the curvature of the spine increases. If the patient has a large curve or the curve is continuing to get worse, screws and rods are used to correct the position of the spine and prevent the curve from worsening.
In patients with obvious bone destruction from fracture, tumor or infection, stabilizing the bones with screws and rods will provide the support needed so the underlying disease can be addressed. The structure of the spine can be improved while the patient receives chemotherapy or radiation. By removing the tumor in the spine, the back pain related to an expanding tumor can be relieved and the patient can remain mobile, which helps to prevent pneumonia and blood clots. Being ambulatory, while receiving chemotherapy and radiation, also improves the patient’s mood and outlook while coping with their disease.
Who is Not a Candidate for Spinal Fusion?
Most patients with disc herniations or pinched nerves do not need a spinal fusion. These conditions can be treated with simpler procedures that allow the removal of pieces of discs or bone spurs that do not increase the movement in the bones.
The more difficult indication for spinal fusion is in the patient with severe pain in the back. Degenerative disc disease is still the leading cause of back pain in the United States, but back pain can have many underlying causes. One of the reasons that spinal fusion developed a bad reputation is that they were performed as a remedy for back pain that did not respond to other forms of treatment. Older fusion methods and inadequate diagnostic approaches left surgeons with few options for treating these patients, so some patients were given fusions as a last attempt to improve their pain . Most patients with lower back pain and degenerative disc disease will not need a spinal fusion.
What Can Be Expected From Spinal Fusion?
It is expected that most patients will be back to their usual state of health and activity at approximately 6-8 weeks after their fusion surgery. Most patients will be pain-free after their spinal fusion. It is important to choose a well-trained surgeon to make educated decisions about your diagnosis and treatment. With the combination of the proper diagnosis and properly applied spinal fusion most patients will have very good outcomes.
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