Back Pain

Spinal Tumor Symptoms & Treatment

Spinal TumorsTumors, whether cancerous (malignant tumors) or noncancerous (benign tumors), can develop and affect bones anywhere in the body, but when a tumor develops in or near your spinal cord or within the bones of your spine, it can be an especially serious condition.

Your spine is an extremely important part of your body as it holds up your head, shoulders and upper body. It also houses and protects your spinal cord and the nerve roots that control your arms, legs, and torso. The spine is made up of 31 small bones, called vertebrae, which are stacked on top of one another and make up the three sections of your spine (cervical spine, thoracic spine, lumbar spine) forming the natural curves of your back.

Your spinal cord runs through the middle part of the vertebra, which is called the spinal canal, and extends from the skull to the lower back. Spinal nerves branch out from the spinal cord through openings in the vertebrae, carrying signals between the brain and muscles.

The most common type of spinal tumor is one that spreads (a metastasis) from cancer arising in another part of the body, such as the breast, lung, kidney, prostate, thyroid, blood cells, or other tissues. Rarely, spinal tumors arise from the nerves of the spinal cord itself. Primary spinal tumors are those that arise from the bones in the spine – these are also relatively rare.

The closeness of a tumor to the spine and nerves that run through and between your vertebrae determines the severity of the condition. Tumors can compress and interfere with nerve function, affecting the messages being sent to and from your brain to the rest of your body. Since the spinal cord is relatively narrow, tumors within it may cause symptoms on both sides of the body. Tumors can also weaken the vertebrae, causing the spine to collapse and potentially cause pain or injure the nerves housed within.

Spinal tumors are different for each unique patient since they originate from different areas or develop from different cell types. Depending on where the tumor is, how advanced it is, how quickly it is growing and whether it is malignant or benign, symptoms and treatment options vary.

Common symptoms of spinal tumors include:

  • Pain
  • Muscle weakness
  • Loss of sensation or numbness (in the legs, arms or trunk)
  • Loss of bladder/ bowel control
  • Difficulty using arms or legs, inability to walk

Treatment for spinal tumors is determined on a case by case basis and may include surgery, radiation therapy, chemotherapy or other medications. If surgery is necessary, the goals are to stabilize the spinal column, relieve nerve pressure caused by the tumor, protect the nerves and spinal cord and remove as much of the tumor as safely possible.

For more information about spinal tumors and spine tumor treatment, visit Emory Orthopaedics & Spine Center. Our world renowned, highly skilled, specialized and experienced team includes orthopedic spine surgeons, neurosurgeons, orthopedic oncologists and radiologists, all working together to diagnose and treat a wide range of spinal tumors.

About Dr. Rhee

John Rhee, MDJohn M. Rhee, MD, is a Spinal Surgeon and Associate Professor of Orthopaedic Surgery specializing in cervical spine surgery, lumbar spine surgery, complex spinal deformity surgery (scoliosis and kyphosis) and surgery for spinal tumors. Dr. Rhee is an active researcher and sought-after teacher/lecturer at the national and international level in multiple medical societies. He has served as faculty and been an invited lecturer at numerous meetings and courses on spine surgery. In addition, he has served as Program Chairman at numerous national and international spine surgery meetings. Dr. Rhee has also published extensively in a number of peer reviewed journals and books, and he has received numerous awards and honors. He is actively involved the training of international research scholars and other spinal surgeons and has been the author and editor of major textbooks on spine surgery techniques.

Related Resources

Patient Video Story: Back to Life after Spinal Tumor Surgery

8 Tips to Fix Your Posture at Work

Good PostureFor the average working American, it is common to sit a minimum of eight hours a day and a majority of that behind a computer. I frequently see patients with neck and back pain that are not related to a specific injury, but rather from spending many hours at their desk (which usually involves using a computer). Sitting for extended periods of time can lead to a variety of health issues, including fatigue, muscle and joint pain.

Do you spend a lot of time behind a desk? If so, make sure your chair and work station are set up to fit you properly and influence good posture. Here are a few tips to help get you started:

  1. MONITOR POSITION: You should be able to sit straight in front of your computer and not have to turn from side to side to access it. The top half of the monitor should be in line with your eye height.
  2. DISTANCE FROM MONITOR: Keep your arms and elbows close to your body and parallel to the floor. You should not have to reach forward to use your keyboard. (Tip: try sitting about 18 inches from your computer screen).
  3. NECK: People who spend a lot of time on the phone often complain of neck pain. If you find yourself cradling your phone between your shoulder and chin so you can type and talk at the same time, switch to a headset or use a speaker phone. Also, be careful to not protrude your neck forward while looking at the computer screen. (Tip: Try keeping your ear in line with your shoulder)
  4. SHOULDERS: Keep your shoulders down and relaxed.
  5. BACK: Sit with your back pushed to the back of the chair with some form of lower back support between you and the chair back.
  6. ELBOWS and WRISTS: While typing, elbows should be at a 90-degree angle from your body, and your wrists and hands should be in a straight line. Make sure not to place stress on your wrists – keep them in a neutral position, not arched or bent. (Tip: Have the keyboard and mouse near each other and at the same height as your elbows).
  7. LEGS: When you’re sitting, your hips/thighs should be parallel to the ground or a little higher than your knees. Also, you don’t want the end of chair hitting the back of your knees—make sure to leave a little gap.
  8. FEET: Feet should touch the ground and lay flat on the floor. Sitting cross-legged or on one leg can lead to slouching. (Tip: if your feet cannot touch the floor, try using a footrest or box.)

Remember to give yourself breaks after you have been sitting for an extended period of time. Get up and move around regularly throughout the day, in fact, for every hour your work at your desk, give yourself several 1-2 minute breaks. Take a quick walk around the office, grab some water, chat with a coworker, or at least stand up and stretch.

I always tell my patients to listen to their body. If you are having pain, your body is trying to send you a message. If you experience neck or back pain that does not improve after trying the tips above, make an appointment with an Emory Spine physiatrist for further evaluation and treatment. To make an appointment, please call 404-778-3350 to speak to a member of our team.

About Diana Sodiq, DO

Dr. Diana SodiqDiana Sodiq, DO, is an Assistant Professor of Orthopedics and Rehabilitation Medicine. She is Board Certified in Physical Medicine and Rehabilitation (Physiatry). As an osteopathic physician, Dr. Sodiq is trained in both traditional medicine as well as osteopathic manipulative treatments (OMT). She started practicing at Emory in 2010.

 

Related Resources

Emory Orthopaedics & Spine Center

“I’m a Medical Miracle!” : One Emory Spine Center Patient’s Experience

Andy ReynoldsBy Andy Reynolds, Emory Spine Center Patient 

In midsummer of 2010, my riding lawn mower flipped over and pinned me underneath. My back was broken in three parts. I had surgery to fuse and implant rods and screws. My pain never went away, so later I had the rods and screws removed in hopes of pain relief.

My pain worsened and more issues developed within the next four years. My nerves were damaged which lead to horrific pain, migraines, insomnia, and I developed Post-traumatic Stress Disorder. I could hardly make it through a day at work, I wore a brace and had seen about 16 different doctors before I was referred to a spine specialist. That spine specialist was my medical miracle doctor, Emory neurosurgeon, Dr. Gerald Rodts.

Dr. Rodts showed me a CT scan image of my spine and surprisingly revealed that my fracture was never repaired, and therefore, never properly healed. Dr. Rodts was in disbelief that I was not paralyzed since my back was still broken.

I had spine surgery November 24, 2014 at Emory University Hospital Midtown. During my surgery, Dr. Rodts worked his magic and reconstructed the damaged area of my spine so my nerves were no longer pinched.

Today, I don’t have a single issue left from my incident and my life has changed drastically. I went from enduring a multitude of health issues, including horrific pain, to being completely healthy and happy. Since my spine surgery, I can stand longer now, travel and go in the pool. I am able to participate in activities I enjoy like outdoor planting and am looking forward to yard work and even getting back on my lawn mower come Spring. I also cannot wait to get back to lifting weights at the gym.

When I look back at photos of me, I can see how bad of a shape I was in by the pained look on my face. My medical miracle would not have happened if it hadn’t been for Dr. Rodts and the spine team at Emory Orthopaedics & Spine Center. Everyone was wonderful; it was like a five star experience.

A note from Dr. Gerald Rodts, Jr.

Andy had originally suffered a severe fracture of the lumbar vertebra, at a crucial transition area between his lower thoracic spine and upper lumbar spine. Despite having had surgery to stabilize the fracture, it ultimately never healed. It became a source of chronic, severe back pain. In order to fix the problem, the surgery required a different approach.

The surgery was done with cardiothoracic surgeon, Allen Pickens, MD. With the help of Dr. Pickens, an incision was made on the chest wall (flank) on the left side. A rib was removed, and the large diaphragm muscle disconnected from the spine. The fracture pieces of vertebra were removed, and the spine was rebuilt with a titanium fusion cage, rib bone graft, and two screws and a rod. The diaphragm muscle was reconnected, and the chest wall closed. This procedure renders the spine immediately strong and stable, and the area of the fracture then continues to strengthen as the bone graft heals.

To learn more about the wide range of spine conditions treated at the Emory Orthopaedics & Spine Center in Atlanta, click here or call 404-778-3350.

About Dr. Rodts

Gerald Rodts, MDGerald E. Rodts, Jr., MD,  is a Professor of Neurosurgery and Professor of Orthopaedic Surgery at Emory University School of Medicine. In addition, he is the Director of the Spine Fellowship Program in the Department of Neurosurgery at The Emory Spine Center and Chief of Neurosurgery Spine Service at The Emory Clinic.

Dr. Rodts graduated from Princeton University with a degree in biology and a Certificate of Study of Science in Human Affairs. He received his M.D. from Columbia University’s College of Physicians and Surgeons in New York and completed his neurosurgery residency training at the University of California in Los Angeles, followed by a 1-year fellowship in complex spinal neurosurgery at Emory University. Dr. Rodts has served as the President of the Congress of Neurological Surgeons as well as serving as the Secretary. He has also served as the Chairman of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. He is also a founding editor of the award-winning website, Spine Universe. He has been selected as one of the Castle and Connelley’s “Top Doc” neurosurgeons in the United States ten years in a row and has received a similar distinction in Atlanta Magazine annually. He is a neurotrauma consultant to the National Football League.

Dr. Rodts manages patients with spinal disorders, and specializes in neoplastic, rheumatoid, degenerative, traumatic spinal disorders, syringomyelia and Chiari malformations. His research interests are in computer-assisted, image-guided surgery and minimally-invasive spinal techniques.

Areas of Clinical Interest:

  • Complex spine surgery and reconstruction
  • Computer-assisted image-guided spine surgery
  • Minimally-invasive spine surgery
  • Revision spinal surgery

Emory Spine Center Patient: “Dr. Ananthakrishnan is a miracle worker.”

By Renee Godley, patient at Emory Orthopaedic, Sports & Spine Center

Emory Orthopedics PatientIn 1969, I had scoliosis surgery. During this surgery, my spine was fused and a Harington Rod was attached to the muscles in my spine. After the surgery, I was bedridden for six months and in a body casts for a total of nine months. I recovered well and learned how to live with my limitations.

In 1990, I started to suffer from lower back pain. I visited Emory Orthopaedic, Sports & Spine Center, in Atlanta, Georgia and I was informed that I needed to have additional surgery. The wear and tear on my lower three discs had progressed to the point that I would need to have them replaced and fused within 10 years. I said no immediately because I knew the process, I had a three year old daughter at home and I would again, be bedridden for three months and in a body cast that extended down to my right knee. I was unwilling to go through the process a second time. Fear lead me to that decision.

From 2007 until 2012 I saw a pain management orthopedist, which helped me to numb the pain. Then I was advised to see Emory Orthopaedic, Sports & Spine physician, Dheera Ananthakrishnan, MD. Fear once again took hold of me. I had done research and quickly realized I was suffering from Flat Back Syndrome. I read information about the surgeries (two, for a total of at least 12 hours), and started to panic. I finally reached the point where the pain was too much and I just couldn’t take it anymore. I did not want to have surgery and I did not know what to do.

My life had become very restrictive. I could no longer go out to eat or even sit on the living room couch for an extended period of time, rather I had to lie down to lessen the pressure on my spine. I loved attending Georgia football games and could no longer attend any games, the car ride, walk to the stadium and sitting in the stands were beyond my capabilities. I just could not go anymore. My husband wanted to go to the movies, and you guessed it, I could not; I couldn’t do anything.

After much fear, unbearable pain and many days and nights spent crying, my life would soon change. I was referred to Emory Spine Center to see Dr. Ananthakrishnan (Doctor A). Doctor A examined me and ran numerous tests and the diagnosis was, as predicted, Flat Back Syndrome. Although I did not want to have the surgeries, I had no choice. I was scheduled for surgery in December of 2012. For thirty days I was taken off my medications (anti-inflammatories) and realized just how disabled I had become. I was immobile, I couldn’t walk, much less do anything.

On, December 7, 2012, I had surgery at Emory University Orthopedics & Spine Hospital with Dr. Ananthakrishnan that included three replacement discs. A second surgery was held on December 11, 2012 where two rods and 16 one inch titanium screws were placed in my back.

Thanks to Dr. Ananthakrishnan, for the first time in 30 years, I had no pain in my back! This is the best feeling that I’ve felt since I met my husband and got married. Dr. A is a miracle worker. In the two years since my surgery I have begun to walk for exercise, averaging approximately five miles of exercise per day. I went from not walking at all to averaging over 70,000 steps per week.

Everyone I see can’t believe how good I look. I stand straight. I am no longer hunched over. When someone tells me they are experiencing back pain, the first thing I ask them is, “Have you gone to Emory yet?” I would not have the quality of life I have today without Dr. Ananthakrishnan.

A note from Dr. Dheera Ananthakrishnan

I vividly remember the first day that I met Mrs. Godley. She was still so traumatized from her scoliosis surgery all those years ago! I was very worried that she would have difficulty coping with such a large revision surgery. Was I ever wrong! She sailed through two really large surgeries, and has been a textbook patient, inspiring others to follow in her footsteps.

One of the great joys of performing surgery is to see how life-altering it can be for patients who have lived with disability and pain for a long time. Mrs. Godley embodies this for me. It has been my great pleasure to know her and care for her. Now the only tears that are shed during our visits are tears of joy.

About Dr. Ananthakrishnan

Dheera Ananthakrishnan, MDDheera Ananthakrishnan, MD, trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, Dr. Ananthakrishnan practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors Without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University. She maintains an interest in developing-world orthopedics through her non-profit, Orthopaedic Link, and is currently involved in projects in the Philippines, Nepal, and Bulgaria.

Dr. Ananthakrishnan’s practice focuses on adult scoliosis and degenerative conditions. She also treats adolescent spinal disorders as well as tumors and cervical conditions. She has been at the Emory Orthopaedic and Spine Center since 2007.

Do You Think You Have a Ruptured Disc? Check Out These Signs and Symptoms of a Herniated or Ruptured Disc

Herniated DiscA herniated disc, also commonly referred to as a ruptured disc or slipped disc, occurs when a cartilage disc in the spine becomes damaged and moves out of place resulting in a pinched nerve. You can have a herniated or ruptured disc in any area of your spine but most often it affects the lumbar spine (lower back area). There are many causes of a herniated or ruptured disc including:

  • Degeneration due to aging
  • Wear and tear
  • Injury to the vertebrae
  • Sudden strain or sprain in lower back
  • Sports injuries or accidents

Symptoms of a herniated or ruptured Disc

Symptoms of a ruptured disc will vary from person to person but the most common symptoms of a herniated or ruptured disc include:

  • Severe pain in the back around the ruptured area
  • Muscle weakness, numbness, shooting pain or tingling in the legs
  • Muscle spasms
  • Pain in shoulders, arms, chest, ribs or thighs (depending on where the rupture has taken place)

Treatment for a herniated or ruptured Disc

Most often herniated discs can be treated without surgical intervention. We typically recommend starting a patient on anti-inflammatory medications, ice and heat to reduce the severity of the pain. In some cases a steroid injection may be helpful, and in others physical therapy with back exercises can be added to the treatment plan. If all other options are exhausted and radiating arm/leg pain persists after 6 – 12 weeks of treatment, surgery may be recommended.

If a herniated or ruptured disc is identified quickly, treatments are more likely to be successful. Any one with a ruptured disc should modify their activity level to avoid lifting heavy objects as well as avoid bending or any activities which worsens the radiation of arm/leg pain. Sports activities should also be reduced while healing.

Some surgery options for herniated or ruptured discs are:

At Emory, our nationally renowned spine specialists work together to diagnose and treat cervical spine and lumbar conditions. Emory physiatrists (non-operative physicians) and surgeons use innovative approaches to spine care and have extensive experience that allows us to boast high success rates. Emory is one of the largest University – based Spine Centers in the United States. Our physicians typically exhaust non-surgical options first, but if surgery is recommended, most surgeries for herniated or ruptured discs are performed at Emory University Orthopaedics & Spine Hospital in Tucker. Emory University Orthopaedics & Spine Hospital is a dedicated orthopedic and spine hospital and it leverages the pioneering vision, latest research and medical advances to provide high quality patient and family centered care.

About Scott Boden, MD

Scott Boden, MDScott D. Boden, MD, is Professor of Orthopedic Surgery and Director of the Emory Orthopaedics & Spine Center. Dr. Boden started practicing at Emory in 1992. During his fellowship at Case Western Reserve Hospital in Cleveland, Dr. Boden trained with one of the founding fathers of modern spine surgery, Dr. Henry Bohlman. A primary original researcher on bone growth factor development and spine fusion technology, Dr. Boden is also an internationally renowned lecturer and teacher and the driving force behind the Emory University Orthopedics & Spine Hospital (EUOSH).

Dr. Boden’s Clinical Interests:
Dr. Boden’s areas of clinical interest include surgical and nonsurgical management of adult degenerative spinal disorders including herniated discs, spinal stenosis, and spondylolisthesis in the cervical and lumbar spine. He was recently named in another Becker’s list of Top 50 Spine Surgeons in the U.S. and is a skilled surgeon with techniques of microdiscectomy, laminectomy, spinal fusion, and laminoplasty.

The Road to Emory: Education
• Medical School: University of Pennsylvania School of Medicine, Philadelphia, PA 1986
• Internship: George Washington University Medical Center, Washington, D.C. 1987
• Residency: George Washington University Medical Center, Washington, D.C. 1991
• Fellowship: Case Western Reserve University Hospital, Cleveland, OH 1992

Personal
Dr. Boden is the proud father of triplets who graduated first and tied for second in their high school class. He is also a baseball aficionado and coaches high school and travel softball teams.

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Spinal Stenosis: Treatment Options

spinal stenosisSpinal stenosis is a condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed (or narrowed). This narrowing occurs most often in the lower back or neck, and can put pressure on the spinal cord and nerves, causing a “pinching” of the spinal cord and/or nerve roots. The pinching can lead to a variety of symptoms, including pain, weakness and numbness. Symptoms often start slowly and get worse over time, and typically a person with this condition complains of severe pain in the legs, calves or lower back when standing or walking. Other symptoms include abnormal bowel/and or bladder function and loss of sexual function. Depending on where the narrowing takes place, you may feel these symptoms in the lower back and legs, neck, shoulder or arms. Usually, it is relieved by sitting down, leaning over or sitting forward.

In most cases, the narrowing is caused by osteoarthritis of the spinal column and discs between the vertebrae. It may also be caused by a thickening of the ligaments in the back, as well as by a bulging of the discs that separate the vertebrae. If you suffer from any or all of the above you should schedule an appointment with an orthopaedic spine specialist to determine if you have spinal stenosis.

How is Spinal Stenosis Treated?

The preferred treatment for cases of persistent back pain from spinal stenosis is a combination of physical therapy, prescribed exercise, and medications for chronic pain. Only if you have persistent pain, or if your pain does not respond to these efforts, will your physician consider surgery to relieve the pressure on the affected nerves or on your spinal cord. Here is what you can do:

  • Exercise: Regular exercise can help you build and maintain strength in the muscles of your arms and upper legs. This will help to improve your balance, ability to walk, bend and move about, as well as control pain. A physical therapist will identify and show you what exercises are right for you.
  • Medications: The most common treatment for chronic pain in spinal stenosis is non-steroidal anti-inflammatory drugs (NSAIDs). These include: ibuprofen (Advil, Motrin), acetaminophen (Tylenol) and Naproxen (Aleve). Your physician may also prescribe other medications to help with pain and/or muscle spasm.
  • Cortisone injections: Injections directly into the area around the spinal cord (known as epidural injections) may provide a great deal of temporary, sometimes permanent, relief. These medications include: Cortisone (Celestone, Kenalog) and methylprednisolone acetate (Depo-Medrol, Medrol).
  • Surgery: In some cases you may need surgery to relieve spinal stenosis, particularly if a disc fragment is lodged in your spinal canal and is pressing on a nerve, which can cause significant loss of function. Some patients with severe or worsening symptoms (but who are otherwise healthy) may be candidates for what is known as a decompression laminectomy. This surgery removes the bone spurs and buildup of bone in the spinal canal, freeing space for the nerves and the spinal cord. This may be done in conjunction with a spinal fusion to connect two or more vertebrae and better support for the spine. It should be noted that while surgery may bring some relief, it will not cure spinal stenosis and symptoms may recur.

Living With Spinal Stenosis:

Spinal stenosis can be a real challenge day to day, but certain steps can be taken to ease some of the symptoms. Some treatment options include:

  • Get moving. If you’re capable, regular exercise is very important and you should do it often – at least three times a week for about 30 minutes. Start slowly and as you begin to feel stronger, add walking or swimming to your plan.
  • Modify activity. Don’t do anything that can trigger or worsen pain and disability such as lifting heavy objects or walking long distances.
  • Hot or cold packs. Some symptoms of cervical spinal stenosis may be relieved by applying heat or ice to your neck.
  • Canes or walkers. In addition to providing stability, these assistive devices can help relieve pain by allowing you to bend forward while walking.

About Dheera Ananthakrishnan, MD

Dheera Ananthakrishnan, MDDr. Ananthakrishnan trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, she practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University, where her focus is on adult and adolescent scoliosis.

In 2009, Dr. Ananthakrishnan co-founded Orthopaedic Link, a non-profit dedicated to improving orthopaedic care in the developing world by mobilization of unused implants from the United States. She is also a candidate member of the Scoliosis Research Society. Although Dr. Ananthakrishnan routinely performs complex spinal reconstruction surgery, an injury in 2012 caused her to reevaluate her own approach to musculoskeletal health. Her practice philosophy now focuses on strengthening, stretching and general conditioning as an adjunct to surgical care of her patients.

Related Resources:

Could I Be Suffering from a Herniated Disc?

Herniated DiscLower back pain has been found to be the number one cause of disability around the world, according to the 2010 Global Burden of Disease study. Though many conditions can cause back pain, a herniated disc is a common cause.

Discs are the soft, rubber-like pads that fit between the bones (vertebrae) of the spinal column and cushion it. The discs allow the back to flex and bend and absorb shock.

Herniated discs, which can also be called slipped or ruptured discs, are caused when all or part of the disc is forced through a weakened part of it, which places pressure on the nearby nerve and/or spinal cord, causing numbness, and most commonly, pain. Herniated discs can occur both in the lumbar spine (lumbar herniated disc) and the cervical spine (cervical herniated disc).

This can happen when the disc moves out of place (herniates) or breaks open (ruptures) due to injury or strain. It is most commonly found to happen in the lower back, but can also affect the neck’s discs, or, even more rarely, the discs in the upper-to-middle back.

Herniated Disc Risk Factors

If you’re not sure if a herniated disc is causing your pain, the American Academy of Orthopedic Surgeons point out a few factors that can put you more at risk:

  • Usually, herniated discs are caused by the natural aging of your spine. When we’re young, our discs have a high water content, making them spongy. When we age, they begin to dry out, becoming weaker and narrowing the spaces between our vertebrae. This is called disc degeneration.
  • Men between 30-50 are more likely to have a herniated disc
  • Jobs or tasks that require you to repeatedly lift heavy objects can put you at risk, especially if you are lifting with your back and not your legs, or if you are twisting while you lift.
  • Being overweight can add stress on the discs of your lower back
  • If you are frequently in the car, staying seated for long periods of time along with the vibrations of the car, can put pressure on your spine and discs
  • Staying sedentary can cause herniated discs
  • Smoking can reduce the amount of oxygen reaching your discs to cause more rapid degeneration

Herniated Disc Symptoms

For most people suffering from a herniated disc, lower back pain is the first symptom. The pain may come and go, but can eventually lead to leg pain, numbness or weakness. These sensations can reach all the way below the knee, to the ankle and foot.

Additionally, the symptoms can be all or one of the following:

  • Back pain
  • Leg and/or foot pain (sciatica)
  • Numbness or tingling in the leg and/or foot
  • Weakness in the leg and/or foot
  • Loss of control over the bladder or bowels (very rare.) This could be a more serious problem known as cauda equina syndrome, which is caused by compression of the spinal nerve roots. This requires immediate medical attention.

If you feel like you may be suffering from a herniated disc, see your orthopedist for a physical examination or MRI scan, so they can make sure that it’s the cause of your back pain. Due to a wide range of non-surgical and surgical treatments available, most patients are free from their symptoms in 3-4 months!

About Dheera Ananthakrishnan, MD:
Dr. Dheera AnanthakrishnanDr. Ananthakrishnan trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, Dr. Ananthakrishnan practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors Without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University. She maintains an interest in developing-world orthopedics and is currently involved in projects in the Philippines and Malawi.

Dr. Ananthakrishnan’s practice focuses on adult degenerative conditions, including scoliosis. She also treats adolescent spinal disorders as well as tumors and cervical conditions. Dr. Ananthakrishnan started practicing at Emory in 2007.

Related Resources:

90% of Back Problems Can Be Resolved Without Surgery

The thought of having to have spine surgery is terrifying to most people. The good news is that only about 10% of patients who have back or neck problems are candidates for surgery. At Emory Orthopaedics, Sports & Spine, we have non operative as well as operative physicians who specialize in the diagnosis and treatment of acute back and neck pain injuries. The non-operative physicians, physiatrists, only recommend surgery in the cases where it is absolutely necessary. There are many non-surgical spine treatment options that may fix back problems before opting for surgery. These non-surgical back treatments include anti –inflammatory medication, ice, heat, gentle massage, physical therapy, orthotics, and injections.

Patients should only consider surgery if all of the conservative treatment options have been exhausted. In this short video below, Emory’s non-operative sports medicine and spine physician, Dr. Oluseun A. Olufade describes Emory’s approach to caring for active individuals with back or neck pain. It is important to note that if your physician immediately suggests you have back surgery before giving you other options for your care, it may be a good idea to get a second opinion.

Related Resources:

About Dr. Olufade
Oluseun Olufade, M.D.Dr. Olufade is board certified in Sports Medicine, Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team. Dr Olufade is also the team physician for Emory University and Blessed Trinity High School.

Dr. Olufade employs a comprehensive approach in the treatment of sports medicine injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in treatment of sports related concussions, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at our clinic at Emory Johns Creek Hospital.

Dr Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth
Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth. Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek. Mathew Pombo, MD and T. Scott Maughon, MD see patients in Duluth. Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine. To schedule an appointment call 404-778-3350.

Exercises to Improve Lower Back Pain

Exercises for Lower Back PainAmericans are suffering from lower back pain in record numbers. Many people with low back pain mistakenly think that they need to rest to heal the back pain but actually, most low back pain will get better if you stay active. Exercise has been shown to help decrease lower back pain as well as help you recover faster from the injury. In addition, exercise can help prevent the back from being reinjured and reduces the risk of disability due to back pain. It is important to stay active right after the pain starts so you don’t lose any strength or flexibility. The loss of strength or flexibility could lead to further, more debilitating pain.

Exercises for back pain:
People who have back pain can do several activities that will strengthen the back including walking, swimming and walking in waist deep water.

It is also important to stretch and do strengthening exercises such as:

  • Back extensions – while lying on your stomach on the floor, press your elbows onto the ground and push up. Hold this pose for 30 seconds and allow your body to relax and then repeat 4 – 6 times.
  • Knee to chest stretch – lie on your back on the floor and bend your knees, keeping your heels on the floor. Place hands behind each respective knee and bring your knees to your chest.
  • Hip stretch – stand with your feet shoulder-width apart. Take a step back with one foot and bend the opposite knee while shifting the weight to the opposing hip.
  • Neck stretch – sit in a comfortable chair with a straight back. Bend your head forward until the chin hits the chest or you can feel a light stretch in the back of the neck.
  • Chair stretch (for hamstrings) – Sit in a comfortable chair with legs straight out in front of you in another stable chair. Reach forward gently to one foot and then repeat with other foot.

Note, that if at any time you are doing a stretch or exercise that is increasing your pain, you should stop immediately.

Exercises you should not do when you have low back pain:

There are also some exercises you should avoid when you have low back pain including:

  • Sit ups, either with straight legs or with bent legs
  • Leg lifts
  • Touching your toes while standing with legs straight
  • Heavy lifting above the waist

Although, some patients with lower back pain need to receive medical attention, many people can relieve the pain associated with back pain with simple strengthening and stretching exercises. When you have a question on whether to get medical attention or not, it is best to be cautious and talk to your provider for a recommendation.

About Dr. Olufade
Dr. Oluseun OlufadeDr. Olufade is board certified in Sports Medicine, Interventional Pain Medicine and Physical Medicine & Rehabilitation. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team. He is currently team physician for Emory University and Blessed Trinity High School.

Dr. Olufade employs a comprehensive approach in the treatment of sports medicine injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in treatment of sports related concussions, tendinopathies, platelet rich plasma (PRP) injections and percutaneous tenotomy and fasciotomy. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at our clinic at Emory Johns Creek Hospital.

Dr Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth
Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth. Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek. Mathew Pombo, MD and Scott Maughon, MD see patients in Duluth. Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine. To schedule an appointment call 404-778-3350

What is the Sciatic Nerve? What is Sciatica?

Back PainOver 65 million Americans suffer from back pain. In fact, according to the National Institute of Neurological Disorders and Stroke, back pain is a leading cause of missed work and the most common cause of job – related disability in the United States. Many times, pain in the lower back could be caused by a condition called sciatica. Sciatica is a condition often caused by a ruptured or herniated disk that irritates the sciatic nerve. The sciatic nerve is formed from the nerve roots coming out of the spinal cord into the lower back. When the nerve is irritated it can cause debilitating pain, numbness or a tingling sensation down the leg and occasionally all the way to the foot. At times, the pain is so severe that the pain sufferer may lose control over the leg.

Causes of sciatica

Treatments for sciatica

Depending on the cause of the sciatica, it can take weeks to years to relieve the pain from the condition. Research has not shown that low activity versus high activity and physical therapy will help the symptoms. Although medications do not always relieve the pain in the sciatic nerve, medications are typically the first line treatment option. If medications don’t work, the physician will work with the patient to determine the next steps which could include surgery, epidural injection or alternative medicines.

When should you see a physician regarding sciatica and what type of physician should you see?

Patients with sciatica or similar conditions are typically seen by Orthopaedists or Neurosurgeons. At Emory Orthopaedics & Spine we like to see patients when pain failed to be relieved with activity modifications and OTC medication or if it is associated with sensory or motor deficits, such as numbness or weakness

Dr. Di CuiAbout Dr. Cui
Dr. Cui is a physiatrist at the Emory Orthopaedics & Spine Center who specializes in non-surgical management of back, spinal and neck pain. Dr. Cui completed his medical school and residency at the Emory University School of Medicine. He has a special interest in oxidative stress and nutrition, and how they are related to aging.

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