Back Pain

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.

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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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When it Comes to Your Health, are High Heels Worth the Price of Looking Good?

High Heels Back PainEmory Orthopaedics, Sports and Spine physicians Kyle Hammond, MD  and Oluseun A. Olufade, MD recently participated in “Ladies Night Out”  at Emory Johns Creek Hospital.

The Ladies Night Out event is an annual health fair held by Emory Johns Creek Hospital for women to talk with physicians and other providers in the Johns Creek and North Atlanta communities and learn about services near them.

At the Emory Orthopaedics, Sports & Spine table, Drs. Hammond and Olufade spoke with women about potential injuries that could occur from wearing high heeled shoes and what women might be able to do to help prevent injuries to their backs, ankles, feet, hips and knees.

As a fun activity at the Ladies Night Out event, we also had a free drawing for high heeled shoes that were displayed at the table.  Five lucky women went home with a new pair of shoes and lots of tips to prevent orthopedic injuries.

Emory Orthopaedics and Spine Team at the Ladies Night Out Event
Below are 5 orthopedic conditions or injuries related to wearing high heels and tips on how you can prevent them:

ACHILLES TENDINITIS

Symptom: Pain & swelling in lower calf and heel cord resulting in decreased calf flexibility

Achilles Tendinitis Prevention:

  •  Calf stretches with towel or band
  • Calf raises / strengthening exercises
  • Heel pads
  • Wear short heels or flats

ANKLE SPRAIN / FRACTURE

Symptom: Pain, bruising, swelling and inability to walk

Ankle Sprain & Fracture Prevention:

  • Wear short, wide heels (no stilettos)
  • Single leg balancing
  • Ankle ‘A, B, Cs’

BUNIONS

Bunion Symptom: Tenderness and prominence inside of the big toe joint

Bunion Prevention:

  • Ensure proper shoe size & fit
  • Wear short heels with wide toe box
  • Use pads to cushion bunions
  • Wear heels for brief periods of time if possible

KNEE AND HIP INJURIES

Symptom: Muscles in your hip and knee have to work harder when you wear heels as muscles become fatigued and more prone to injury

Possible Injuries:

  • Muscle strain
  • Tendinitis
  • Meniscus tear
  • Hip impingement

Hip & Knee Injury Prevention:

  • Stretch hamstrings, quads, & hip
  • Strength training for lower body
  • Alternate heels with flats during the work week
  • Balance exercises

LOW BACK PAIN

Low Back Pain Causes: Normal center of gravity changes, increasing the curvature of your low back and tilting your pelvis forward.

Low Back Pain Prevention:

  • Change into flats for long walking distances
  • Strengthen your core (crunches & low back extension exercises)

Although high heels look nice and are fun to wear at special events, try to limit the high heels to special occasions and stick with flats for your day to day activities.  Your body will thank you!

About Dr. Kyle Hammond

Dr. Hammond is an orthopaedic surgeon new to the Emory Orthopaedics faculty.  He recently completed his fellowship at the University of Pittsburgh Medical Center.  While at the University of Pittsburgh he was the Associate Head Team Orthopaedic Surgeon for both the Duquesne University Football team and the University of Pittsburgh Men’s Basketball team.  He also worked as a Team Physician for the Pittsburgh Steelers, the Pittsburgh Penguins, the University of Pittsburgh athletics, Robert Morris College athletics, as well as the Pittsburgh Ballet.

Dr. Hammond sees patients at Emory Johns Creek Hospital, as well as Emory Orthopaedics & Spine Center in Atlanta.  Dr. Hammond has a special interest in the overhead/throwing athlete, ligament injuries to the knee, Tommy John surgery, joint preservation surgery, and is one of the few fellowship trained hip arthroscopists and concussion specialists in Georgia.

About Dr. Oluseun A. Olufade

Dr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Sports Medicine and Interventional Pain 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 employs a comprehensive approach in the treatment of  sports related injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in concussion, 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 Emory Johns Creek Hospital.

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 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

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Is an Epidural Right for my Back or Neck Pain?

More than 90% of people with back or neck pain find relief through non-operative treatment. Some patients will benefit from physical therapy or treatment at a pain management center while others may need an injection or series of injections to help decrease their pain.

How do I know if a spinal injection is right for me?

Epidural Steroid Injection Back Pain

This is a difficult question to answer because not all patients are candidates for spinal injections. Some conditions are better treated with surgery while other conditions are more appropriately treated with conservative treatment including spinal injections.

Depending on the type and severity of your back or neck pain, your physician may recommend a spinal injection. The type of injection you receive is based on your specific symptoms and the physical exam performed by your physician.

What is an epidural steroid injection & how can it help my back pain?

A common injection that we perform is the epidural steroid injection. This type of injection is used to relieve radiating pain down the arm or leg. The medicine used in the injection is a mixture of long-acting anti-inflammatory steroid and numbing medication. During the injection, the physician will position you on the table and then perform the injection with the help of x-ray guidance to ensure the injection is given in the correct place.

Most patients will notice a decrease in pain within 2-3 days, but some may take 1-2 weeks to notice the benefit of the injection. Depending on your spine condition, your physician may recommend a series of epidural steroid injections. Your physician will discuss the treatment plan with you.

Epidural steroid injections are commonly administered without problems, but there is always a slight risk whenever you have an invasive treatment.

Recently, a serious concern has been raised in the national medical community regarding the use of contaminated steroids causing an infection of the spine called spinal meningitis. Fortunately, at Emory Spine Center we have always carefully selected the pharmacies we use to supply all of our medications, including the steroids used for injections. Only those suppliers with best quality control have been chosen. Clearly, the end result has been beneficial as none of our patients received contaminated steroids.

It is important to remember that serious complications like the one discussed above are extremely rare. Please visit our website to learn about the other spinal injections we perform.

About Dr. Jose Garcia-Corrada

Dr. Jose Garcia-Corrada

Dr. Garcia-Corrada is an Assistant Professor in the departments of Orthopaedics and Physical Medicine & Rehabilitation at Emory University School of Medicine. He specializes in non-operative spine care and focuses on helping patients achieve their best functional level. Dr. Garcia started practicing at Emory in 2001.

 

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Novel Treatment Option for Chronic Low Back Pain

Back pain treatmentMore than 80% of the population will at some time have problematic low back pain. Typically these episodes of low back pain improve with time, but some people have persistent issues. In fact, it is estimated that over 6 million people in the US have chronic low back pain that persists for at least three months.

The CDC’s National Center for Health Statistics suggests that chronic low back pain is a leading cause of chronic pain. The total cost of low back pain is estimated to be between $100 billion and $200 billion annually. Much of this cost is related to decreased wages and productivity.

Studies suggest that discogenic pain, a painful degenerative disc, is the most common source of chronic low back pain. Unfortunately, there is no great treatment for painful degenerative discs and both conservative and surgical options often fall short in helping people with this issue.

Research at the Emory Orthopaedics & Spine Center

The Emory Orthopaedics & Spine Center has been a part of an exciting research study that evaluated the injection of stem cells into a patient’s painful degenerative disc. In the study, stem cells called mesenchymal precursor cells that come from bone marrow were injected into a painful degenerative disc.

The early interim analysis of this study is promising. At six months out, a single low dose injection of stem cells led to an average reduction in back pain of 69%. Additionally, 71% were considered to be a “treatment success” as defined by clinically significant improvement in pain and function. Both of these findings were significantly better than controls.

These are only preliminary results but it does provide optimism for a major condition that has been difficult to treat. We are not recruiting patients for this trial but another follow up study may start in a year.

If you are suffering from back or neck pain, you’ll find the comprehensive spine care you need at the Emory Spine Center in Atlanta, Georgia. At Emory, we have the most highly trained spine specialists in the country working together to diagnose and treat spinal disorders. You can call us at 404-778-7000 for appointments. We are on the web at http://www.emoryhealthcare.org/spine/

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About Dr. Beckworth

Dr. Jeremy BeckworthDr. Beckworth is board certified in Physical Medicine & Rehabilitation (Physiatry), Electrodiagnostic Medicine and Pain Medicine. Dr. Beckworth has won multiple teacher of the year awards for the Department of PM&R residency program. He is a section editor for Spineline, a publication of the North American Spine Society. Dr. Beckworth started practicing at Emory in 2007. He has been involved in various research studies. A recent study dealing with anomalous location of the vertebral artery won “best basic science study” at the 20th Annual Scientific Meeting of the International Spine Intervention Society. He has been invited as a board examiner for the American Board of Physical Medicine and Rehabilitation.

Atlanta Opera Violinist Back on Her Feet Thanks to Emory Orthopedists!

Fia Mancini Durrett, Atlanta Opera Orchestra Violinist and Emory patient, recently played her violin for Emory Sports Medicine physician Sam Labib, MD and his clinic staff. Fia made a deal with Dr. Labib that if he could help rid her of foot and back pain, she would play her violin for him in clinic.

Dr. Labib held up his end of the deal, so on her last visit to the Emory Orthopaedics & Spine Center, Fia brought her violin along.

Patient Video Story: Back to Life after Spinal Tumor Surgery

Spine Tumor Patient Story VideoDoug House is an Emory Spine Center patient who had a large spinal tumor. Doug was in pain for over 10 years and had several problems performing basic daily activities including walking, sleeping, and controlling his bladder. He thought he would live the rest of his life unable to perform basic life functions. Doug was referred to our team at the Emory Spine Center and now is back to his old self and able to enjoy life again.

Watch Doug’s incredible story in the video below and learn more from Emory physicians Dr. Gerald (Rusty) Rodts and Dr. Daniel Refai on what makes spinal tumor treatment at Emory different.

Does Your Child Have Hip or Spine Problems? Chat Live with Dr. Fletcher!

Pediatric Orthopedic ChatDid you know that children can be affected by a wide array of orthopaedic hip and spine issues? Scoliosis, kyphosis, hip dysplasia, leg length differences and femoroacetabular impingement are just a few of the conditions our team sees most commonly from pediatric patients. These conditions can lead to time away from school and chronic pain and disability later in life.

Join Emory Pediatric Orthopaedic surgeon, Dr. Nicholas Fletcher, for a live interactive web chat on Tuesday, February 5 at noon to get all your questions about symptoms, causes and the newest treatment options for pediatric orthopedic hip and spine conditions answered! See you there!


Sign Up for the Chat


About Dr. Fletcher
Dr. Nicholas FletcherDr. Fletcher takes care of all pediatric orthopaedic trauma, neuromuscular disorders, leg length differences, foot conditions, and angular deformities of the lower limbs. In addition, the management of pediatric spinal and hip conditions are particular areas of expertise. Dr. Fletcher also specializes in pediatric and young adult hip conditions including hip dysplasia, femoroacetabular impingement (FAI), perthes disease, avascular necrosis, and slipped capital femoral epiphysis. He is one of only a handful of surgeons in the southeast with expertise in the Ganz or periacetabular osteotomy (PAO) for hip dysplasia and the modified Dunn osteotomy for slipped capital femoral epiphysis. He takes care of children of all ages with hip conditions in addition to young adults with hip dysplasia and impingement.

Understanding the Potential Benefits of Physical Therapy

National Physical Therapy MonthThe American Physical Therapy Association (APTA)’s National Physical Therapy Month (NPTM) is celebrated each October as a way to bring awareness around the potential health benefits to be sustained via physical therapy. Over 90% of back and neck problems, for example, will resolve themselves without surgery, and for some patients, there are unique benefits achieved from treatment by a physical therapist.

Physical therapy is a form of treatment—practiced by a licensed physical therapist under the referral of a physician. The purpose of physical therapy is to improve and/or restore mobility in patients for whom it is limited due to a medical condition, surgical procedure, accident or fall, neurological disease or other medical condition that has limited a patient’s functional mobility.  Often the injury limits the performance of everyday tasks.

Physical therapy programs at Emory Healthcare are available to support every type of mobility and functionality issue patients may experience. Whether a patient’s functional mobility issues relate to a neurological occurrence like a stroke, or an athletic injury like a torn ACL, our physical therapists available on both an inpatient and outpatient basis are here to help.

For more information on our physical therapy programs, including information on our department of Rehabilitation Medicine, please visit the links below.

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