Posts Tagged ‘back pain’

How Cell Phone Use Impacts Our Neck Over Time

neck-illustrationTechnology has become an incredibly integral part of our lives. As it has adapted and changed, so have humans in the 21st century; we’re constantly on our smartphones—texting, calling, checking our Facebook updates, often for hours every day—and it may have a significant detrimental effect on our bodies.

The average human head weighs between 10 and 12 pounds in a neutral position–when your ears are over your shoulders. But as the neck bends forward and down, the weight on the cervical spine (neck) begins to increase, causing stress. According to a study in 2008, if you lean 15 degrees forward, it’s as if your head weighs 27 pounds. If you lean 30 degrees, it’s as if your head weighs 40 pounds. If you lean 45 degrees, it’s 49 pounds. When you’re hunched over at a 60 degree angle, like most of us are many times throughout the day, you’re putting a 60 pound strain on your neck.

So what does this mean for your spine? This pressure can put a lot of stress on your neck and spine, pulling it out of alignment. Over time, this poor posture can lead to disc herniations, pinched nerves, metabolic problems, degeneration and even spine surgery. Think about the effect of 60 pounds for a moment – it’s the equivalent 5 bowling balls weighing 12 pounds or an eight year old child hanging around your neck.

While it is nearly impossible to avoid the technologies that cause these issues, there are some simple steps we can take to take this strain off of our necks. A few easy fixes include:

  • Take frequent breaks while using any mobile device or desktop computer.
  • Practice exercises to help you build strength, such as standing in a doorway with your arms extended and push your chest forward to build muscles that help posture.
  • Be mindful of your posture – keep your neck back and your ears over your shoulders.
  • Look down at your mobile device with your eyes without bending your neck.

In short, continue to enjoy the incredible benefits of your smartphone, but remember to keep your head up!

About Dr. Refai

refai-danielDaniel Refai is the director of spinal oncology at the Emory Orthopaedics & Spine Center. Dr. Refai focuses on both intradural and extradural spinal tumors as well as metastatic and primary tumors of the spine. He performs complex spine tumor surgery and spine reconstruction surgery. He also directs the stereotactic radiosurgery division of the Emory Orthopaedics & Spine Center for spine tumor treatment. Dr. Refai’s research interests include outcome analysis following surgery and radiosurgery for spine tumors. He has published extensively on the treatment of spinal disorders and has developed innovative multidisciplinary approaches for treatment. H  e is a member of the American Association of Neurological Surgeons, Congress of Neurological Surgeons, and the North American Spine Society.

Dr. Refai completed neurosurgical residency at Washington University in Saint Louis under the tutelage of Ralph Dacey MD. He spent six months as a specialist registrar in neurosurgery at Beaumont Hospital in Dublin, Ireland. He completed a combined orthopaedic and neurosurgery spine fellowship at the Cleveland Clinic under Edward Benzel MD, Iain Kalfas MD, Gordon Bell MD, and others. He specializes in all aspects of complex spine surgery and is actively in clinical research. Dr. Refai enjoys teaching and has received numerous patient and medical education distinctions throughout his training.volved in clinical research. Dr. Refai enjoys teaching and has received numerous patient and medical education distinctions throughout his training.

Sources:

[1] Hansraj, Kenneth. “Assessment of Stresses in the Surgical Spine Caused by Posture and Position of the Head.” https://cbsminnesota.files.wordpress.com/2014/11/spine-study.pdf

 

“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.

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

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.

 

Related Resources:

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/

Related Resources:

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.

8 Types of Low Back Pain that Mean You Should Visit Your Doctor

Back pain warning signOver 80% of the population will suffer from lower back pain at some point in their lives. Low back pain is a common complaint in medical offices and is a common issue causing many people to miss work and be unable to participate in daily life activities. Sometimes back pain is due to a pulled or strained muscle and many times will not require a trip to your doctor’s office. Other issues such as fractures, tumors and infections of the spine are very serious and need to be evaluated by a physician promptly.

Patients should see a doctor immediately if they experience low back pain as a result of severe trauma. Patients should also make an appointment with a doctor if low back pain is accompanied by any of the following: fever, loss of bowel or bladder control, serious trauma, numbness, unplanned weight loss, personal history of cancer, back pain that persists more than 6 weeks, or severe night pain.

Fever and Back Pain
Fever combined with back pain can indicate an infection in your kidneys or back. A primary care physician can determine if you need antibiotics to eliminate the infection.

Loss of control of your bowel or bladder and Back Pain
If you have back pain along with new incontinence, you could have a serious back condition causing pressure on the nerves that requires immediate medical care.

Serious Trauma and Back Pain
Trauma such as a car accident or falling down a flight of stairs can cause a fracture in your back. Seek immediate care from your physician or the emergency department.

Numbness or Tingling in Leg and Back Pain
Numbness on tingling in your leg and back pain could indicate nerve irritation or nerve damage. You could have a herniated disc or spinal stenosis. A doctor can prescribe medications, treatments or even surgery to help relieve the pressure on the nerves.

Unexplained weight loss and Back Pain
If you lose a lot of weight without changing your diet or activity level and have back pain, a doctor should order imaging and blood work to check for cancers or hormonal disorders.

History of Cancer and New Back Pain
If you have had cancer, onset of back pain could be a sign that cancer has spread to you spine. You should visit your physician for further evaluation.

Back Pain at Night
Pain in your back that causes you to lose sleep should not be dismissed. This could be a sign of spinal tumors or even cancer.

Back pain that lasts more than 6 weeks
Any pain that lasts more than a month or two should be evaluated more fully.

If you experience significant trauma and back pain, an evaluation in the Emergency Department is indicated. In most other cases, your primary care physician can evaluate your condition and begin treatment. . If he or she is unable to help with your condition he can refer you to a spine specialist.

For more information about low back pain, visit Spine-Health.com. Our spine physicians at Emory regularly contribute content to this website for not only our own patients, but for anyone searching for spine information.

Dr. Susan DreyerAbout Susan Dreyer, MD
Dr. Dreyer is an Associate Professor in the departments of Orthopaedics and Physical Medicine & Rehabilitation at Emory University School of Medicine. Dr. Dreyer specializes in non-operative spine care and focuses on helping patients achieve their best functional level. She has taught many national and international courses on spine care and spinal injections for sciatica and other causes of back and neck problems. She is also active in several professional societies. Dr. Dreyer started practicing at Emory in 1992.

 

Related Resources:

Are You One of the 7 Million in the U.S. Affected by Scoliosis?

Scoliosis, or a curvature of the spine, is a condition that affects almost 7 million people in the U.S. While it does occur in adults, it is most commonly seen in children, especially girls, during periods of growth. Although the deformity is complex and 3-dimensional, often times the spine in a person with scoliosis looks like an “S” or a “C” instead of a straight line.

Scoliosis

Adolescent scoliosis is the most common spinal deformity affecting pre-teens and teenagers, however it does not always result in significant pain or discomfort. Scoliosis may also occur in younger children and is often referred to as early onset scoliosis (EOS) in children less than five years old. EOS may significantly worsen as the children grow and cause severe spinal deformity and problems with the lungs or other internal organs.

Signs & Symptoms of Scoliosis

  • Uneven musculature on one side of the spine
  • Uneven hips, shoulders, or legs
  • Difference in the chest or breast area
  • Slowed nerve action (in some cases)

Causes of Scoliosis

About 65% of scoliosis cases are from unknown causes. Congenital scoliosis (caused by abnormally shaped vertebrae) accounts for about 15% and the rest is speculated to be caused by neuromuscular disease. Some researchers think genetics may play a role in who develops scoliosis, but it is not completely understood at this point.

Scoliosis Treatment Options
At Emory, we typically use non-operative treatments to minimize the worsening of scoliosis before we consider surgical treatments. Surgery is typically reserved for more severe cases of scoliosis. The vast majority of adolescent scoliosis can be managed with non operative measures including careful observation or spinal braces. Our surgeons have access to many local orthotics groups allowing for accurate and effective bracing for scoliosis.

Emory’s Experience in the Treatment of Scoliosis
Emory Healthcare orthopaedic surgeons have tremendous experience in caring for children of all ages with scoliosis. Our physicians are also unique in that they provide care to patients with scoliosis of all ages. When combined with our adult spine center, Emory is the only center in Georgia capable of treating patients from infancy into adulthood.

Emory pediatric orthopaedists Dr. Robert Bruce, Jr. and Dr. Nicholas Fletcher have extensive experience with growing rod and Vertical Expandable Prosthetic Titanium Rib (VEPTR) for the management of severe scoliosis in young patients. These techniques allow for continued growth of the spine in younger children to allow normal development and function. Emory is also one of the few centers in this region offering Mehta casting which is a non-surgical treatment in which the doctor manipulates the spine and then places the child’s torso in a plaster cast. This is especially useful for young children with early onset scoliosis and has been found to actually correct the curvature in certain patients.

Scoliosis Research On the Horizon
Our physicians have been involved in research evaluating opportunities to maximize scoliosis care in children of all ages and assess the long term outcomes of scoliosis surgery. Our research has been presented locally, nationally, and internationally in places as far away as Japan. Dr. Fletcher’s research has focused on clinical outcomes following scoliosis surgery including one of the longest term follow up studies on modern surgical treatment ever published.

Drs. Bruce and Fletcher are currently heading a study highlighting our post operative care following scoliosis surgery which has resulted in discharge 50% faster than the national average without any difference in complications allowing for early return to school for children and work for their parents. Another study is examining discrepancies in access to healthcare and the impact this may have on scoliosis severity.


Dr. Robert Bruce, Orthopedic SurgeonAbout Dr. Robert Bruce, Jr.
Dr. Bruce has been a fixture in the Atlanta community for 17 years having started practicing at Emory in 1995. His interests in spinal conditions include caring for all forms of pediatric spinal problems with an emphasis on idiopathic scoliosis and scoliosis in patients with cerebral palsy and other neuromuscular disease.

He is the director of the Children’s Healthcare of Atlanta (CHOA) cerebral palsy program and has a tremendous experience caring for all types of orthopaedic conditions in children with cerebral palsy from the spine to the hips to the feet. Dr. Bruce is also specialty trained in Ilizarov and the treatment of leg length differences and angular deformities. Outside of his clinical duties, Dr. Bruce serves on the CHOA medical board, is the past medical director of Egleston campus, and is currently the head of the orthopaedic team at Egleston hospital.

Dr. Nicholas FletcherAbout Dr. Nick Fletcher
Dr. Fletcher has been practicing at Emory since 2010 and cares for all forms of pediatric spinal problems including adolescent scoliosis, neuromuscular scoliosis, congenital scoliosis, early onset scoliosis, kyphosis, and spondylolisthesis.

He also has spoken locally, nationally, and internationally on his research in scoliosis. His work on adolescent scoliosis has been presented as far away as Japan and he has published multiple studies on early onset and adolescent scoliosis. His current research on comparing spinal casting and growing rod surgery was recently nominated as a top 10 podium presentation at the Pediatric Orthopaedic Society of North America meeting. He also received the 2010 T. Boone Pickens Award for Spinal research for his research in Adolescent Idiopathic Scoliosis.

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.
emoryhealthcare.org/orthopaedics

Backpack Awareness: Tips to Help Kids Avoid Backpack Pain & Injuries This School Year

Backpack AwarenessIf you have a child who’s middle-school age or older, you’re very aware of their overloaded backpack. Or maybe you’re in school and suffering from overly weighty textbooks. Whoever carries the load in your family, it’s time for everyone to take the backpack seriously.

Heavy backpacks and book bags cause back, neck, and shoulder pain and injury. It’s a fact. That’s why the American Occupational Therapy Association, Inc. (AOTA) instituted the third Wednesday in September – this year, it’s September 19th – as National School Backpack Awareness Day™.

Consider these facts from AOTA:

  • More than 79 million children in the U.S. carry school backpacks.
  • More than 2,000 backpack-related injuries were treated in ERs, clinics, and doctors’ offices in 2007 alone.
  • About 55% of students carry a backpack that is heavier than the recommended guideline of 10% of the wearer’s body weight.

That’s right. A loaded backpack should never weigh more than 10% of the wearer’s bodyweight (15% at absolute max). That means a 100-pound child’s backpack shouldn’t weigh more than 10 pounds. You’re thinking, “Try telling that to my kid’s teacher!” right? Well, there are some steps you can take to improve your child’s lot. Take a moment and share these back-saving tips:

  1. Choose the right bag. School backpacks are sized according to age group, so be sure to get one that’s not too big. Choose a light-weight bag with wide, well-padded shoulder straps, a padded back, and a waist strap. Avoid leather shoulder straps, as they add unnecessary weight. If you know your load is going to exceed the 10% rule on a regular basis, get a bag with wheels. Don’t risk injury.
  2. Pack your bag properly. Load the heaviest items first, so they’ll be closest to your back, and arrange books and materials so they don’t slide around. Pack only what’s necessary. Do you really need that laptop? If not, leave it out. If you have to, carry a book or two by hand to avoid breaking the 10% rule.
  3. Carry your bag correctly. Always wear your backpack on both shoulders and wear the waist belt, so that the weight is distributed evenly. You may think it looks cool to sling your pack over one shoulder, but you’re putting your back at risk for injury. Adjust the shoulder and waist straps so that the pack fits snugly. The backpack should rest evenly in the middle of the back and should never be more than 4 inches below the waistline (if it’s hitting your bottom, it’s too low).

As the school year gets going, pay attention to your child’s load. If your child is struggling to get the backpack on or off, complains of back pain, or has to lean forward to carry the pack, it’s probably too heavy. And carrying an overloaded backpack shouldn’t have to be a childhood rite of passage.

Do you or your child carry a heavy backpack to class? How do you handle the load? We welcome your questions and feedback in the comments section below.