Posts Tagged ‘back pain’

The Importance of a Second Surgical Opinion

spine-second-opinion-squareIf you’re one of the 13 million Americans suffering from back pain, neck pain or sciatica (pain running down your leg), your doctor may recommend surgery to relieve your discomfort.

While surgery can be life-changing for the better, it certainly isn’t a decision to be taken lightly. Surgery comes with its own risks and doesn’t always solve the problem. It may even introduce new ones.

You should get a second opinion before you have surgery. Don’t worry about offending your doctor. Second opinions are common practice. It can give you peace of mind that you’re making the right decision, especially if that decision is to go through with surgery.

Questions to Ask your Doctor

Before you jump into surgery, be sure to ask:

  • What is the likelihood of success?
  • What is the possibility of residual or worsened symptoms?
  • What are the risks of anesthesia?
  • What are the risks of spine surgery?
  • What is the chance of recurrence of my symptoms in the future?
  • What will happen if I don’t have surgery?

Rethinking Surgery

The good news is that most cases of back and neck problems can be resolved without surgery. In fact, spine surgery is only absolutely needed in a small percentage of cases.

If pain is the only symptom, then surgery is almost always elective, and the decision to proceed is based on weighing the risks versus potential benefits.

Surgery is usually the best option for severe weakness due to nerve or spinal cord compression; however every case is unique. Every patient has a different set of symptoms, exam findings, medical comorbidities (other health disorders) and life goals that drive the decision-making process.

Weighing the Options

Fortunately, most of the patients seen at the Emory Spine Center can be treated with less invasive treatments such as physical therapy, spinal injections or tweaking lifestyle choices that affect spine health. Usually surgery should only be considered once the conservative therapies have been exhausted. If you haven’t already, be sure to talk to your doctor about nonsurgical treatment options for your condition.

The decision to have surgery for most people with back or neck problems usually comes down to your lifestyle goals and desired quality of life.

For example, some people don’t mind living with a certain amount of pain and are content to manage it with anti-inflammatory medications. They can function well through day-to-day tasks and are willing to give up some activities, like running, in favor of lower impact exercise like walking. For them, they may feel the investment and risk of surgery isn’t worth it.

Other patients at this same level of discomfort may prefer to have surgery in hopes of less pain and more mobility. For some people, pain may interfere with daily tasks like doing the laundry or even just getting in and out of the bathtub. They may feel the potential benefits of surgery far outweigh the risks.

If your pain and other symptoms keep you from doing the kinds of activities you enjoy, and less invasive treatments haven’t helped you achieve your health and lifestyle goals, surgery might be a reasonable choice.

We Can Help

If you have been told you need surgery and would like a second opinion, then the Emory Spine Center is a great place to start. We will review your current imaging and obtain any necessary X-rays the same day. Once your records are reviewed and a history and physical exam are performed, we will give our own opinion on the best course of action. This will give you peace of mind that you are making the right choices for you and your family.

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About Dr. Gary

gary-matt-webMatthew Gary, MD, attended medical school at the University of Florida where he was inducted into Alpha Omega Alpha for academic excellence.  Following medical school, he completed residency training in neurological surgery at Emory University. During his residency, he gave numerous presentations at local and national neurosurgical society meetings and received research awards at the Congress of Neurological Surgeons and Georgia Neurosurgical Society.  He went on to complete a complex and minimally invasive spine fellowship at the University of Miami/Jackson Memorial Hospital under the tutelage of Drs. Barth Green, Allen Levi and Michael Wang.  He is interested in all facets of spine health and maximizing patients’ quality of life with a focus on minimally invasive spine surgery.

Using Heat and Cold to Treat Injury

back-painIt’s hard to get through life without straining a muscle, spraining a ligament, or wrenching your back. When something hurts, ice and heat are often the go-to solutions, and using temperature therapy to complement medications and self-care can be very effective. But while both heat and cold can help reduce pain, it can be confusing to decide which is more appropriate depending on the injury. Our tips below give you the facts on when to use (and not use) heat and cold therapies.

When to Use Cold Therapy

Cold is best for acute pain caused by recent tissue damage is used when the injury is recent, red, inflamed, or sensitive. The inflammatory process is a healthy, normal, natural process that also can be incredibly painful. Here are some examples of common acute injuries:

  • Ankle sprain
  • Muscle or joint sprain
  • Red, hot or swollen body part
  • Acute pain after intense exercise
  • Inflammatory arthritis flare ups

When you sprain something, you damage blood vessels causing swelling to occur. Applying something cold causes the blood vessels to constrict, reducing the swelling and limiting bruising. Cold therapy can also help relieve any inflammation or pain that occurs after exercise, which is a form of acute inflammation. However, unlike heat, you should apply ice after going for a run to reduce post-exercise inflammation.

Tips for Applying Cold

  • Cold should only be applied locally and should never be used for more than 20 minutes at a time.
  • Apply cold immediately after injury or intense, high-impact exercise.
  • Always wrap ice packs in a towel before applying to an affected area.
  • Do not use ice in areas where you have circulation problems.

When to Use Heat Therapy

While ice is used to treat acute pain, heat therapy is typically used for chronic pain or conditions. Unlike cold therapy’s ability to constrict blood vessels, heat allows for our blood vessels to expand and our muscles to relax. That’s why overworked muscles respond best to heat. Heat stimulates blood flow, relaxes spasms, and soothes sore muscles. Some common chronic conditions that heat is used to treat are:

  • Muscle pain or soreness
  • Arthritis
  • Stiff joints

Tips for Applying Heat

  • Unlike cold therapy, heat should be applied before exercising. Applying heat after exercise can aggravate existing pain.
  • Protect yourself from direct contact with heating devices. Wrapping heat sources in a folded towel can help prevent burns.
  • Stay hydrated during heat therapy.
  • Avoid prolonged exposure to heating sources.

Low Level Heat

If you find that heat helps ease your pain, try a continuous low-level heat wrap, available at most drugstores. You can wear a heat wrap for up to 8 hours, even while you sleep.

What to Avoid

Heat can make inflammation worse, and ice can make muscle tension and spasms worse, so be careful. Just like anything else, don’t overdo it! It’s normal for your skin to be a little pink after using cold and heat therapies, but if you start to notice any major skin irritation like hives, blisters or swelling, you should call your doctor. Otherwise, use whatever works for you depending on your condition. Both ice and heat can be very effective if used correctly!

About Emory Sports Medicine Center

At the Emory Sports Medicine Center, our experts specialize in advanced procedures to treat and repair a wide range of sports related injuries. Recently recognized as one of the nation’s TOP 50 orthopaedics programs, Emory Orthopaedics, Sports and Spine has 6 convenient locations across metro Atlanta, as well as 6 physical therapy locations. Click to learn more >>

About Dr. Mines

mines-brandonDr. Brandon Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream, Decatur High School and a team physician for NFL’s Atlanta Falcons. He is also a rotational physician for United States soccer teams.

Dr. Mines enjoys giving talks and lectures regarding the prevention of sports injuries. In fact, as an active member of the American Medical Society for Sports Medicine and the American Society for Sports Medicine, Dr. Mines has attended and presented at various national conferences. Through the years, he has helped all levels of athletes return to the top of their game.

Takeaways from Dr. Boden’s Spine Surgery Chat

Thanks to everyone who joined us Tuesday, August 25, for our live online chat on “When Should You Consider Spine Surgery?” hosted by Scott Boden, MD, director of the Emory Orthopaedics & Spine Center.

If you have been told you need spine surgery, it is important to make sure you have the proper information before electing to have spine surgery. The good news is that less than 10% of patients who experience back or neck problems are actually candidates for surgery.

See all of Dr. Boden’s answers by checking out the chat transcript! Below are a few highlights from the chat:

Question: I have disc degeneration at all lumbar levels, can surgery be performed, if not, what else can be done to relieve pain?

boden-scott

 

Dr. Boden: When there is disc degeneration at all levels and the primary symptom is back pain (and not radiating leg pain), we would typically not suggest surgery. You would have to come in to see a spine specialist to fully address your pain and specific situation, though.

 

Question: If less than 10% of patients who experience back or neck problems are candidates for surgery, why is that?

boden-scott

 

Dr. Boden: The majority of back or neck problems will resolve with time or non-operative treatments such as physical therapy or medications. Only a very small percentage will require or benefit from surgery.

 

Question: Could you walk us through a general sequence of determining whether or not a patient should consider surgery following a disc herniation, PT and epidural steroid injections? Having a hard time sorting out the difference between patience to allow healing and delaying and inevitable surgery now 2 years post injury.

boden-scott

 

Dr. Boden: In general, a disc herniation might need surgery if the primary symptom is radiating leg pain rather than just low back pain.

 

 

The majority of disc herniations – over 90% – resolve on their own within three months. During that time steroid injections, physical therapy and medications can be tried to help relieve pain while the body heals the disc.

If the leg pain persists longer than 3 months than the ideal surgical window is between 3 and 6 months after the leg pain started. You can still get acceptable results after 2 years, but the likelihood of success is slightly smaller.

Watch as Dr. Boden shares more insight into when it’s time to consider back surgery in this Fox5 Atlanta news feature. (Note: this news segment contains advertisements and external links which are not endorsed, administered or controlled by Emory Healthcare.)

At the Emory Orthopaedics & Spine Center, our team of highly-trained spine specialists work together to diagnose and treat cervical spine and lumbar spine conditions ranging from herniated discs to more complex problems such as spinal tumors and scoliosis.

To make an appointment with an Emory spine specialist, call 404-778-3350 or complete our online appointment request form >>

 

 

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.

 

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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.