Posts Tagged ‘back pain’

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

May 23rd, 2013 By Emory Orthopaedics & Spine Center

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.

 

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

December 13th, 2012 By Emory Orthopaedics & Spine Center

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

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

September 18th, 2012 By Emory Orthopaedics & Spine Center

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.

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3 Things You Can Do Now to Prevent Future Back Pain

July 5th, 2012 By Emory Orthopaedics & Spine Center

At some point in our lives, most of us struggle with lower back pain. The good news is it’s never too late to make positive changes in your lifestyle. Preventive steps now can help keep your back healthier down the road.These three things may make the difference between future suffering and living pain free:

1. Get active. Staying active may be the single most important thing you can do to maintain a healthy back. When you don’t get enough exercise, the muscle tone in your lower back can weaken, which may cause the pelvis to tilt too far forward, causing back pain. Regular exercise helps prevent back pain by strengthening your back and abdominal muscles. Just 30 minutes a day of a low-impact exercise like swimming, walking, or stationary cycling can increase muscle strength and flexibility. Yoga is also great for stretching and strengthening muscles and improving posture. If you’re already experiencing back pain, you may want to meet with an Emory physiatrist or physical therapist, who can customize an exercise plan for you.

2. Lose weight. If you’re overweight or obese, chances are you already experience back pain. One of the best things you can do now to ease pain and prevent future back pain is to lose weight. Being overweight or obese affects not only the cardiovascular and endocrine systems but the skeletal system. The skeletal system is made to support a healthy weight. Obesity puts an extra strain on all your weight-bearing joints, such as the hips and knees, but also on the spinal column. The resulting poor posture can cause chronic back pain.

3. Stop smoking. If you’re a smoker, you already know it’s not healthy. But you may not have realized it can contribute to back problems, not just later in life, but now. Many of the chemicals in cigarettes, including nicotine, have been shown to be toxic to spinal disc cells in laboratory experiments. Also, the carbon monoxide in cigarettes decreases the amount of oxygen in the blood. Because spinal discs have no capillaries, they rely on osmosis for oxygen delivery. Without oxygen-rich blood, the discs don’t get the nutrients they need, making them brittle and at risk for rupture.

Do you suffer from back pain? If so, what treatments have worked best for you? We welcome your questions and feedback in the comments section below.

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Can Yoga “Wreck” Your Body? A Physical Therapist’s Perspective

January 26th, 2012 By Emory Orthopaedics & Spine Center

Emory’s David Pasion, MPT, physical therapist at the Emory Orthopaedics and Spine Center was recently interviewed by the team at CNN in response to a recent article in the New York Times titled, “How Yoga Can Wreck Your Body.”

yoga physical therapist perspectiveAs Pasion put is, “Reading that article, if somebody wasn’t familiar with yoga or let’s say they were planning on doing yoga, if they read that article, they’d say, let me find something else to do. And so, in that aspect, no, I don’t think it was fair. There was too many negatives thrown out.”

While David Pasion agrees that it is possible to sustain injuries while practicing yoga, he also believes the article was “alarmist” and lacked context to present a fair assessment of the health benefits and risks of practicing yoga.

To get David’s take on the article and potential risks of participating in yoga, check out the video from CNN below:

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Could Yoga be the Solution for Your Chronic Low Back Pain?

November 28th, 2011 By Emory Orthopaedics & Spine Center

Yoga for Low Back PainIn September, we shared with you some resources on the health benefits of practicing yoga, in honor of Yoga Awareness Month. Make sure to check that resource out, as a new study has recently found that participating in weekly yoga classes is equally as effective as regular deep stretching in relieving symptoms of low back pain. The study, from which findings were published in the Archives of Internal Medicine, followed over 200 people for up to 26 weeks, making it the largest study focusing on yoga’s effect on low back pain.

Of the 228 followed, subjects participated in weekly classes in which they practiced either yoga or deep stretching and also practiced the same thing at home, with the help of instructional CDs 7 DVDs for 20 minutes, at least 3 days a week. The outcomes for the group who practiced yoga and the group who practiced deep stretching in classes were compared to a “control” group, whose members were given a book with tips and best practices for relieving chronic low back pain. The results of the study showed that both yoga and deep stretching were equally as useful in easing or relieving low back pain, as long as either the yoga or stretching were practiced regularly.

Couple these results with the fact that 80% of people will suffer from low back pain at some point in their lives with the fact that Americans spend at least $50 billion each year on low back pain 1 and it becomes obvious that yoga could evolve to be an easy and fairly cost-effective method for alleviating chronic low back pain with potential to be as beneficial for improving pain as it is for reducing stress and improving flexibility and breathing.

Has your low back pain been improved by practicing yoga? If so, we’d love to hear from you in the comments below!

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Is Your Desk Job Hurting You?

September 14th, 2011 By Dr. Diana Sodiq

Neck Back Pain Desk Job PostureThese days, more and more jobs are desk jobs, meaning many people spend a minimum of eight hours a day behind their desks and at their computers. I frequently see patients with neck and back pain with no specific injury, but who spend many hours behind a computer. This type of work can have a number of health implications, including muscle and joint pain.

If you’re a desk jockey, one of the easiest things you can do to prevent pain from a poor workstation set-up is to have an ergonomic setup designed just for you. You want your chair and work station to fit you properly. Here are a few tips to help get you started:

  • Be sure your body is properly aligned with your desk and your computer. You should be able to sit straight in front of your computer and not have to turn from side to side to access it.
  • Keep your head, neck, and torso in line, and keep your arms and elbows close to your body but within reaching distance of your keyboard. You shouldn’t have to reach forward to use your keyboard.
  • While typing, your elbows should be at a 90-degree angle from your body, and your wrists and hands should be in a straight line, with your wrists in a neutral position, not arched or bent.
  • To prevent back pain, be sure your chair has good back support.
  • When you’re sitting, your thighs should be parallel to the ground or a little higher than your knees, and your feet should touch the ground. You don’t want the end of chair hitting the back of your knees—you want a little gap there.

Neck pain is a common complaint of people who spend a lot of time on the phone. If you find yourself cradling your phone between your shoulder and chin so you can type and talk at the same time, switch to a headset or use a speaker phone.

Don’t forget to get up and move around regularly throughout the day. If you feel pain during your work day, stretching and moving around can help ease that pain, as can a heating pad or ice pack. You may even find some relief by treating yourself to a massage at one of the many Atlanta spas. I always tell each patient to listen to your body. If you are having pain, your body is trying to send you a message. If you are having neck or back pain that isn’t improving after trying the tips above, make an appointment with an Emory Spine physiatrist for further evaluation and treatment.

Do you spend a lot of time behind a desk? What do you do to get moving and ease pain? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About Diana Sodiq, DO:

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

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When Does Back Pain Call for an Epidural Steroid Injection?

September 1st, 2011 By Susan Dreyer, MD

Back pain epidural steroid injectionAs a physiatrist at the Emory Orthopaedics & Spine Center, I diagnose and treat back pain non-operatively, and one of the questions I’m asked most often by patients is whether they’re candidates for an epidural steroid injection.

If you have spinal pain, whether in your neck or back, your doctor will ask you whether it’s axial pain or radicular pain. Axial pain does not radiate into the arms or legs—it’s localized in one area. Radicular pain does radiate into the arms or legs. Axial pain typically is treated conservatively, with pain medication and exercise, and does not benefit from an epidural injection. However, if you have radicular pain and conservative measures haven’t helped, you may be a candidate for an epidural steroid injection.

In most cases, radicular pain is caused by one of two conditions—a herniated disc or spinal stenosis. Herniation is when a piece of the disc becomes disclocated, or slips, and presses on a nerve. This is more common among middle-aged patients, and 80% of patients with a herniated disc will get better over time without intervention. Disc herniations shrink as the body naturally self-heals. However, an epidural steroid injection can ease the pain and make the healing process more comfortable.

Spinal stenosis usually is caused by the natural wear and tear on the spine that comes with aging. Most patients with stenosis are 65 or older. Stenosis is degenerative and can lead to spinal nerve root compression or bony stenosis, which can cause pain, numbness, and weakness. While spinal stenosis may eventually require surgery, an epidural steroid injection can be a good temporary measure if you’re not quite ready for surgery or are not a candidate.

At Emory, we used different injection techniques depending on the condition. An interlaminar epidural is similar to the epidural a pregnant woman may opt for before giving birth. In this case, the goal is to introduce the steroid around the nerve root to decrease inflammation, which, in turn, eases pain. A transforaminal epidural is a more selective injection in which we target a specific nerve root that may be compressed by a herniated disc or a bone spur. Your doctor will decide which technique will benefit you.

In most cases if you have back or neck pain, your first step should be to try conservative pain-relief measures. However, when pain medication and exercise don’t help, and you’re suffering from radiating pain, an epidural steroid injection may be a good solution. An Emory physiatrist can work with you to diagnose your pain and set you on the right course of treatment.

Have you had an epidural steroid injection for back pain? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below. If you’re interested in learning more, we have some great information on epidural steroid injections for back pain our website.

About 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.

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