Frequently Asked Questions
Q: Why do so many people suffer from back pain?
A: With age, our bones and muscles lose tone and elasticity. They become
less able to properly cushion the vertebrae and more likely to spasm or break.
When a spinal disc ruptures or bulges, it places pressure on the surrounding
nerves and results in pain signals traveling to the brain. Other factors such
as smoking, obesity, poor posture and lack of sleep can also contribute to back
Q: How can I avoid back pain?
A: Prevention is the best strategy for coping with back pain and can save a great deal of time and agony. Become an educated health care consumer by learning about effective prevention methods.
Q: How can I incorporate ergonomics into my everyday lifestyle?
A: Applying ergonomics can help prevent repetitive motion injuries such as carpal tunnel syndrome, particularly if you are constantly working at a computer.
Q: What’s the difference between a slipped disc, a bulging disc, a ruptured disc and a herniated disc?
A: All four cases occur when discs become weakened over time and part of a disc is sticking out between the bony parts of the vertebra.
Q: Why is a multidisciplinary approach to spine care so important?
A: By receiving care from spine specialists within multiple
fields, the diagnosis and treatment process is less likely to become
biased or limited. Multidisciplinary care involves a team of specialists
that pools together its expertise for the greatest benefit of the patient.
Surgery is reserved as the last card to be played. As a patient, instead
of being limited to one medical specialty, you can benefit from the
combined expertise of many physicians.
Q: What is physical medicine and rehabilitation (PM&R)?
A: A spine-specialized physiatrist, or physical medicine and rehabilitation doctor, specializes in the nonsurgical management of back and neck pain. PM&R treatment is characterized by comprehensive care that considers the whole person rather than addressing one or two symptoms.
Many doctors provide drugs to mask pain symptom, but this can leave
a patient debilitated and dependent upon the drugs. A physiatrist,
on the other hand, provides techniques and treatments such as spinal
injections that enable back and neck pain sufferers to return to activity
Q: How often is surgery needed to treat back pain?
A: Although more and more chronic back pain sufferers are becoming
aware of all the nonsurgical treatment options available, too many
still believe that surgery is the only truly effective cure. A survey
conducted by the AAPM&R found that about one in two people believe
this to be true. However, experts estimate that just 5% of back pain
cases will be effectively helped by surgery. The good news is that
most episodes of low back pain improve within six weeks of onset.
Q: When should someone consider surgery for back pain?
A: After nonsurgical treatments such as ice and heat therapy,
bed rest (1-2 days at most), exercise, injections and medications have
not proven effective, your physician may consider recommending surgery.
A back pain sufferer may also want to explore alternative treatments
such as acupuncture.
Q: What is fellowship training?
A: A fellowship is the highest level of training available to
a specialized physician in the U.S. It involves a financial grant for
advanced study or training or to allow payment for work on a special
project. It provides a stipend, and, in some cases, the miscellaneous
expenses involved in the study, training or project (Source: Mosby’s
Q: What type of physician will I see during my initial visit to the spine center?
A: You will immediately be admitted to…
Q: It doesn’t make sense to me to treat my back pain with exercise instead of rest. Please explain!
A: Lying in bed causes muscles to weaken, which inhibits recovery.
Even though activity may be uncomfortable or hurt a bit, this doesn’t
mean that it’s worsening your condition. On the contrary, building
strength in the muscles surrounding the vertebrae can help achieve
a full return to activity. Also, on the mental side, being bedridden
can lead to feelings of frustration and hopelessness, which can slow
you down. Regardless, studies have shown again and again that activity
leads to a quicker return to work.
Q: What is minimally invasive surgery?
A: Minimally invasive surgical techniques provide the opportunity
to successfully treat back problems with minimal interruption to the
patient’s regular, active lifestyle. Results achieved from these
methods have been proven to match that of conventional "open surgery." The
surgeon makes smaller incisions, sometimes only a half-inch in length.
Through these tiny incisions, the surgeon inserts special surgical
instruments and probes in order to access the damaged disc in the spine.
By using minimally invasive techniques, access and repair to the damaged
disc or vertebrae is achieved without harming nearby muscles and tissues.
Other benefits of minimally invasive techniques include shorter surgery
duration and recovery time, less visible scars and reduced pain and
Q: How can osteoporosis impact the spine?
A: Osteoporosis can have extremely serious consequences on the
spine. Because osteoporosis often progresses undetected, the first
indication could be as disastrous as a bone fracture. These fractures
typically strike an area of the body that carries the most stress,
such as the spine, wrists or hips. Spinal fractures can occur without
notice, as vertebrae simply compress. Compression fractures can be
very painful and may lead to stooped posture, loss of height and risk
of serious neurological damage to spinal nerves.
Q: What is scoliosis?
A: Scoliosis is a disease characterized by an abnormal curvature
to the spine, in which the vertebrae twist like a bent corkscrew. In
less severe cases, scoliosis may cause the bones to twist slightly,
making the hips or ribs appear uneven. Scoliosis can progress into
a serious health problem if bones become so severely twisted that they
compress vital organs or if the spinal deformity is so severe that
spine health and posture is threatened. If this happens, surgery may
be necessary. If left untreated, severe cases of scoliosis can shorten
a person's life span. The best way to care for scoliosis is to achieve
early detection and take measures to minimize its progression.
Q: What is degenerative disc disease?
A: A natural byproduct of aging is the loss of resiliency in
spinal discs and a greater tendency for them to herniate, especially
when placed under a weighty load, like when we lift heavy objects.
Additionally, some people have a family history of degenerative disc
disease, which increases their own risk of developing it. When a natural
disc herniates or becomes badly degenerated, it loses its shock-absorbing
ability, which can narrow the space between vertebrae.
Q: Why is the artificial disc big news?
A: The artificial disc is the best alternative to date for fusion
surgery. More than 200,000 spinal fusion surgeries are performed each
year in the U.S. to relieve pain caused by damaged discs in the low
back and neck areas. Some experts estimate that over the next 10 years,
more than half of patients who would otherwise receive a fusion will
receive an artificial disc instead.
Q: Who is a candidate for the artificial disc?
A: Patients with a diseased disc between L4 and L5 or between
L5 and S1 (all in the lower back) that is worn out or become injured
and causes back pain are candidates for the artificial disc. Other
candidates include those with degenerative disc disease (DDD) whose
bones (vertebrae) have moved less than 3mm. Your physician will help
you determine whether or not the artificial disc is a good choice for
you. Factors that will be considered include your activity level, weight,
occupation and allergies (Source: Charite Artificial Disc).
Q: What are the benefits of the artificial disc?
A: Generally speaking, those who receive artificial disc replacements return to activity sooner than traditional fusion patients. Also, because there is no need to harvest bone from the patient’s hip, there is no discomfort or recovery associated with a second incision site. Some of the overall benefits of artificial disc surgery include:
Q: Are there any drawbacks associated with the artificial disc?
A: When treating knee and hip replacement patients, orthopedic surgeons try to postpone the implantation of an artificial joint until a patient is at least 50 years old so that they do not outlive their artificial joint, which typically lasts anywhere from 15 to 20 years. Revision surgery, which may be necessary to replace a worn-out artificial joint, can be complex.
This is also a concern with
the artificial disc. Unlike knee and hip replacement patients who are
typically in their 50s or 60s, many patients can benefit from artificial
disc technology at a much younger age — in their 20s or 30s.
Therefore, the implantation of an artificial disc in younger patients
can raise a surgeon’s concern about the potential life span of
the artificial disc in the spine and the need for revision surgery
to replace a worn-out artificial disc, which can be complex.
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