How prevalent are back pain and spine problems today?
By age 40, about 60% of all adults have developed some form of degenerative disc disease. By some estimates, 51 million Americans are afflicted with some form of chronic back pain. That said, only about 5% of those sufferers will actually need back surgery.
How many back surgeries are performed in the U.S. annually?
It is estimated that there were over 916,000 spinal surgeries performed in the U.S. last year—including more than 400,000 lumbar spinal fusion procedures.
What are the most common causes of back pain and spine problems?
Back pain often develops without a specific cause that your doctor can readily identify with a test or imaging study. Typical causes include: muscle or ligament strains caused by heavy lifting or sudden, awkward movements; a ruptured or bulging disk; osteoarthritis, especially in the lower back and associated with spinal stenosis; osteoporosis, which creates brittle vertebrae that are more subject to compression fractures; skeletal irregularities; and severe spinal curvatures such as scoliosis.
Other than general back pain, what are some other typical symptoms?
Back and spine problems are often accompanied by: chronic muscle aches, a stabbing or shooting pain, pain that runs down the leg, limited flexibility or range of motion of the back, and an inability to stand up straight.
What are causes and treatments for stiffness along the spine?
Stiffness along the spine can make daily activities painful or difficult to accomplish. A little stiffness can result after a hard workout, but stiffness that persists for days or weeks at a time may be caused by something else. In this article, we will discuss what exactly may be causing stiffness along your spine – and also offer up some treatment options for these conditions and injuries.
CAUSES OF SPINE STIFFNESS
Spinal stiffness can be the result of numerous potential causes. Here are some potential causes of stiffness that occurs all along the spine:
- Exercise. Stiffness in the back is a common after-effect of a good workout. This type of stiffness will typically go away on its own after a day or two.
- Spinal Stenosis. Stenosis is a narrowing of the spine and often causes stiffness in the area.
- Nerve & Disc Issues. Damage to the nerves and discs of the spine can result in stiffness as well. These issues often require minimally invasive surgery.
BEST TREATMENT OPTIONS FOR A STIFF SPINE
An accurate diagnosis should always be the first step when treating stiffness and pain in the spine. There are many different possible causes of spine stiffness, and treatment options vary greatly depending on the root cause of the symptoms. For example, a pinched nerve requires a different treatment approach than a spinal vertebrae fracture. Depending on your diagnosis, treatment options may include physical therapy, chiropractic, pain medication, injections, or minimally invasive spine surgery. Patients typically begin with conservative treatment options, and consider surgery if these treatment methods fail to resolve the symptoms.
Inspired Spine is a leader in spinal surgery technology. We have developed revolutionary minimally invasive procedures (The Inspired OLLIF and the Inspired MIS-DTIF) that are study-backed. Our innovative surgical techniques have the fastest operating times, shortest recoveries, and require no overnight hospital stays so you can recover in the comfort of your own home. Inspired Spine procedures have been used to treat stiffness and other spinal issues and may be the right treatment option for your situation. Contact us today to learn more about these procedures or figure out if you are a good candidate. You can also find a spine surgeon in your area with our online tool.
What can I do at home to treat my back pain?
Many back pain sufferers temporarily benefit from applying heat via a hot bath or heating pad. Also, applying cold via an ice pack, ice bag, or cold gel pack can provide some back pain relief. Short periods of rest and over-the-counter pain relievers can be effective. It is also preferable to maintain your normal daily activities—unless heavy lifting is required.
When should I see a doctor about my back pain and/or spine problems?
Back pain, especially lower back pain, is incredibly common. Often, if proper care is taken at home, the problem will gradually improve within a few weeks. However, if some improvement isn't seen after 72 hours, you should see your doctor. You should also consult your doctor if your back pain follows a fall, a blow to your back, or other injury; is associated with a fever and/or throbbing in the abdomen; or causes bowel or bladder problems. You should also contact your doctor if your back pain is intense or constant, especially at night; spreads down one or both legs and below the knee; causes weakness, numbness, tingling in one or both legs; accompanies redness and/or swelling of the back; or is accompanied by weight loss.
Is there anything I can do to prevent chronic back pain?
The best way to help prevent and/or avoid back pain is to make an effort to keep your back healthy and strong. By exercising regularly, making an effort to build flexibility and muscle strength, and maintaining a healthy weight, you'll protect and support your back while reducing the stress placed upon it. Being aware of your "body mechanics" can also help reduce the risk of chronic back pain and spine problems. Making an effort to maintain good posture, sitting properly at work in a good chair and changing positions at least every half hour, and remembering to always "lift with your legs" will all benefit your back.
What if my primary care physician says my back pain is serious enough to warrant back surgery? Now what?
You'll probably be referred to a specialist, most likely an orthopedic spine or neurological spine surgeon, who will evaluate your specific back problem(s) and recommend one or more surgical approaches based upon your general health, age, and other relevant factors.
If back surgery turns out to be my best option, what are my chances for a speedy recovery?
Obviously, every patient's situation is different. However, thanks to recent advances in surgical technologies and procedures, significantly shorter surgery times, hospital stays, and recovery times are now possible—as are improved outcomes.
Pain, numbness, and weakness:
We help manage pain for the first three months post operatively after which point the patient returns to their primary care physician or pain consultant. For all medication refills, please have your pharmacy send a refill request or call our office at least 48 hours in advance of your last dose. Please call us if the pain does not seem right or worsens (when not associated with increased activity).
Am I supposed to have this pain?
Besides surgical pain, it is not uncommon to still experience some of the pain that you had prior to surgery. If you still have radiating pain, numbness or weakness, please know that it often resolves on its own over the next couple of months. This pain and delay of relief is due your nerve(s) being pinched. Although we relieved this pressure surgically, nerves are incredibly slow to heal and thus pain, numbness and even weakness can linger. Please do not be alarmed if similar symptoms, or other nerve-like symptoms, are still present. Please inform your provider about these symptoms.
It is common to experience pain between the shoulder blades, upper shoulders, and into the base of the skull; this is almost always due to muscle spasms. A muscle relaxer such as Flexeril is often prescribed in an attempt to help relieve this pain.
Thoracic or lumbar pain?
Pain around and below the area of the incision is very common. It is most commonly caused by muscle spasms. Medications like Flexeril are commonly prescribed to help with this pain.
Nerve irritation after OLLIF surgery?
This nerve irritation is caused from your nerve being moved during your surgery. This is more likely to happen in the levels of L5/S1 than any other level. If you had nerve irritation prior to surgery, you are more likely to have increased nerve irritation after surgery.
Why is it difficult to swallow?
The medical term for difficulty swallowing is dysphagia. Dysphagia is common after a cervical procedure due to your surgeon moving your esophagus to the side to reach your spinal column. The gentle retraction can cause patients to experience difficulty swallowing. This issue usually resolves on its own with time.
Can I take off the 3M Steri-Strips™?
Please do not remove the suture/Steri-strips from the incision site. They are there to help the wound close. It's OK if they fall off on their own, your nurse or physician will take off the remaining strips at your two-week follow-up appointment.
Can I Bathe?
You may get the incision wet in the shower, just pat the site dry with a clean towel. However, you should avoid taking baths. You do not want to soak the wound in water because it will increase your risk of infection at the incision site. Please wait at least 3 weeks before taking baths to bathe to be sure the incision is well healed.
When Can I Drive?
Abstain from driving until you are no longer taking any narcotic pain medication. Once off them, you should be able to safely operate your vehicle.
When can I go back to work?
This depends on the type of surgery, your age and other factors such as smoking. We will inform you of your prospective outlook to recovery. Some general rules for a more speedy recovery include cessation of nicotine, walking as much as possible as permitted by pain and rest.
Should I wear a brace?
A cervical collar is generally needed; back braces however, are often not required. We will provide you with a brace if we believe it is medically necessary. If we do give you a collar/brace, it is vital to wear it in vehicles for three months after surgery. Occasionally, you may be advised to wear collar/brace when you're up and moving around (commonly for the first 6 weeks). Factors that affect whether we recommend a brace include tobacco use, density of bone and the level of surgical invasiveness. Again, your physician will give you specific instructions, but you are welcome to ask.
Please remember that braces are meant to be temporary support only. The brace limits motion and helps support the back, which gives your muscles a break and often offers relief. Although this is usually comforting at first, long-term use of the brace can lead to muscle wasting, which decreases your natural back support.
How does the fusion affect my range of motion?
Overall fusion usually does not decrease range of motion. In fact, most patients actually report a better range of motion after surgery because they are no longer limited by pain. There are also other levels of the spine that can compensate for the fused levels, so restrictions in movement are not commonly reported.
Am I too old for surgery?
More important than the chronological age is the biological age! More and more surgeons tend to take biological age as a factor when assessing surgical risk. Different tests can evaluate the function of heart, lung, kidney, etc. Many complex cases can even be done on even 80- or 90-year-old patients safely. Our job is to provide you with a realistic estimate of risk vs. benefits so you can make an informed decision. We will be very honest about the risks and benefits of the surgery for you.
Extensive research has been done on this topic, and experts have found that patients experience better outcomes and heal faster with appropriate physical and occupational therapy treatments following surgery. Tristate Brain and Spine Institute’s patients are generally referred to physical and occupational therapy the morning after the surgery. Patients are encouraged to work closely with physical and occupational therapy throughout their recovery process.
The goal of the physical therapy is to help the patient recover more quickly and achieve greater range of motion, to educate the patient regarding daily activities and exercises they need to continue at home. In the process of clearance for discharge, patients undergo observation by physical therapy and they will receive valuable education on the performance of daily activities without overstressing the spine. Every patient and surgery is unique, and each case will be reviewed by the surgeon for the occasional exception for which Physical and/or occupational therapy is not a fit.
When would I use Traction Therapy/Devices and Why?
Traction is a form of therapy used to help relieve pain and decompress the spine. This form of therapy can be of danger to the fusion site if applied post-operatively. Thus, the patient should avoid any traction for at least 4 months after surgery. Traction may be used in a different part of the body than the surgical site, but must not affect the surgical area. If you think that you need traction, please discuss it with your physician before proceeding with it.
Are there any breakthroughs in back surgery therapies or procedures that I should know about and research?
Several new advanced back surgery approaches, including the OLLIF (oblique lateral lumbar interbody fusion) procedure, are both minimally invasive and minimally disruptive, which allow them to be performed on an outpatient basis.
Who are the best candidates for a back surgery procedure like the OLLIF?
Because the OLLIF procedure can access all five levels of the lumbar region (L1 through L5), it's generally suitable for lumbar spinal fusion surgery candidates who suffer from degenerative disc disease (DDD), a herniated disc, spinal stenosis, or spondylolisthesis in the lower back.
How does a new procedure like the OLLIF compare with more traditional, so-called "open" approaches to lumbar spinal fusion surgery?
The OLLIF procedure is considered minimally invasive because all it requires is a single 15-mm incision—smaller than a dime. It's also considered minimally disruptive because it eliminates the need for the surgeon to retract and/or dissect major muscles, blood vessels, ligaments, and bones. Often, it can even be performed as an outpatient procedure.
How does a less invasive, less disruptive procedure like the OLLIF benefit the patient after surgery?
Surgeons report that many of their patients are often able to walk, and even return home within a few hours after surgery. They also report that there's typically reduced pain and discomfort, reduced post-surgery complications, and a faster return to normal activities.