Who Can Get Back Pain?

Back pain is not just a symptom of aging. Anyone, of any age, in any physical condition, can and will likely experience back pain at some point in their life. So if you are experiencing back pain, don’t think that you’re alone. There are plenty of seventeen year-old athletes who experience back pain and thus seek the same medical care that you do for your own back issues.

While getting older can be a cause of back pain, as your body’s discs, joints, muscles and ligaments carry you through your life for a longer amount of time, and while many people experience their first back pain episodes while in their 30s and 40s, there are other top causes of back pain:

• Being overweight. When you’re carrying extra weight above your ideal body weight, that can put extra pressure on your spine, muscles and joints, leading to back pain.
• Not being physically fit. People who do not exercise on a regular basis, and thus lack good muscle tone and bone strength, often experience more back pain.
• Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
• Your job. If your job requires you to lift heavy boxes, or push or pull heavy loads, you might experience greater back pain.
• Lifting heavy items. Or people. Like grandchildren who may be growing and getting heavier, yet you still want to lift them. And if you’re a caretaker of an ill relative, lifting them can aggravate your back as well.
• Sitting too much. If you sit at a desk or worktable for too many hours in a row, with poor posture and without getting up to stretch and walk around a bit, you might experience back pain.
• Smoking. If you’re a smoker, you may experience back pain, because your body might not be able to get enough nutrients to the discs in your back. You might also have a smoker’s cough that puts pressure on your body and affects your back. And smokers are also slow to heal, so your back pain might be longer-lasting.
• Other diseases. Some types of arthritis and cancer can cause back pain.

In short, anyone can get back pain. And perhaps you see yourself in several of the above causes, so take steps now to help prevent back pain or help lessen your back pain symptoms.

What Is Back Strain?

Hearing “It’s just a back strain” may not be very comforting when you’re experiencing severe back pain. While back strain may sound like a minimal back injury, it can cause you a great deal of discomfort, perhaps sleepless nights, back spasms that can cause severe lower back pain and in some cases, immobility. Many people with back strains go to the emergency room for relief.

Most lower back pain episodes are caused by damage to the muscles and/or ligaments in the lower part of the back. When you have back strain, you may have one or both of the following:

• A muscle strain, caused when a muscle is over-stretched or torn, resulting in damage caused to the muscle fibers (also called a pulled muscle).
• A lumbar sprain, caused when ligaments – the tough fibrous tissues connecting the muscles to the bones and joints — are stretched too far or torn.

Strain and sprain are often used interchangeably, since the treatment and prognosis for both of these are the same. So one is not worse than the other, although the amount of pain you’re experiencing may make you think that what you have is indeed the worse of the two. Especially since you cannot see inside your back, your imagination may conclude that you have something much worse than a back strain or sprain. Patients experiencing pain can often jump to dramatic conclusions and envision difficult treatments ahead.

It can calm your worries to understand what a back strain is. When the muscles or ligaments in the lower back are strained or torn, the area around the muscles will likely become inflamed. That back inflammation leads to back spasms that can cause your severe back pain and immobility.

“How did this happen to me?” is likely the next question on your mind. Back strains are often the result of a movement or movements that put undue stress on the lower back. Motions like lifting a heavy object, lifting multiple heavy objects (such as with landscaping using large rocks or bricks,) lifting and twisting, a sudden and single twisting motion (like your last golf tee-off of the day,) or a fall are just some of the movements that can cause back strain.

Symptoms of back strain may range from a mild ache to sudden, debilitating pain often localized in the lower back. The pain of a back strain is likely to be located in the low back, and not radiate down your leg (as with sciatica.) Your back may be sore to the touch, pain comes on suddenly and strongly, you may have those muscle spasms in your lower back, and you might find standing or walking to be more uncomfortable than resting.

With a doctor’s care and pain-reducing medications, you may find your back strain’s worst pain subsiding quickly, but with back strain, you may experience a lower level of pain, or flare-ups of pain, for a few weeks to a few months, depending on how severe your back strain is. And how well you rest after being diagnosed. Self-care is essential with back strain, so that those stretched or torn muscles of ligaments can heal well. Most back strains and sprains are much better after 3 to 4 weeks, since the large muscles in your back have a good blood supply, which delivers healing nutrients and proteins to your injury site for healing to take place. You might not be able to see that happening, but as you heal from your back strain, that’s what’s happening beneath the surface.

What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a generalized term used to describe ongoing pain after back surgery. After going through a spinal surgical procedure, of course both you and your surgeon desire your complete painlessness.  But, even with the best spinal surgeon and the best indications for your spinal surgery success, there is always a small chance that back pain may continue after surgery and recovery (studies report continued back pain after 5% of all spinal surgeries ).

What causes Failed Back Surgery Syndrome? There are many reasons why a back surgery might not result in a completely pain-free existence, partially owing to the fact that spine surgery is only able to accomplish stabilizing a painful joint and decompressing a pinched nerve. If your back condition involves more than these two pain-causing situations, your spine surgeon will need to continue your care and explore additional solutions to your back pain condition.

Back surgery is reported to be 95% successful at changing anatomy that causes pain and correcting the physical results of a back injury.  But it’s also important to realize that back surgeryisn’t a cure-all for every type of back pain-causing condition. Since the spine is a very complex part of your anatomy, with many vertebrae, nerves, and cushioning between your discs, it can be a complex process to get to the root of what’s truly causing you pain.

Your back surgeon will thoroughly assess your back pain condition, and use top technology to diagnose your back pain causes, but it’s important for you to have realistic expectations of what back surgery can and cannot accomplish for you. If you experience Failed Back Surgery Syndrome, your skilled physician will then conduct additional tests and map out a plan of action to remedy as much of your back pain as possible. All valuable things take time, so don’t set yourself up for possible disappointment by expecting a quick fix to any back pain. It may take an extra procedure or extra treatment after your back surgery to get you feeling much better.

If you do have great success after your back surgery, then you’re in that fortunate 95% of back pain patients whose symptoms lessen and whose lifestyle will very soon be active and more comfortable again.

Sleep Tips for Back Pain Sufferers

Sleep provides important healing and rejuvenation to your back. When you’re suffering from back pain, it can be difficult to get a solid and healthy good night’s sleep. Lying down can be painful, and sleep simply doesn’t come. One of the many unpleasant symptoms of inadequate rest is being even more sensitive to pain. So it’s essential to take the smart steps necessary to improve your ability to sleep.

It may seem to be an impossible goal, but there are ways to improve your sleep quality while dealing with back pain:

• Get a new mattress. A soft, old mattress that sags and provides inadequate lumbar support may be the culprit causing your back pain. When you sleep with your back arched on a mattress with the slope downward right at your hip level, you’re creating a terrible arch in your spine that can compress nerves and even cause disc damage. Upgrading to a top-quality new, medium-firm mattress that has no sag or slope and can cradle your body in a more natural and healthy position. Yes, a quality mattress is often pricy, but it’s worth the investment to improve your back pain.  Add in a posture-correcting orthopedic-approved pillow for your neck and head.  It will properly position your spine for better sleep and potentially less pain.
• Sleep in a back-supporting position. One preferred position is lying flat on your back, and placing one or two pillows beneath your knees so that your spine is in a neutral, non-arched position while you sleep. If you prefer to sleep on your side, place one pillow between your slightly-bent knees while you lie on your side, and place another pillow against your chest, with your arm draped over it. This second pillow position prevents you from twisting your upper body and keeps your spine in neutral alignment as you sleep. Don’t sleep on your stomach, since this position arches your back and aggravates the spine, nerves and muscles affected in your back pain condition. Some frequent stomach-sleepers place a tennis ball in their pajama front pocket to prevent them from rolling over onto their stomachs during the night.
• Reduce stress. Stress is a cause of chronic back pain, so focus on eliminating the sources of your stresses through meditation or deep breathing methods, journaling, limiting exposure to stressful people, lightening your load of life obligations such as running committees and other stressful jobs, or even getting short-term psychotherapy to deal with larger stressful issues in your life.
• Limit or eliminate caffeine. You might be more sensitive to caffeine than you realize, and even moderate use can affect your sleep quality.
• Don’t eat before bedtime. Limiting your snacking can help prevent nighttime indigestion or acid reflux, and it can also help keep your weight at a healthy level, which is better for your back.
• Talk to your doctor about nighttime pain medications that can help you sleep. Your physician will assess your best pain medication regimen, which might include muscle relaxants, over-the-counter pain relievers, such as aspirin, Tylenol (acetaminophen), or Advil or Motrin IB (ibuprofen) which can be effective for short-term use and might be available in a ‘PM’ formula that can help you sleep.  Naproxen sodium (Aleve) is long-lasting and may offer pain relief throughout the night. Use these medications only as directed and with a doctor’s care.
• Talk to your doctor about gentle exercises. Always consult with your doctor about recommended back pain-calming exercises. Never look online for ‘back pain exercises’ to do on your own, since your back might not be strong enough at this time for some exercises like planks or resistance band work. Your doctor will start you off slowly with a few exercises that can calm your back pain before bed, and then work with you to progress your back-improving movements over time.
• Practice a good bedtime routine. Turn off the television and computer, dim the lights in your room to ready your body for sleep, cool your bedroom with a fan to help you sleep better, and avoid reading or working in bed before sleep. Winding down can prepare your mind, as well as your body, for a deep, restful sleep that lets your body heal better, and after a good eight hours of healthy sleep can make your pain levels easier to tolerate in the daytime.

When to See a Doctor for Types of Severe Back Pain

 

Back painslows down millions of Americans each year, with symptoms ranging from nuisance soreness to back pain so severe and debilitating that a visit to the emergency room becomes the first step on a path leading to a spinal surgeon’s care. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

* Disc degeneration. Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.

* Sciatica. While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) become irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve also can be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.

* Lumbar spinal stenosis. When spinal degeneration occurs the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.

* Osteoarthritis. Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae or both anywhere along the spine, pinching the nerves and causing pain.

*Herniated disc. Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

When severe back pain occurs, your physician will assess you for any or all of these conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, return your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to better quality of life.

The TOPS™ System is one such solution. The TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

How to Prepare for Spinal Fusion Back Surgery

 

Spinal fusion back surgery is often performed in conjunction with spinal decompression treatment. The decompression procedure relieves pressure on pinched nerves emanating from the spine, reducing pain and restricted mobility in limbs caused by the compressed nerve. But the spinal decompression surgery involves removing portions of vertebrae, making the spine weaker at these points. Thus, spinal fusion surgery is performed to strengthen the spine after decompression, and involves fusing two adjacent vertebrae with the use of an implant.

Preparing for spinal fusion surgery – whether performed on the lumbar, thoracic or cervical spine – is similar to preparations for any spinal operation, but there are a few specifics to be aware of. First, be prepared to be thoroughly examined before the surgery is performed, so your physicians can plan all aspects of your operation. Radiograph assessments of spinal instability, EMG to test nerve function, and an MRI, CAT, or other scan is often performed to identify nerve compression.

Your overall physical condition will also be assessed to ensure you are in sufficient health to undergo the rigors of the surgery. You will need to discuss any and all pre-existing medical conditions with your physicians, and further evaluation of such conditions may be necessary before proceeding with spine fusion surgery. In fact, one of the most important ways to prepare for spinal fusion is to get into the best physical condition possible. Being in good physical condition translates into fewer complications during surgery and faster recoveries after, among other benefits.

Spinal surgery of any kind should be considered a last resort, undertaken only if more conservative treatments have proven ineffective. But many patients undergoing spinal decompression now have an alternative procedure to spinal fusion, shown in clinical tests around the world to have better outcomes than spinal fusion. The TOPS^TM (Total Posterior Solution) System stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does. So one of the best ways to prepare for spinal fusion is to find out if an alternative solution like TOPS makes more sense than spinal fusion surgery for you or a loved one.

What is a Lumbar Laminectomy?

Medical terminology doesn’t go out of its way to be complicated or hard to understand. It’s simply that the language has to be very precise, and that much of it comes from Latin. Hence, it can be difficult to decipher some med-speak without a little help. Take the term “lumbar laminectomy,” a fairly common surgical procedure that can help alleviate the pain, mobility limitations and other symptoms that often accompany medical conditions of the lower spine. Indeed, the word “lumbar” refers to the lower spine. The lumber portion of the spine comprises the lowest five vertebrae of the spinal column, which bear the designation L1 through L5 – “L” standing for lumbar.

Every vertebra in the spinal column is covered in a bony sheath called the lamina, which helps protect

the nerves that run through the spinal column. But sometimes, due to injury, disease, degenerative changes, or other causes, the lamina can put pressure on nerves emanating from the spinal column, a condition referred to as a pinched nerve. Problems within the vertebrae, such as an unnatural narrowing of the spinal canal, a condition called spinal stenosis, can also result in pinched nerves.

When surgery is performed to relieve pressure on a pinched spinal nerve, a procedure called spinal decompression, it requires cutting away the portion of the lamina that is impinging on a nerve, or to gain access to the interior of the vertebrae t

o address a condition such as spinal stenosis. In medicine, the suffix “ectomy” refers to excision or removal. Thus, cutting away a portion of the lamina is a procedure called a laminectomy. So a lumbar laminectomy is an operation in which a portion of the lamina on one of the first five vertebrae is trimmed away. A lumbar laminectomy can achieve dramatic results in alleviating the symptoms of pinched nerves. Traditionally, spinal fusion back surgery was performed in concert with a laminectomy to stabilize the spine at the point of the operation. Now lumbar laminectomy patients have an alternative that provides better outcomes than spinal fusion surgery, while preserving the full range of the spine’s motion: The TOPS (Total Posterior Spine) System procedure. If you’re a candidate for a lumbar laminectomy or other spinal decompression procedure, make sure you understand all your treatment options.

Recovering from Lumbar Spinal Stenosis

Lumbar spinal stenosis, a common medical problem, denotes an unnatural narrowing of the spinal canal, the center of the spinal column housing the spinal nerves that relay sensorial information to the brain and control the movements of our muscles. The term stenosis comes from Latin, and means a narrowing. When a portion of the spinal canal narrows unnaturally, it can put pressure on the spinal nerves, and these pinched nerves in turn can cause pain and limit mobility.

The good news is that a variety of treatment options are available that have been proven effective in helping individuals recover from or ameliorate the symptoms of spinal stenosis. Conservative, non-invasive therapies include simple lifestyle changes, medications, physical therapy, and injections of anti-inflammatory agents. For patients with spinal stenosis, there’s no way of knowing which of these approaches will be most successful, so physicians may simply prescribe one of these treatments as a first step, and monitor the results to see how the patient responds. If the first method selected doesn’t achieve the results of helping the patient recover from spinal stenosis, the next option may be tried, and so on.

For patients with moderate to severe spinal stenosis who do not respond to conservative treatments, surgery may be recommended. In this form of spinal decompression surgery, the surgeon trims away excess bone in the narrowed center of the affected vertebra, relieving pressure on the compressed nerve or nerves. Historically, a spinal fusion back surgery operation has been performed in conjunction with surgery to relieve spinal stenosis, in order to stabilize the region of the spine where the operation was performed. Today there’s an important, and better alternative to spinal fusion. The TOPS (Total Posterior Spine) System procedure provides better clinical outcomes than spinal fusion surgery. The TOPS solution has the added benefit of preserving the spine’s full range of motion, unlike spinal fusion, which permanently fuses adjacent vertebrae. TOPS also offers a much quicker recovery from surgical treatment for spinal stenosis than spinal fusion. If you’re a candidate for spinal stenosis surgery, make sure you understand all the advanced surgical solutions available today, and what impact each will have on your recovery from this condition.

Back Treatment Options

In our previous blog we discussed the tremendous stresses borne by the lumbar, or lower portion of the spine comprising the five lowest vertebrae. In fact, lumbar back pain is a significant health issue, affecting about 70 to 85 percent of Americans at some point in their lives, according the National Institutes of Health (NIH). Among the most common causes of lumbar spinal problems is the degeneration of bones and tissue in the spine that occur as a normal part of aging. But one doesn’t have to be older to have lumbar spinal problems. Back pain is the most frequent cause of activity limitation in people under the age of 45, according to the NIH. Trauma or injury, poor posture and biomechanics, genetics, obesity and poor muscle tone can all result in lumbar spinal problems that cause pain, limit mobility, and have other serious health consequences. These conditions include spinal stenosis, bulging disc, herniated disc, slipped disc, radiculopathy and spondylolisthesis.

A variety of treatment options are available for individuals affected by conditions causing lumbar back pain. Individuals with moderate to severe cases of these conditions who do not respond to conservative treatment options such as medication, physical therapy and lifestyle changes, may opt for a surgical solution. Frequently this involves cutting away portions of a lumbar vertebra that is impinging, or putting pressure on a nerve emanating from the spinal column. Such spinal decompression surgery can have a dramatic impact on relieving pain and restoring mobility. However, removing bony elements also weakens and destabilizes the spine, so historically a procedure known as lumbar fusion, or lumbar spinal fusion has been performed in conjunction with spinal decompression back surgery of the lower spine. In this procedure the vertebra from which tissue was removed is fused to an adjacent vertebra. This stabilizes and strengthens the spine, but lumbar fusion eliminates the natural flexion and independent motion of the fused vertebrae. Today lumbar decompression surgery patients have an alternative to lumbar fusion: the TOPS™ (Total Posterior Spine) System. TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. If you are considering surgery for a lumbar spinal problem, ask your physician about all your surgical options.

What is Lumbar Spinal Decompression?

Imagine if the branches of a tree were just as big at the top as they are at the bottom, and that sometimes, heavy loads were placed on the ends of the very highest branches. Think of the stress that would put on the lower portion of the tree trunk. Well, that’s analogous to the situation we humans experience with our spinal columns. Our spinal column is like the trunk of a tree, but we’re just as big at the top of our trunks as at the bottom. The stress this puts on our lower backs – also called the lumbar region of the spine – is exacerbated by the cumulative affect of a lifetime of lifting and twisting in combination with degenerative changes of the spine that occur as a result of aging. So it’s not surprising that the majority of back problems that bring patients to spinal specialists are centered in the lower, or lumbar region of the spine.

These stresses, along with our genetic makeup, disease or injury, can result in a host of spinal disorders such as bulging or herniated discs, slipped disc and spinal stenosis. These disorders, in turn, can result in unnatural pressure being put on nerves that emanate from the spinal column, potentially causing pain, restricted mobility, and other symptoms of pinched nerves. We talked about the problem of pinched spinal nerve and spinal decompression in general in a previous blog. As we noted, spinal decompression is a means of easing pressure on impinged spinal nerves, and can be performed either non-surgically or surgically. Lumbar spinal decompression simply refers to decompression procedures performed on the lower portion of the spine.

The surgical solution for a lumbar pinched nerve involves removing tissue from vertebrae in the lumbar region that impinge, or put pressure on a nerve. This is called lumbar spinal decompression surgery. Historically, spinal fusion back surgery has been performed in conjunction with lumbar decompression surgery to stabilize the spine. Today, the TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion that preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world. This provides an important more treatment option for individuals with moderate to severe symptoms of pinched nerves who do not respond to non-surgical lumbar decompression procedures.