Have you heard of radiculopathy? This condition results from nerve irritation and, if it progresses, can induce debilitating symptoms. If you’ve already been diagnosed with radiculopathy, you know that it can alter your ability to complete day-to-day motions and activities.
Understanding radiculopathy, what causes it, and what symptoms it triggers can help you more effectively cope with this neurological condition.
Radiculopathy is a term that refers to chronic injuries resulting from the bones of the spinal column (vertebrae), or the cushioning discs between them, impinging on a nerve root in the spinal column. With this condition, the affected nerve root is irritated or inflamed, leading to a variety of neurological symptoms.
Any part of the spine can be affected by radiculopathy. With lumbar radiculopathy, the condition can trigger lower back pain that spreads down to one or both legs.
Common symptoms of radiculopathy include numbness, tingling, weakness, loss of motor function, muscle spasms, and radiating pain.
The symptoms of radiculopathy may be felt all the way to the tips of fingers or toes, even though the nerve compression occurs at the base of the nerve in the spine. This is because spinal nerves extend from the spinal canal throughout the body, supplying sensation to the extremities.
Radiculopathy can be serious if it’s left untreated. In other words, radiculopathy symptoms become more serious with time when a patient fails to receive professional medical care.
When it’s promptly addressed, radiculopathy often improves within six to 12 weeks. Many radiculopathy cases even resolve with at-home care alone, without the need for medications or hands-on treatments.
Most patients can work with radiculopathy. Although it can affect your ability to work, in severe cases, radiculopathy most often goes away with rest and at-home treatments.
When radiculopathy persists longer than a few weeks, it can start to affect your work. This is particularly true for patients in careers that require physical exertion, such as construction, warehouse work, landscaping, agricultural work, firefighting, and professional athletics.
Surprisingly, radiculopathy can even inhibit your ability to work if you have a sedentary job. This is because lumbar radiculopathy can lead to debilitating pain in the lower back and legs with prolonged periods of sitting. With this in mind, patients who have been diagnosed with radiculopathy and have desk jobs should try to take a break from sitting at least once every hour.
Radiculopathy can become a permanent disability over time.
Patients who are suffering from lumbar radiculopathy may be eligible to reap disability benefits. Eligibility requirements can vary depending on your disability insurance plan.
Radiculopathy may be considered a disability because it can be debilitating, making it difficult to work. Severe radiculopathy can diminish a patient’s ability to walk, stand up, move around, and remain seated for extended periods.
An MRI can show radiculopathy. It’s considered the gold standard of imaging modalities to diagnose radiculopathy.
Generally, an MRI is used to confirm a radiculopathy diagnosis, even if the doctor is confident of the diagnosis after a physical examination. MRIs can clearly display nerve impingement in the spine and even show any structural lesions that are irritating the affected nerve. This makes MRI scanning an invaluable tool for spinal specialists as they diagnose radiculopathy and other conditions that affect spinal nerves.
The most common cause of radiculopathy is spinal degeneration associated with the normal aging process. Age causes the spinal structures to weaken and lose flexibility. As the spine shifts as a result of these changes, nerve root irritation can occur.
Whether due to spinal stenosis, spinal disc herniation, or bone spurs, spinal degeneration can narrow the openings where nerve roots exit the spine, known as foramina. This condition may be referred to as foraminal stenosis and can lead to nerve root compression. When a spinal nerve root becomes irritated and inflamed, it can result in symptoms of radiculopathy.
Besides spinal degeneration, radiculopathy can be caused by a range of other factors, including:
Additionally, genetic predisposition and the presence of other spine disorders can increase one’s risk of developing spinal radiculopathy.
Radiculopathy is treated with rest, physical therapy, and anti-inflammatory medication, in most cases.
In some mild cases, radiculopathy resolves on its own over time, without the need for treatment. However, patients with persistent symptoms that don’t gradually improve should visit a physician for a treatment plan. Some severe cases of radiculopathy require surgery to restore patients’ mobility and quality of life.
Physical therapy helps radiculopathy by strengthening the muscles in the abdomen and back that support the spine. Greater muscle strength in these areas will alleviate some pressure from the irritated nerve root, leading to reduced symptoms.
Additionally, physical therapy helps radiculopathy by improving the patient’s body mechanics. This facilitates a balanced distribution of weight with day-to-day motions, which helps alleviate pressure on the affected nerve root.
Physical therapists may also implement a variety of alternative treatment methods to ease radiculopathy symptoms, including massage and dry needling.
Massage helps reduce muscle tension, which can ease the muscle spasms associated with radiculopathy. Additionally, massage offers anti-inflammatory benefits, helping to reduce the swelling and irritation around the nerve root.
Dry needling is a treatment that involves inserting thin filiform needles into myofascial trigger points. This process reduces muscle tension, boosts blood circulation, and eases pain. A 2021 study found that trigger point dry needling can effectively decrease pain in patients with lumbar radiculopathy.
Your physical therapist may include massage and dry needling in your radiculopathy treatment plan alongside stretching and strengthening exercises.
A chiropractor can help fix radiculopathy by addressing structural imbalances in the spine. This can alleviate nerve irritation and lessen the patient’s pain.
A study published in the Journal of Chiropractic Medicine evaluated the clinical outcomes of 162 patients with radiculopathy treated with chiropractic care. Of these patients, 85.5% experienced a resolution of the main subjective radicular complaints after nine treatment sessions.
Chiropractic adjustments involve a chiropractor manually manipulating the spine to improve its alignment. This process also improves spinal mobility and creates more space around the irritated nerve, allowing blood, oxygen, and healing nutrients to reach the injury.
Additionally, chiropractors may implement non-surgical spinal decompression to treat radiculopathy. During non-surgical decompression, the chiropractor implements a motorized traction device (a table with a harness and motor) that gently pulls the spine, creating more space between the vertebrae.
A 2022 study published in BMC Musculoskeletal Disorders evaluated the effects of non-surgical decompression therapy with physical therapy for radiculopathy, compared to physical therapy alone. The study found that the combination of non-surgical spinal decompression therapy and physical therapy was statistically and clinically more effective than physical therapy alone for lumbar radiculopathy patients. It was more effective for improving lumbar range of motion, functional disability, quality of life, and back muscle endurance.
A neurologist can establish a treatment plan to restore sensation and alleviate pain for radiculopathy patients.
Neurologists specialize in the diagnosis and treatment of nerve, brain, and spinal cord disorders. They may recommend physical therapy, chiropractic care, medication, or even surgery to resolve radiculopathy symptoms.
For patients whose radiculopathy doesn’t improve with several months of conservative treatment, spinal decompression surgery may be recommended.
During this procedure, the portion of a vertebra impinging on the nerve root is trimmed away. This can provide dramatic relief from radiculopathy symptoms while giving the irritated nerve space to heal.
Traditionally, spinal fusion back surgery has been performed in conjunction with spinal decompression. Spinal fusion is used to stabilize the spine at the point of the operation, preventing future injury and discomfort. Unfortunately, spinal fusion also comes with its own risks and complications.
Spinal fusion eliminates the natural independent motion of the fused vertebrae, which can compromise patients’ ability to enjoy various physical activities. This procedure may also contribute to the deterioration of adjacent vertebrae, creating the risk of future back pain and neurological symptoms.
Today, there’s an alternative to spinal fusion for lumbar radiculopathy: the TOPS™ (Total Posterior Spine) System implant. This revolutionary device preserves the natural motion of the spine and allows movement in all directions.
Clinical studies have shown that it provides superior clinical outcomes for patients with chronic lumbar spine disorders like radiculopathy, spinal stenosis, and spondylolisthesis. It has been shown in clinical studies around the world to provide better clinical outcomes than spinal fusion.
With major medical advances rapidly being released, patients must remain up-to-date on the latest treatment options for chronic back pain. Talk to a spine specialist in your area to learn more about emerging therapies like the TOPS™ System.
With advanced procedures performed by highly trained and experienced surgeons, spinal surgery today boasts highly successful outcomes. Yet, complications can (and do) occur during the post-surgery recovery process.
The spinal surgery patient can serve as the first line of defense against these complications by taking an active role in managing his or her recovery. To ensure a successful recovery, patients need to prepare for the procedure well in advance.
In this article, we’ll discuss everything that patients need to know before undergoing spine surgery, including the precautions to take and the complications to be aware of.
Before spine surgery, you should prepare for the recovery process and follow all of your surgeon’s instructions. This will involve preparing your body for the procedure by:
The most important thing to do before spine surgery is to stop taking medications that could interfere with the procedure. Continuing to take these medications could alter the effects of the anesthesia, impede the recovery process, and lead to medical complications.
While this is one of the most important things to do before spine surgery, you should follow all of your surgeon’s recommendations to ensure a safe, successful procedure and recovery. Some patients will need to take particular pre-operative steps to account for underlying conditions, such as diabetes.
Before spinal surgery, take the following precautions:
A pre-operation checklist includes the steps and precautions that patients should take before surgery to ensure a successful recovery. These steps generally include:
There is a risk of complications from spinal surgery, as there is with any surgical procedure. Since spinal surgery involves operating around the spinal cord and nerves, there is a risk of nerve injury and paralysis. Although serious nerve complications are rare, it’s important to discuss this risk with your physician before planning to undergo spinal surgery.
Other possible complications from spinal surgery to be aware of include:
Infection is one significant postoperative risk. The rate of infection varies significantly depending on the type of spinal surgery, ranging from 0% to 18%. The patient’s underlying health also impacts his or her risk of infection.
You’ll be prescribed antibiotics as part of your post-operative recovery regimen. You’ll also be instructed on how to care for your surgical incision as it heals. Proper wound care is crucial to prevent infection – you’ll need to keep the wound clean and dry until it’s fully healed.
It’s important to carefully follow all of your physician’s directives to minimize the risk of infection. Infections inhibit the healing process and, if they spread, can affect other tissues and organs.
Shock is a possible complication of spinal surgery. It occurs when the patient’s blood pressure severely falls, leading to a serious reduction in the body’s blood circulation.
Infection, blood loss, metabolic issues, and brain injury can trigger shock in spine surgery patients. This complication can be treated by curbing the blood loss, assisting breathing, limiting heat loss, supplementing blood, fluids, or oxygen, and implementing medications that increase blood pressure.
Allergic reactions to anesthesia are rare but can occur. These reactions can range from mild to severe. The most severe type of reaction to anesthesia is known as malignant hyperthermia, which can be fatal without immediate treatment.
Most side effects from anesthesia are mild, including vomiting, nausea, sore throat, chills, and temporary confusion.
Blood clots in the leg are a potential complication of spinal surgery. Known as deep vein thrombosis, or DVT, this complication causes pain and inflammation in the leg. If the condition escalates, it can lead to a severe condition called pulmonary embolism.
The risk of DVT after spinal surgery is low, especially with minimally-invasive surgical techniques.
Pneumonia is another post-surgery risk. It’s a lower respiratory tract infection that causes symptoms including cough, chest pain, trouble breathing, and fever. Again, taking an active role in your recovery is the best way to avoid pneumonia and other respiratory problems.
Risk factors for postoperative pneumonia include:
Post-operative respiratory difficulties are exacerbated by inactivity and shallow breathing. The sooner you get up and about, the lower the risk of postoperative pneumonia. Talk to your doctor about how to safely remain active after spinal surgery.
Patients who undergo spinal fusion back surgery are at risk of the bone graft not healing property, known as a “failure of fusion”.
Spine fusion surgery is typically performed to stabilize the spine after spinal decompression surgery. During spinal decompression, the surgeon removes tissue that’s impinging on the spinal nerves to resolve conditions such as spinal stenosis, spondylolisthesis, and herniated disc. Spinal fusion may be done to stabilize the spine after this procedure.
The chances of fusion failure are greatly increased for smokers or patients who use nicotine in any form, including nicotine patches. Some hospitals perform urine tests on patients before spinal fusion to ensure that they have no nicotine byproducts in their systems.
Adjacent segment disease is another possible complication of spinal fusion. It occurs when the vertebrae surrounding the fused segment break down more rapidly than usual. This condition develops because the adjacent vertebrae must bear added impact to offset the fusion.
Today, the TOPS (Total Posterior Solution) System provides an alternative to spinal fusion for patients undergoing spinal decompression surgery. The TOPS System has been proven in clinical studies conducted globally to produce superior clinical outcomes and fewer complications than spinal fusion. It’s a dynamic implant device that moves with the spine in all directions while preventing instability.
The more you know about the surgical options available to you, the more you can minimize your chances of post-surgical complications. Talk to your spinal surgeon to learn more about preparing for your spinal procedure.
Though the majority of spinal problems appear between the ages of 35 and 55, wrought by natural processes associated with aging, you don’t have to be an adult to have back problems. Back pain can also affect adolescents and even children.
As many as half of all young people will experience back pain by age 20. It may appear as a sharp, shooting pain, or as a burning or aching. It may be felt anywhere in the back. These are the same symptoms adults experience, but the causes of adolescent back pain are usually different than those that afflict their elders.
Continue reading to learn more about the differences between the causes of back pain in adolescents and adults.
Back pain is normal for adults because it’s an extremely common medical condition. An estimated 80% of adults experience lower back pain at some point in their lives.
But, why exactly has back pain become normal for adults? There is no singular answer to this question, but medical experts believe that the growing prevalence of back pain is due to factors including:
The red flags for back pain that indicate the potential for serious complications include:
If you experience back pain with any of the symptoms listed above, seek out urgent medical care. Possible causes of these symptoms, such as cauda equina syndrome, require immediate treatment to prevent permanent complications.
Back pain in adolescence is most often caused by sprains, strains, scoliosis, herniated disc, and spondylolysis (vertebral stress fracture).
Benign musculoskeletal diseases and trauma are responsible for most cases of back pain in adolescents, just as they are for adults. Any strenuous or straining activity – sports or play, carrying a heavy backpack, or falling – can sprain muscles in the back and cause pain. Such strains and trauma account for many of the younger patients seen in hospital emergency rooms suffering from back pain.
Less commonly, back pain in adolescence can be caused by spinal infections, kidney infections, or spinal tumors.
Back pain is normal during puberty, to a degree. Growth spurts during puberty can cause muscular imbalances as the muscles and ligaments struggle to keep up with the growing bone.
Clinical research published in BMC Musculoskeletal Disorders focused on puberty-related back pain in young girls. This research identified a “highly significant trend” for worsened back pain with increasing levels of puberty until teens reach maturity. Lower back pain, in particular, was linked to puberty, while mid-back and neck pain didn’t seem to correlate with the pubertal stage.
You should worry about your child’s back pain if it lasts for longer than several weeks, occurs constantly, keeps them awake at night, or is accompanied by other symptoms, such as fever or neurological symptoms. If your child is exhibiting back pain with these symptoms, seek out prompt medical care for a diagnosis and treatment.
Fortunately, most cases of adolescent back pain resolve on their own. The exact cause of back pain is never identified in at least half the adolescents seeking treatment. However, adolescents can exhibit severe spinal conditions capable of causing long-term problems.
These include stress fracture of the spine, known as spondylolysis, spondylolisthesis, which is forward slippage of one vertebra on another, and lumbar disc herniations. Infections, inflammatory diseases, and tumors can also cause back pain in children and adolescents, as can other congenital or acquired conditions. However, most cases of back pain in children are caused by muscle strains and generally resolve within a few weeks.
If your child is experiencing significant, persistent back pain, don’t hesitate to seek out professional medical care.
To get rid of back pain for adults, start by improving your posture, focusing on your sleep quality, and managing inflammation with ice and heat therapy. Over-the-counter medications, like NSAIDs, can also help reduce back pain and swelling.
When at-home methods fail to relieve back pain, it’s time to see a medical professional. Your doctor can work to pinpoint the cause of your pain and, if appropriate, refer you to a spinal specialist.
Your physician and/or spinal specialist may recommend:
Physical therapy focuses on strengthening muscles that can lessen the impact on the spine. Physical therapists can also implement other treatments for back pain, including massage, electrical stimulation, and ultrasound.
Physical therapy is often the most effective for back pain when it’s paired with lifestyle adjustments. Your physician can recommend the changes that will be the most effective for your diagnosis, which may include:
Certain prescription medications can help with back pain, including muscle relaxants, antidepressants, and prescription-strength NSAIDs.
Steroid medication can be injected directly into the site of your back pain to suppress inflammation and provide fast pain relief. However, physicians advise that patients undergo no more than three to four steroid injections per year to avoid tissue damage.
When non-surgical methods don’t improve back pain after several months, physicians may recommend surgery. This is typically used as a last resort when back pain starts to disrupt the patient’s normal activities.
Spinal decompression surgery can alleviate back pain, neurological symptoms, and restricted mobility from conditions like spinal stenosis, spondylolisthesis, and herniated disc. During this procedure, the surgeon removes the tissue that’s impinging on the spinal nerves, providing the space that it needs to heal and recover.
To eliminate the possibility of spinal instability after decompression surgery, many surgeons perform spinal fusion. It involves placing bone graft material between the affected vertebrae to spur bone fusion, eliminating all motion at the spinal segment.
The fusion process can lead to reduced mobility and adjacent segment degeneration in all patients, regardless of age. In fact, when spinal fusion is performed on younger patients, it’s more likely to lead to complications. This is simply because younger patients have more years to experience the effects of spinal degeneration.
Adolescents and adults can both benefit from the TOPS™ System as a spinal fusion alternative. A TOPS™ System implant can be used following decompression spine surgery, rather than the spinal fusion procedure that’s typically performed.
Whereas spine fusion surgery eliminates the independent movement of fused vertebrae, the TOPS™ System preserves each vertebra’s full range of flexion and rotational motion. That’s welcome news for spine decompression patients of all ages.
If you or your child is struggling to manage persistent back pain, schedule an appointment with a spine specialist in your area to learn more about your treatment options.
Osteoarthritis, commonly referred to as Degenerative joint disease, is a problem that often affects people in their advancing years and can cause pain and discomfort, as well as reduce a person’s mobility.
In this article, we will describe what causes the disease, the possible symptoms, and how it may be treated.
After receiving a degenerative joint disease diagnosis, it’s common for patients to wonder what the condition entails. With this condition, degeneration usually results from the normal process of aging. This typically begins in middle age with the breakdown of cartilage, which is the rubbery tissue that serves as a cushion between bones and around joints.
Degenerative joint disease is a condition involving wear and tear on the joints. It’s the most common joint disorder and may also be referred to as osteoarthritis.
Osteoarthritis is frequently seen in the joints of the spinal column due to the many stresses and strains put on these joints. These stresses gradually wear down the cartilage that protects these joints, leading to increased friction with daily motions. This friction causes inflammation, pain, and stiffness.
Degeneration in the spine is characterized by a breakdown of the cushion-like spinal discs. This leads to bones rubbing against each other, resulting in pain, stiffness, swelling, reduced motion of the joint, and various other symptoms.
Occupations that involve physically demanding kneeling or squatting can also predispose one to degenerative joint disease. Injury or disease can further contribute to degenerative changes in the affected area later in life. Excessive weight, lack of exercise, smoking, and a poor diet can also exacerbate joint degeneration.
Degenerative joint changes can result from the natural aging process.
Cartilage protects your joints from impact, facilitates joint flexibility, and improves bone longevity. But, as the body’s collagen levels drop with age, the cartilage becomes weaker and more brittle. With time, this cartilage continues degenerating, tipping the first domino in the chain of degenerative joint changes.
As cartilage breaks down, the bones that make up a joint start to change. They become stiffer and less flexible. Additionally, the ligaments of a joint generally become shorter and more rigid, further contributing to joint stiffness.
Increased friction within a joint can lead to the formation of bone spurs. This degenerative joint change occurs when extra bone tissue forms in a joint. This is your body’s attempt to repair the lost cartilage.
Degenerative joint disease symptoms develop as the cartilage in the joints gradually degrades. The symptoms can vary depending on the location of the degeneration and worsen over time.
The common symptoms of degenerative joint disease are:
Joints that are affected by osteoarthritis may become painful when a person is active, or immediately afterward. The pain may even occur with the simplest of movements, such as standing up or sitting down.
Additionally, the pain will occur around the degenerating joint. For example, if degenerative joint disease affects the joints of the spine, the patient will likely experience persistent pain in the back.
The affected joints may be tender to the touch. In advanced cases of degenerative joint disease, patients may experience tenderness even under the lightest of pressure on or around the problem area.
With degenerative joint disease, the soft tissue around the affected joint can become inflamed. This may lead to visible swelling.
The joints could become stiff, impacting a person’s flexibility and mobility. This will likely occur first thing in the morning or during a long period of sitting still. Patients with degenerative joint disease of the spine may find it difficult to fully straighten, twist, or bend their spines.
You may notice a significant decline in the flexibility of the joint affected by degenerative joint disease. You may no longer be able to move it freely and enjoy a full range of motion.
With degenerative joint disease, you may experience a sensation like grating or grinding while moving. This feeling is often combined with unexpected sounds such as cracking, or popping. These sounds aren’t a problem on their own, but indicate damage within the joint.
Bone spurs occur when extra bone tissue forms around the affected joint. These portions of bone may feel like hard lumps underneath the skin. In some cases, bone spurs come into contact with nearby nerve roots, leading to pain and even neurological symptoms like numbness, weakness, and tingling.
Several treatment options are available for degenerative joint disease of the spine, including physical therapy, medications, and injections.
Although the condition cannot be cured, steps can be taken to stop it from worsening and to reduce the symptoms.
Here is a summary of the treatment options available to degenerative joint disease sufferers:
It may seem counterintuitive, but exercise can help patients with degenerative joint disease overcome their symptoms. This is because regular exercise provides natural lubrication to the cartilage of the affected joint. With this lubrication, the arthritic joint becomes less stiff and painful.
Additionally, exercising regularly promotes higher energy levels, improved sleep quality, and weight management. Given that osteoarthritis pain tends to worsen at night, improved sleep quality can help patients more effectively manage nighttime pain. Additionally, by helping patients reach a healthy weight, an exercise regimen can reduce the impact on the joints with daily activities.
Of course, not all forms of exercise are beneficial for patients with osteoarthritis. Medical professionals generally recommend that patients opt for low-impact activities, such as walking, swimming, yoga, and biking.
Physical therapy is a conservative treatment option that’s widely recommended for osteoarthritis patients. For this joint condition, physical therapy mainly involves aerobic and neuromuscular exercise. The goal of aerobic exercise is to improve the patient’s muscle strength and stamina, while neuromuscular exercise focuses on joint stability and function.
Over time, physical therapy can improve joint pain, increase range of motion, and restore the joint’s function.
Pain medication and/or steroid injections may be recommended to help patients manage pain from degenerative joint disease. These medications may be available over the counter or with a prescription, depending on the patient’s needs.
NSAIDs are widely considered to be the best oral medications for osteoarthritis. These drugs offer both anti-inflammatory and painkilling effects. Examples include Advil, Motrin, and Aleve, as well as Voltaren, which is a topical medication.
In some cases, steroid injections are used to treat degenerative joint disease. With this treatment, the steroid medication is injected directly into the arthritic joint to curb inflammation and pain. Regrettably, steroid injections can lead to tissue damage if they’re used too often, so physicians generally limit patients to three or four shots per year.
When it’s combined with regular exercise, a healthy diet can help you reach an ideal weight and prevent weight gain down the road. This is crucial for osteoarthritis patients because, as we’ve already mentioned, excess weight puts more pressure on the injured joint with every step you take.
If you’re already making dietary changes to manage your weight with degenerative joint disease, it’s an excellent opportunity to incorporate anti-inflammatory foods into your diet. These foods can help fight inflammation within your body and include:
Conversely, it’s in your best interest to avoid foods that encourage inflammation in the body (also known as inflammatory foods), such as:
Your choice of footwear can have a sizable impact on your joint health. So, for patients with degenerative joint disease, it’s particularly important to wear supportive footwear. The wrong choice of shoes could lead to worsened joint pain in the future.
As general guidelines, look for shoes with significant cushioning and arch support to absorb shock while you walk. The sole should be flexible enough to move with your foot, but not so flexible that it moves out of place. Additionally, avoid high heels, which are arguably the worst shoe type for osteoarthritis.
Some cases of degenerative joint disease benefit from a brace to stabilize and protect the affected joint. Patients with spinal osteoarthritis can consider wearing a back brace, which prevents excessive spinal flexion and compresses the spinal joints. This can help alleviate pain while reducing the risk of further injury.
When symptoms of degenerative joint disease persist regardless of conservative treatment or severely compromise the patient’s mobility, physicians may recommend spinal decompression surgery.
For patients with moderate to severe osteoarthritis that isn’t improved with non-invasive approaches, spinal decompression surgery may provide relief. This procedure reduces the pressure on pinched nerves caused by diminished cushioning within the joint.
During spinal decompression surgery, the surgeon removes the tissue that’s impinging on the spinal nerves. This may involve a portion of the lamina or a bone spur.
The spinal decompression procedure has historically been performed in tandem with spinal fusion surgery. This approach stabilizes the spine by fusing two vertebrae at the point where the decompression procedure was performed.
The TOPS™ System provides a clinically proven, superior alternative to spinal fusion by enabling patients to maintain the full range of motion of each vertebra. You may not be able to stop natural degenerative spinal changes, but a range of effective medical options are available to treat them. A qualified specialist can help you choose the one that’s right for you.
The key benefits of the TOPS System are:
As a long-term condition, degenerative joint disease requires lifestyle changes to help you cope with its symptoms and lessen the impact it may have on the overall quality of your life. This is why it’s always important to speak to medical professionals who can offer support and ease the strain of osteoarthritis.
Preventing degenerative joint disease is not entirely possible as it’s simply a result of aging, affecting millions of people across the globe. However, it is possible to minimize the risk of osteoarthritis by maintaining a healthy, active lifestyle with good habits.
Regular exercise is a great way to limit the chances of developing osteoarthritis. But, workouts that put excessive strain on the joints, such as running and weight lifting, can have the opposite effect. Opt for low-impact exercises to prevent accelerated joint degeneration.
Activities like swimming and cycling are great ways to keep in shape while controlling the strain placed on your joints. Two and a half hours of steady exercise each week, including some strength exercises, can build muscle strength and maintain healthy joints.
Try to correct your posture at all times and avoid bending in an unnatural position for too long. This will help keep your spine in a healthy position. Additionally, adjust the height of your chair while working in an office and try to walk around every so often to encourage blood circulation.
Carrying extra weight is one of the main reasons why a person can suffer from joint-related issues, including osteoarthritis. Eating healthily and trying to lose weight can significantly reduce your chances of developing such issues.
If you’ve been diagnosed with degenerative joint disease, make sure to speak with your doctor about the latest available treatment options for pain relief.
Ancient medical experts believed that back pain was brought on by a fluid imbalance. Therefore, many patients with back pain were treated with bloodletting.
Today, we know that back pain can have a variety of causes. Muscle and ligament sprains cause many episodes of back pain. Problems in the internal organs or tumors can also lead to back pain by affecting nerves that emanate from the spinal column. Stress can even trigger back pain by tightening the back muscles.
In this article, we’ll discuss some of the key types and causes of back pain to help you more effectively find professional pain care.
The main types of back pain are:
Acute back pain occurs suddenly and typically resolves after a few days or weeks. It’s most often caused by abrupt injuries to the muscles or ligaments that support the spine, such as muscle strains, tears, or spasms.
Subacute back pain may occur suddenly or gradually and typically resolves after one to three months. This type of back pain can be caused by either abrupt injuries, like muscle strains, or overuse/degenerative injuries, like a herniated disc.
Chronic back pain is often considered the most severe. It’s defined as pain that develops quickly or gradually, persists longer than three months, and occurs every day. Some of the most common causes of chronic back pain include spinal arthritis, herniated disc, spinal stenosis, spondylolisthesis, and degenerative disc disease.
The organs that can cause lower back pain include the kidneys, colon, appendix, gallbladder, liver, pancreas, uterus, and reproductive organs.
Let’s explore how these organs can lead to lower back pain in more detail:
Kidney stones and kidney infections can both cause lower back pain. Kidney stones can trigger pain on one or both sides of the back, typically in between the ribs and hips.
Kidney infection is a severe form of urinary tract infection also referred to as acute pyelonephritis. It may cause pain on the side of the back with the infected kidney (if the left kidney is infected, the left side of the lower back will hurt). This pain may be intense or dull and can be accompanied by fever, nausea, vomiting, and pain during urination.
Ulcerative colitis, a form of inflammatory bowel disease, can lead to lower right back pain. It’s caused by chronic colon inflammation and, in addition to back pain, can trigger weight loss, fatigue, rectal pain, and diarrhea.
Appendicitis occurs when the appendix is infected or inflamed. Patients with appendicitis may have sudden pain in the lower right side of the back, possibly with fever, vomiting, and/or nausea.
Pain in the right side of the back and upper right portion of the abdomen with serious indigestion can indicate gallbladder inflammation or dysfunction. This condition more commonly affects women than men.
Back pain can stem from liver issues like liver scarring, inflammation, hepatocellular carcinoma, liver abscess, liver failure, or an enlarged liver. These conditions can also cause pain in the upper right portion of the abdomen, fatigue, reduced appetite, jaundice, and nausea.
Pancreatitis, or inflammation of the pancreas, can trigger pain that spreads from the upper abdomen to the lower left area of the back. It may be described as a dull pain that worsens with fatty food consumption.
Lower right back pain can stem from one of many female reproductive organs. Endometriosis, for example, develops when cells akin to the uterine lining are located outside of the uterus, often on the fallopian or ovarian tubes. This may lead to pelvic pain that can spread to the lower right back.
Muscle or tendon injuries, degenerative spinal conditions, arthritis, and disc problems can cause lower back pain.
Sprains, strains, arthritis, and nerve impingement can cause hip and lower back pain.
When a muscle, tendon, or nerve that extends over both the hip and lower back is injured, the patient may experience hip and lower back pain at the same time. Most commonly, this is a sign of a sprain or strain, which can resolve with at-home care. However, if hip and lower back pain doesn’t go away within a few weeks, becomes worse, or starts to inhibit your day-to-day activities, seek out professional medical care.
Severe lower back pain can be caused by disc problems, structural spinal issues, arthritis, spinal tumors, and spondylolisthesis. These conditions can all worsen with age and overuse, leading to severe pain and even disability.
You can tell if your back pain is muscular if it worsens when you move, feels like a dull ache, and is accompanied by stiffness and/or soreness. Additionally, muscular back pain typically starts to go away after resting for a few days.
Your back pain may not be muscular and indicate something else if you’re experiencing pain that radiates into the extremities. This, along with numbness, weakness, and tingling, indicates spinal nerve inflammation, which occurs with conditions like a herniated disc, spinal stenosis, and spondylolisthesis. This is also known as neuropathic pain.
Additionally, if back pain isn’t muscular, the problem could be bone-related. This is less likely than neuropathic pain but can occur if the patient has developed bone spurs, osteoarthritis, osteoporosis, cancer, or a bone infection.
Muscular, neuropathic, and bone pain all require different back pain treatments. If your pain doesn’t go away with rest and at-home methods, your doctor can provide a diagnosis and treatment plan.
Many people suffer from back pain as a result of traumatic and degenerative spinal disorders. These spinal disorders, such as spinal stenosis and herniated disc, put pressure on nerves within or emanating from the spinal column. This pressure on the nerves – commonly referred to as a pinched nerve – causes pain and other problems associated with these conditions.
When pinched nerves do not resolve with conservative treatments, such as physical therapy or medications, spinal decompression surgery is an option to consider. This procedure can relieve pressure on spinal nerves and dramatically reduce the patient’s back pain.
In the past, spinal fusion back surgery was routinely performed in conjunction with spinal decompression surgery to stabilize the spine. It involves fusing adjacent vertebrae at the surgical site.
Spinal fusion back surgery eliminates the independent motion of the fused vertebrae, potentially leading to reduced mobility. Thankfully, patients today no longer need to surrender spinal motion to benefit from decompression spinal surgery.
The TOPS™ System from Premia Spine enables spinal decompression patients to maintain their full range of spinal motion. Instead of fusing adjacent vertebrae during surgery, the surgeon implants the TOPS™ System and preserves pain-free flexion, extension, lateral bending, and axial rotation at each vertebra.
From simple conservative treatments to advanced surgical procedures, whatever the cause of your back pain, it’s comforting to know that effective treatments are available from qualified spine specialists.
Your lower back is more susceptible to injury than the other regions of the spine. So, it’s unsurprising that a pinched nerve in the lower back is among the most common spinal injuries. Though a pinched lumbar nerve can often clear up on its own, some patients may need medical attention to resolve their symptoms.
This article will answer the most common questions about having a pinched nerve in the lower back, including the available treatment options.
A pinched nerve is a condition that can cause pain and restrict one’s mobility. It develops when adjacent tissue, such as bone, muscle, or cartilage, impinges on a nerve. This can lead to various neurological symptoms, namely weakness, tingling, and numbness in the extremities.
Though pinched nerves can occur almost anywhere, the spine and, in particular, the lumbar region of the spine, account for a significant percentage of cases. This is due to the spine’s complex structure and the fact that the lower back experiences more strain with motion than the cervical or thoracic spine. This condition is referred to as a pinched lumbar nerve or a pinched nerve in the lower back.
The nerves of the lumbar spine extend throughout the pelvis, legs, and feet. The sciatic nerve, for example, is the longest nerve in the body and runs from the lower back through the hips and down the backs of the legs. A pinched sciatic nerve can cause persistent back pain, tingling, and other symptoms that are referred to as sciatica.
The symptoms of a pinched nerve in the lower back include lower back pain that radiates to the buttocks, legs, and feet, along with weakness, numbness, and tingling in the extremities.
In some cases, a pinched nerve in the lower back may also cause muscle spasms, the sensation of the feet “falling asleep”, or a “pins and needles” sensation. These symptoms can vary depending on the severity of the nerve impingement, along with the patient’s overall health.
Sometimes, a pinched nerve in the lower back can escalate, leading to a condition known as cauda equina syndrome. This dangerous condition can lead to permanent neurological damage if it’s not promptly treated. So, if you have a pinched nerve in the lower back, keep an eye out for the following warning signs of cauda equina syndrome:
If you experience the warning signs listed above, seek out emergency medical care.
A pinched nerve in your back may feel like sharp, shooting pain, a burning sensation, weakness in the legs, and/or tingling. In mild cases, patients may experience only minor discomfort or back pain that comes and goes.
The symptoms of a pinched nerve vary depending on the exact nerve and the extent of the pressure. In addition to the symptoms listed above, this condition can cause a loss of reflexes and motor skills, as well as atrophy of the affected muscles.
The symptoms of pinched nerves will go away on their own if the pressure on the nerves is only temporary. If this is the case, patients will regain the full function of the spine without the need for medical intervention.
It typically takes four to six weeks for a pinched nerve to go away on its own. To manage your symptoms while this spinal injury naturally heals, consider at-home treatment options like rest and over-the-counter pain medications. While you’re resting with a pinched nerve, make sure to avoid activities that may strain the affected area of the spine, such as:
You can perform some forms of exercise but not others with a pinched nerve. Gentle, low-impact exercises that don’t strain the spine are considered beneficial for a pinched nerve in the back. This is because they promote circulation, muscle strength, and flexibility.
The best forms of exercise for a pinched nerve in the back include:
Forms of exercise to avoid with a pinched nerve in the lower back include:
If your pinched nerve doesn’t go away on its own, there are many treatment options available to you. These include:
A physical therapist can provide special exercises to help resolve pinched nerve symptoms. These exercises focus on strengthening the abdominal muscles to better support the spine and stretching the back to alleviate muscle tension.
Spinal manipulation may help ease the symptoms of a pinched nerve by relieving pressure on the affected nerve and promoting circulation to the area.
Over-the-counter and/or prescription medications may be used to reduce tension in the back muscles and alleviate inflammation in the painful area of the back.
Massage therapy is often good for pinched nerves in the lower back. This is because it can help alleviate muscle tension that may be causing or worsening nerve impingement. As a safe and natural treatment option, massage therapy is widely used by patients to help with pain and stiffness from a pinched nerve.
There are many different types of massage, but the most popular for pinched nerves in the back include deep tissue massages and Swedish massages. Make sure to visit a licensed and reputable massage therapist to prevent further irritating the impinged nerve.
A chiropractor can treat a pinched nerve with manual adjustments, along with remedies like heat/cold therapy and lifestyle changes.
During a chiropractic adjustment, the chiropractor will use their hands or a small instrument to manipulate the spine. This helps restore the proper alignment of the spine, reduce pressure on the spinal nerves, and promote circulation to the injured area.
For virtually any condition, the best therapy is preventive. Pinched nerves and many other spinal problems can be avoided by:
To get rid of a pinched nerve in your back that doesn’t respond to non-surgical treatments, you may want to consider surgery.
When preventative measures and non-invasive treatments fail, surgery for a pinched nerve is a viable option. Spine specialists don’t consider surgery for a pinched nerve in the back unless the patient has undergone six to 12 months of conservative therapies with no notable improvement. Additionally, candidates for pinched nerve surgery typically have severe, chronic pain that diminishes their ability to complete day-to-day tasks.
Spinal decompression surgery is recommended for some patients who don’t respond to minimally-invasive treatments for a pinched nerve. Spinal decompression therapy can have a dramatic effect on relieving the symptoms of a pinched nerve in the lower back.
The most common form of spinal decompression surgery for a pinched nerve in the back is laminectomy. During this operation, the surgeon removes a small piece of the bone that covers the spinal canal, known as the lamina. Removing some of this bone allows the surgeon to create more space for the affected nerve and resolve the impingement.
Typically, spinal fusion back surgery is performed in conjunction with decompression surgery to stabilize the spine. Without some form of stabilization, decompression surgery can leave the spine vulnerable to future injury.
Spinal fusion is performed after decompression surgery. During the procedure, the surgeon positions bone graft material in between the affected vertebrae. Gradually, this bone graft will cause the vertebrae to combine into one bone.
This process eradicates all motion between the fused vertebrae, which prevents injuries related to instability of the area. Unfortunately, it also permanently reduces the patient’s mobility and can cause degeneration in the adjacent spinal segments.
Today, the TOPS (Total Posterior Spine) System provides an alternative to spinal fusion for a pinched nerve in the back. In contrast to spinal fusion, TOPS restores the full range of the spine’s natural motion. It’s also been shown to provide superior outcomes when compared to fusion in clinical studies performed around the world.
The TOPS System presents a great new option for some individuals affected by pinched nerves in the lower back. Contact a medical center that offers the TOPS System in your area to learn more!
Back pain is a universal health concern, and it doesn’t discriminate. The factors that trigger back pain are often the same in women and men. However, certain causes of back pain, such as menstruation, pregnancy, and osteoporosis, are either unique to or more prevalent among women.
The most common issues of lower back pain in females are menstruation, pregnancy, stress, osteoporosis, and spinal conditions like disc disease, herniated discs, spondylolisthesis, and spinal stenosis. Let’s research them deeper:
Menstruation is a key cause of back pain that exclusively affects women. During menstruation, the uterus produces substances known as prostaglandins. Prostaglandins manage muscle contraction, and during menstruation, they send messages to the uterus instructing it to contract.
These muscle contractions are the direct cause of cramps and back pain during menstruation. Additionally, the cramps associated with menstruation place added stress on the back muscles, potentially leading to back muscle pain.
Pregnancy often causes back pain, particularly in its later stages. The added weight of carrying the fetus puts significant stress on the spine, as well as the supporting muscles and ligaments.
Additionally, the ligaments stretch and soften during pregnancy. This is one of the body’s methods of childbirth preparation. Unfortunately, as the ligaments soften, the lower back and pelvis become less supported. This may trigger back pain.
Also, while being overweight for any reason can cause back pain, the rapid weight gain that occurs during pregnancy compounds the problem.
Mental stress is known to cause or contribute to back pain, in part because it contributes to the involuntary tightening of muscles in the back. Stress can also cause or exacerbate back pain during pregnancy which, as a major life change, is a time of great psychological stress.
Later in life, our bodies’ bone-building process gradually weakens. As a result, calcium is depleted from our bones, and our overall bone mass drops. The bones become more brittle, making them more prone to breakage. This phenomenon, which is referred to as osteoporosis, is more common among women than men.
If osteoporosis causes spinal fractures (known as compression fractures), it can lead to severe back pain. With a compression fracture from osteoporosis, patients typically struggle to sit, stand, and walk.
Common spinal conditions, such as degenerative disc disease, herniated disc, spondylolisthesis, and spinal stenosis, affect women, just as they do men. These conditions can lead to chronic lower back pain.
Lower right back pain in females can be caused by spinal conditions, soft tissue injuries, endometriosis, uterine fibroids, pregnancy, or various underlying conditions.
The spinal conditions that can cause lower right back pain in females include spinal stenosis, degenerative spondylolisthesis, and disc degeneration. These conditions can trigger spinal nerve compression, which may lead to sharp or burning pain in the right side of the back.
Endometriosis, uterine fibroids, and pregnancy are possible causes of lower right back pain that can only occur in women.
Certain internal organs can lead to lower right back pain in female patients. Specifically, organs located in the pelvis, abdomen, and mid-back area may be the root of lower back pain.
In women, the reproductive organs in the pelvis can trigger pain in the lower right area of the back. For instance, endometriosis, which typically affects the ovaries and fallopian tubes, can lead to pain that extends to the lower back.
The appendix is an organ that’s linked to the large intestine. People who develop appendicitis, which occurs when the appendix becomes inflamed, can develop lower right back pain.
Appendicitis requires immediate treatment to prevent rupture and complications. In addition to lower right back pain, symptoms may include sudden pain on the right side of the lower abdomen that worsens with abrupt motions, loss of appetite, nausea, and vomiting.
The kidneys are organs that remove waste from the blood. Kidney issues, such as kidney stones or a kidney infection, can lead to pain on one side of the lower back. Other symptoms of kidney problems often include pain while urinating, nausea, and vomiting.
Ulcerative colitis is a condition that’s characterized by inflammation in the colon. It causes repeated cramping in the abdomen that may trigger lower back pain, as well as symptoms including diarrhea, weight loss, and fatigue.
Extreme lower back pain can be a cause for concern. But, since back pain is a common ailment, it can be difficult to know whether or not your pain requires medical attention.
As a general rule of thumb, visit your doctor for an evaluation if you experience back pain that persists for longer than two weeks and holds you back from regular activities. If you experience severe back pain, visit a doctor sooner than after two weeks. Additionally, seek out immediate medical care if you have:
Whatever its origin, there’s no reason to live with back pain, as a variety of treatment options exist for all their causes. Women wondering how to help lower back pain may consider physical therapy, medication, or even lifestyle changes to alleviate back pain caused by spinal conditions.
Physical therapy can help with lower back pain by helping relieve tension in the back muscles. Additionally, physical therapy exercises can target and strengthen the muscles that support the back.
Over-the-counter pain and anti-inflammatory medications may help women manage lower back pain in the short term. These medications can also help alleviate menstrual cramps and the associated back pain.
However, women experiencing back pain caused by more complex conditions, such as endometriosis, should speak with their doctors about the available prescription medications for the condition.
Lifestyle changes may help you naturally achieve relief from lower back pain. For example, in women experiencing back pain during pregnancy, gentle, low-impact exercise may offer relief.
Women with back pain caused by cramps during menstruation can consider lifestyle changes including quitting smoking, cutting down on alcohol consumption and adding more high-fiber foods to their diet. Additionally, women with spinal conditions, such as spinal stenosis, may need to modify their activities to avoid straining the spine.
Surgery is rarely required for women with back pain. However, if the back pain doesn’t resolve within six months of conservative treatment, your doctor may recommend spine surgery for lasting pain relief.
Among women for whom spine surgery is recommended, there are multiple surgical approaches to consider. Thankfully, advanced microsurgical techniques and stabilization systems provide effective treatments for potentially disabling spinal conditions.
Decompression spinal surgery is a commonly performed spinal procedure for conditions including spinal stenosis, spondylolisthesis, and herniated disc. In this procedure, a portion of the vertebra that’s impinging on a spinal nerve is removed. Decompression surgery can have a dramatic and immediate impact on back pain associated with prevalent spinal conditions.
Spinal fusion surgery has traditionally been performed in conjunction with spinal decompression. This process involves fusing adjacent vertebrae at the affected segment to stabilize the spine.
Unfortunately, while spinal fusion may offer pain relief for patients suffering from chronic back pain, it has numerous drawbacks. For one, spinal fusion eliminates the patient’s motion at the affected segment. As a result, the patient loses the ability to bend, twist, and flex that area of the spine.
Additionally, spinal fusion can lead to adjacent segment disease. This fusion complication occurs when the vertebrae surrounding the fused bone degenerate faster than usual. As a result, the patient may experience back pain, stiffness, and/or neurological symptoms.
Alternatives to spinal fusion are available and can help patients avoid the drawbacks of spinal fusion. The TOPS™ System from Premia Spine, in particular, provides a superior, clinically-proven outcome when compared to spinal fusion back surgery.
Unlike spinal fusion, the TOPS™ System preserves the vertebrae’s range of motion. Having been used since 2005, the system has enabled patients around the world to maintain their full range of activities following decompression surgery. TOPS™ has further advanced the treatment of common but potentially debilitating spinal conditions.
Women experiencing back pain from spinal conditions should consult their doctors to learn about the complete range of spinal treatments available today.
Although it’s not as common as spinal stenosis or a herniated disc, spondylolysis is near the top of the list of conditions that can cause lower back pain. This spinal condition is relatively common, affecting approximately one out of 20 people. You may also hear it referred to as a stress fracture or pars defect.
Learning about spondylolysis can help you better understand the factors that could be behind your back pain. In this article, we’ll provide a detailed overview of spondylolysis, including modern treatment options for this condition.
Spondylolysis is a stress fracture in a vertebra, which is a bone in the spinal column. The fracture occurs at the point where the vertebra connects to the vertebra above it, known as the pars interarticularis.
The pars interarticularis is a thin piece of bone that links the upper and lower segments of the facet joints. It connects the vertebrae and facilitates the movement of the spine.
The fracture in the pars interarticularis can allow a vertebra to move out of its usual position and press against, or compress, the spinal cord. This condition is called spondylolisthesis. Spondylolisthesis can cause several symptoms, with lower back pain being the most common.
Spondylolysis isn’t rare, affecting an estimated 3% to 7% of Americans. Many of the patients who are diagnosed with spondylolysis are younger than traditional spinal patients. In fact, in one orthopedic series, spondylolysis accounted for 47% of cases of acute lower back pain in teen athletes.
Spondylolysis is rooted in a weakness in the pars interarticularis. The exact cause of a weakness in the pars interarticularis isn’t known.
With that said, factors that can influence the weakness in the vertebrae that characterizes spondylolysis include:
Genetics are believed to play a role in some cases of spondylolysis. Some children are born with this spinal condition.
Repetitive spinal trauma may also lead to spinal trauma. This commonly occurs in young athletes who frequently stress the spine. In two prospective studies, the incidence of lower back pain in athletes with spondylolysis was 72.5 % in high school rugby players, 80.5% in college football players, and 79.8% in high school football players.
The good news is that many people with spondylolysis remain asymptomatic. Asymptomatic patients have no symptoms and are usually unaware they even have spondylolysis.
When the spondylolysis does cause lower back pain, it usually spreads across the lower back. Spondylolysis pain often feels like a muscle strain and is generally exacerbated by exercise or vigorous activities.
In adolescent patients, spondylolysis symptoms often appear during growth spurts. This makes the most common age of diagnosis for teenage patients with spondylolysis 15 to 16.
Spondylosis and spondylolysis are often confused, and it’s easy to see why. The names of these spinal conditions are very similar. But, each is a distinct ailment with different causes and symptoms.
The spondylosis diagnosis is used for degenerative osteoarthritis of the spine. With this condition, the cartilage that protects the ends of the vertebrae breaks down. As a result, the space between the vertebrae shrinks.
Spondylosis may also involve age-related degeneration of the spinal discs and bone spurs. This condition differs from spondylolysis, which specifically involves a stress fracture in the pars interarticularis.
We’ve already mentioned spondylolisthesis and how it can result from spinal instability caused by spondylolysis. Similar to spondylosis, spondylolisthesis is commonly confused with spondylolysis. Additionally, spondylolysis can often cause spondylolisthesis, which further adds to the confusion.
Ultimately, spondylolisthesis involves vertebral misalignment due to spinal instability, while spondylolysis is a stress fracture of the pars interarticularis.
Most cases of lumbar spondylolysis are resolved with non-surgical treatment methods. Non-surgical spondylolysis treatment often involves lifestyle modifications, medications, and physical therapy.
Spondylolysis is a common injury in young athletes, namely those who are involved in sports that involve spinal hyperextension. So, physicians generally recommend that spondylolysis patients take a break from sports to give the spine time to heal.
Simple over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can often relieve mild spondylolysis symptoms.
Physical therapy is one of the most effective non-invasive treatment options for spondylolysis. Your physical therapist can help you regain a high quality of life and safely go back to your usual activities.
The goals of physical therapy for spondylolysis are to:
In general, patients with spondylolysis should try to avoid all high-impact activities, such as running, as well as activities that put added stress on the lower spine. Heavy lifting, football, diving, and competitive swimming can all strain the lower spine.
With spondylolysis exercises to avoid in mind, it’s important to stay active with spondylolysis. Physical activity improves blood flow to the damaged and irritated spinal tissues, which facilitates the healing process. Additionally, gentle exercise will help you maintain muscle strength and mobility throughout your recovery.
Many patients, especially young athletes, are eager to avoid spending time on the bench due to spondylolysis. While genetic factors that may make you more susceptible to spondylolysis can’t be altered, certain tactics may help you prevent this spinal condition.
First off, consider a sports injury prevention program, which may be available from your local physical therapist. This type of program focuses on safely building muscle strength and increasing flexibility. Together, strength and flexibility can help prevent excess strain on the spine.
Additionally, avoiding repetitive motions that strain the back can help prevent lumbar spondylolysis. Unfortunately, this may not be possible in specific sports, such as gymnastics and weightlifting. Athletes who are predisposed to spondylolysis should consider talking to their coaches about their unique needs.
As a general rule of thumb, practicing proper posture can help avert spondylolysis and a host of other spinal conditions. Try to be mindful of your posture while you sit, stand, and lift heavy objects. Keeping your spine straight with your shoulders back and head levels allows for proper spinal alignment.
In moderate to severe spondylolysis cases that don’t respond to conservative treatments, spondylolysis surgery may be required. There are a few different surgical approaches that your physician may recommend.
Surgery may be implemented to repair the spinal stress fracture. During this type of procedure, the surgeon will likely use a titanium screw to secure either side of the fracture together. For additional support, your surgeon may also place bone graft material in the affected area.
Patients with spondylolysis and nerve compression from spondylolisthesis may benefit from spinal decompression surgery. Spinal decompression involves removing a portion of the defective vertebra that’s compressing the spinal nerve.
Typically, spinal fusion surgery is performed following the decompression procedure to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. This process, over several months, permanently fuses the targeted vertebrae.
Unfortunately, while spinal fusion can successfully prevent spinal instability after decompression surgery, it also eradicates the independent motion of the vertebrae. This leaves patients’ mobility seriously compromised and increases the risk of degeneration in the neighboring vertebrae.
With these downsides (among others) in mind, many modern spondylolysis patients look for spinal fusion alternatives. Recently, an advanced alternative to spinal fusion, the TOPS™ posterior arthroplasty procedure, has gained prevalent in the United States. Having been approved and successfully used for years in Europe and other countries, the TOPS™ System provides better clinical outcomes than fusion while preserving the patient’s full range of back motion.
Back pain is one of the world’s most common and debilitating medical conditions. As pioneers of advanced surgical treatments for spinal disorders, we at Premia Spine encourage anyone suffering from back pain, including spondylolysis pain, to learn about all the treatment options available today.
If you’re struggling with persistent back pain along with numbness, tingling, or weakness, you may have a spinal condition. Spondylolisthesis is one possible condition that can trigger these symptoms and ultimately compromise your quality of life.
In this article, we’ll dive into the topic of spondylolisthesis and explain what patients can expect from a spondylolisthesis diagnosis. While the prospect of managing this condition may seem intimidating, rest assured that there are numerous effective treatment options for spondylolisthesis.
With spondylolisthesis, one of the vertebrae in the spine becomes displaced due to instability. As a result, it moves downward in relation to its proper position, settling on the vertebra beneath it.
This malpositioning can put pressure on the spinal cord, as well as the nerves that emanate from the spinal column. This pressure can lead to pain in the lower back and leg.
Spondylolisthesis of the lumbar region (meaning that it occurs in the lower back) is the most common. Specifically, the L5-S1 level of the spine is most frequently affected by spondylolisthesis, followed by the L4-5 level.
You’ve probably heard the common medical term, “a slipped disc”. While this may seem to indicate the slippage involved in spondylolisthesis, it’s an entirely different condition.
Spondylolisthesis affects the spinal bones, which are known as vertebrae. A slipped disc is an injury involving an intervertebral disc, which is a cushion of shock-absorbing tissue. There’s an intervertebral disc located in between each of the vertebrae in the spine.
Given that spondylolisthesis and a slipped disc affect different parts of the spine and develop differently, it’s crucial to distinguish them. A spinal specialist can give you an accurate diagnosis of back pain.
As another spinal condition that’s commonly confused with spondylolisthesis, you may have heard of spondylolysis. This condition, unlike a slipped disc, is related to spondylolisthesis. However, they’re still different conditions.
Spondylolysis is a stress fracture that runs through the pars interarticularis, a small segment of bone that connects two vertebrae. When the pars interarticularis is fractured, patients may experience back pain that worsens with physical activity. However, not all spondylolysis patients have symptoms.
Approximately one out of 20 people have spondylolysis, making it a relatively common condition. Additionally, spondylolysis can lead to spondylolisthesis. This is because the pars interarticularis fracture can diminish the stability of the spine and potentially lead to slippage.
Spondylolisthesis has several possible causes, the most common of which include:
The most common cause of spondylolisthesis is degenerative changes in the vertebral joints and cartilage due to aging. When spondylolisthesis is caused by age-related spinal changes, it’s known as degenerative spondylolisthesis.
Younger individuals may experience spondylolisthesis caused by a birth defect in the facet of the vertebra. The defect, which is present at birth, can cause the vertebra to slip out of position. This is referred to as dysplastic spondylolisthesis.
Spondylolisthesis can also result from sudden trauma, such as a sports injury or car accident. This is known as traumatic spondylolisthesis and can occur in people of all ages.
In athletes that repetitively strain and overstretch the spine, spondylolisthesis is a relatively common injury. This is especially true in younger athletes, given that their spines haven’t fully developed.
The most frequent symptom of lumbar spondylolisthesis is lower back pain. The pain typically worsens after exercise and abates when you sit or bend forward.
Decreased range of motion and tightness of the hamstring muscles are common spondylolisthesis symptoms.
The nerve compression may also result in pain, numbness, tingling, or weakness in the legs, and in cases of severe compression, loss of bowel or bladder control.
Spinal stenosis isn’t exactly a symptom of spondylolisthesis. However, degenerative spondylolisthesis is a prevalent cause of spinal stenosis, which is an abnormal narrowing of the spinal canal.
A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and x-ray imaging, as well as a comprehensive physical exam. You’ll likely stand sideways as the x-rays are taken so your physician can see the vertebra’s slippage clearly.
After your physician has examined the imaging test results, the severity of your spondylolisthesis case will be graded. The grading scale is based on the degree of slippage from the vertebra’s normal position.
Upon making a diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.
As aforementioned, spinal specialists use a grading system to determine the severity of spondylolisthesis cases. Spondylolisthesis grades include:
Several factors can worsen spondylolisthesis, including:
If you’ve been diagnosed with spondylolisthesis, your physician likely recommended lifestyle adjustments to help you avoid the factors listed above.
Any exercises that involve heavy lifting and excessive twisting or bending should be avoided with spondylolisthesis. If you enjoy a specific sport, you should talk to your physician about whether it’s safe to participate in that sport while you’re struggling with spondylolisthesis symptoms.
Sports that tend to exacerbate spondylolisthesis symptoms include:
Treatments for spondylolisthesis include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and epidural steroid injections. In many patients, these treatments are sufficient to alleviate the symptoms of spondylolisthesis.
Physical therapists can help patients manage spondylolisthesis in several ways.
For one, your PT can offer valuable insights and education about how your lifestyle is affecting your symptoms. From your exercise regimen to your footwear to your posture, your physical therapist can identify areas for improvement. In making the recommended adjustments, you can likely reduce the pressure on your spine, leading to an improvement in spondylolisthesis symptoms.
Additionally, your PT can implement various non-invasive methods of pain management. Targeted heat and cold therapy can help alleviate inflammation and pain. Electrical stimulation is another popular method among physical therapists to gently reduce the transmission of pain signals to the brain.
Physical therapists can also recommend stretching and strengthening exercises for spondylolisthesis. By stretching to reduce muscle tension, you can gain greater back flexibility. By strengthening various muscle groups, you can gain greater stability in the lumbar spine, hips, and pelvis.
Many spondylolisthesis patients find that chiropractic care is a helpful tool for alleviating their symptoms. Chiropractors specialize in spinal manipulation to treat issues involving the musculoskeletal system.
Key goals of chiropractic care for spondylolisthesis include improving spinal mechanics, restoring spinal function, and improving posture. In achieving these goals, your chiropractor may alleviate compression on the spinal nerves, which often leads to reduced symptoms.
One of the main benefits of chiropractic care for spondylolisthesis is that it’s non-invasive. Chiropractors focus on methods including manual and instrument-assisted manipulation to adjust the spine, making it a safe back pain treatment option.
Physicians often recommend over-the-counter medications to help spondylolisthesis patients manage pain and inflammation. In more advanced cases that don’t improve with over-the-counter options, physicians may instead suggest prescription medications.
There are a few different types of drugs that may help with spondylolisthesis. The main types include:
In simpler terms, analgesics are painkillers. These over-the-counter medications’ primary function is to relieve pain. The most common analgesic is acetaminophen, or Tylenol.
NSAIDs alleviate inflammation along with pain. There are numerous over-the-counter NSAIDs, such as aspirin, Aleve, and Advil (ibuprofen), as well as prescription NSAIDs.
This type of prescription medication can be helpful for patients suffering from spondylolisthesis nerve pain. Neuropathic agents target nerve pain directly and can help with spondylolisthesis symptoms including tingling, numbness, and weakness.
Gabapentin and pregabalin (Lyrica) are two of the most commonly prescribed neuropathic agents for spondylolisthesis.
Some spondylolisthesis patients experience chronic back pain caused by muscle spasms in the back. In these cases, physicians may prescribe a muscle relaxant to stop the spasms. Soma, Flexeril, Baclofen, Tizanidine, and Robaxin are among the most widely prescribed muscle relaxants.
For patients with moderate to severe spondylolisthesis who don’t respond to conservative therapies, physicians may recommend spinal decompression surgery. The idea of undergoing surgery can be daunting, but note that most patients’ symptoms improve with non-surgical treatment.
If you and your physician determine that surgery is the right route of treatment, you’ll likely discuss the spinal decompression procedure.
Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. There are several different approaches to spinal decompression, including laminectomy, foraminotomy, discectomy, and corpectomy. For spondylolisthesis, surgeons often opt for laminectomy.
Laminectomy involves removing some or all of the lamina. This is the small section of bone that covers the back of the spinal canal. By removing it, your surgeon can create more space for the spinal nerves and alleviate nerve impingement.
Spinal decompression can have a dramatic effect, relieving pain and other spondylolisthesis symptoms. However, removing portions of the lamina reduces the stability of the spinal column. So, after decompression surgery, spinal stability remains a key concern for spondylolisthesis patients.
This is why surgeons traditionally perform spinal fusion after spinal decompression.
Spinal fusion involves placing bone graft material in between the affected vertebrae. Then, screws and rods are implanted to secure the graft in place and provide additional stability.
In the period following spinal fusion surgery, the bone graft material will spur the permanent joining of the affected vertebrae. This prevents all movement between the fused vertebrae, which can prevent instability in spondylolisthesis patients.
Unfortunately, in stabilizing the vertebrae, spinal fusion eliminates the natural independent motion that gives the spine flexibility. This diminishes patients’ ability to carry out certain movements, namely those that require the bending or twisting of the spine. Fusion has also been shown to promote the deterioration of adjacent vertebrae.
In a seven-year study for patients with degenerative spondylolisthesis and lumbar spinal stenosis, the TOPS™ System maintained clinical improvement and stability. Additionally, in a five-year study of the TOPS™ System for 10 patients with degenerative spondylolisthesis and lumbar spinal stenosis, the clinical outcome scores “improved significantly across all scoring systems”. In this study, there were no failures at five years and no patients required revision surgery.
The TOPS™ device is approved for use in Europe and many other countries. In the United States, the FDA granted Premia Spine approval to begin an IDE investigation of the TOPS™ System.
Patient and surgeon testimonials are highly encouraging for the TOPS™ System as a spondylolisthesis treatment. Many patients note that they’re able to return to their favorite activities after the TOPS™ procedure, as it preserves spinal mobility.
We encourage anyone with persistent back problems to consult a physician who specializes in spinal disorders and learn about the latest available treatment options.
Can you really travel to a foreign destination for a vacation and receive high-quality medical care at the same time? That’s the question many people raise when the subject of medical tourism comes up.
Many people are skeptical of medical tourism, and understandably so. When you receive medical care in your home country, you’ll naturally feel more comfortable with the treatment process. However, there are many advantages that medical tourism can offer.
For some patients, traveling to a different country for medical care is a worthwhile task. Keep reading to learn more.
Medical tourism is a term used to describe the action of traveling internationally for medical care.
The following benefits are attributed to the popularity of medical tourism for USA patients:
This is the key benefit of medical tourism. Many people can attain high-quality medical care at a fraction of the cost by traveling overseas. This particularly applies to patients in the U.S., which lacks a public healthcare system.
The quality of care should always be the primary consideration in medical tourism. There are first-rate medical facilities and health care professionals in many areas across the globe. Some of these areas, which are widely considered to be the best countries for medical tourism, include Germany, the United Kingdom, Turkey, Israel, India, Thailand, Singapore, Latin America, Eastern Europe, and Cyprus.
Different areas of the world have different medical regulatory bodies. Here in the United States, the FDA (Food and Drug Administration) protects Americans’ health by regulating drugs, biological products, medical devices, food, cosmetics, and even certain electric products.
In many instances, medical innovations have been developed, proven to be successful, and used for many years in other areas of the world. But, with the FDA’s regulatory processes, it can take a long time for those proven medical solutions to become available in the United States. This can also apply to residents of other countries who don’t have access to many of the advanced medical treatments in the United States.
Medical tourism can give patients access to the latest medical technology and, as a result, a higher quality of care.
The United States has the most expensive healthcare in the world. So, while few people would consider medical tourism to the U.S., many Americans contemplate international travel to lower their medical expenses.
When considering traveling internationally for a procedure, it’s wise to consider medical tourism examples and statistics.
Consumers who are interested in medical tourism value a variety of factors. The most prominent of these factors include:
Finances are arguably the most important factor to medical tourism consumers. In fact, in a study from the Medical Tourism Association, 85% of surveyed patients who traveled overseas to a hospital reported that the cost of medical care was a very important deciding factor.
The healthcare system in the United States leaves an estimated 9.6% of residents without health insurance, as of 2021. Even among individuals who do have health insurance coverage, high co-pays and deductibles can make it difficult to afford medical care.
With these facts in mind, it’s unsurprising that cost is a crucial factor for medical tourism consumers. Above all, these consumers want to secure an affordable price for medical care by traveling overseas.
Quality of care is paramount for many medical tourism consumers. By traveling to other countries, patients can attain a higher quality of care (at a lower cost) when compared to the medical treatment available in their home countries.
However, without the assurances that Americans are accustomed to under the FDA, consumers must consider the laws and regulations surrounding medical care in the country that they’re traveling to, as well as the foreign practice’s certifications.
While discussing the benefits of medical tourism, we mentioned that it can grant patients access to advanced treatments that aren’t available in their home country. With this in mind, the treatments available in other countries are a key consideration for medical tourism consumers.
Waiting lists for health care services are another consideration among medical tourism consumers. As of 2022, in the United States, 28% of patients sometimes, rarely, or never receive a response from their primary physician on the same day. This is a high percentage when compared to many other areas of the globe. However, 27% of patients in the U.S. wait one month or more for a specialist appointment, which is a lower percentage than in many other countries, including Norway and Canada.
With that said, long wait lists are primarily a concern for medical tourism consumers in nations with public healthcare systems.
Although medical tourism can provide several benefits, it also presents certain risks and safety concerns, including:
Some countries have a risk of complications including HIV, hepatitis B, hepatitis C, blood infections, wound infections, and infections from donor tissue or blood.
If patients travel to a facility using a language that they don’t speak fluently, doctor-patient communication can be difficult. Given that doctors provide crucial pre-op and post-op information, as well as procedure specifics, this may lead to confusion and errors.
Certain areas may not have comparable requirements for medical licensing and accreditation. This creates the risk of low quality of care.
Doctors typically advise against air travel immediately after surgery. This is because flying raises the risk of developing a blood clot. Depending on the type of surgical procedure, patients should wait between seven and 10 days before flying.
To avoid these risks, medical tourism consumers should ensure that:
As we’ve already mentioned, a significant benefit of medical tourism is that you can gain access to treatments that have not yet or have only recently been, approved for use in your country. Procedures that have been proven effective and are widely used in certain areas of the world can often benefit international patients.
The TOPS™ (Total Posterior Solution) procedure, performed in association with spinal decompression surgery, is an example of a procedure that has been used extensively in Europe but not yet in the United States. TOPS is an alternative to spinal fusion back surgery.
Spinal fusion is widely used with spinal decompression procedures for conditions like spinal stenosis, spondylolisthesis, bone spurs, and more. Unfortunately, fusion can severely limit patients’ range of motion in the back. Additionally, the complete recovery process for spinal fusion may last for six months to a year.
The TOPS System preserves the full range of motion between the individual vertebral segments, unlike spinal fusion. It involves a minimally-invasive surgical procedure, which greatly shortens the spinal surgery recovery period. In fact, patients may start moving around the day after TOPS surgery with few, if any, restrictions.
For certain patients with specific medical conditions, medical tourism could be the ticket to high-quality, low-cost healthcare. If you think you may benefit from medical tourism, make sure to conduct thorough research, find an accredited facility, and evaluate all of the risks before scheduling your appointment abroad.