Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:
In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining
These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.
Spinal Infection Types
They are classified according to the type of tissue they infect. The most common include:
Vertebral Osteomyelitis
This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:
Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site
Treatment includes:
Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.
Discitis
This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.
Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:
Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving
Treatment options include:
Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility
Epidural Abscess
This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:
Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems
Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.
Risk Factors
Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:
Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery
Risk factors include:
Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.
Surgical risk factors:
Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area
Diagnosis
Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:
Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI
Outcome
These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.
Body Composition
Practice Mindfulness
Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.
Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.
References
American Association of Neurological Surgeons. Spinal Infections. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.
Stat Pearls. (2021). Diskitis. https://www.ncbi.nlm.nih.gov/books/NBK541047/
Stat Pearls. (2021). Spinal Epidural Abscess. https://www.ncbi.nlm.nih.gov/books/NBK441890/
Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. https://www.frontiersin.org/articles/10.3389/fmed.2014.00007/full
Microorganisms. (2020). Spinal Infections: An Update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/
The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” https://www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext
Muscle cramp and muscle spasm: Three types of muscles make up the body.
Cardiac muscle makes up the heart.
Smooth muscle cells line the blood vessels, gastrointestinal tract, and organs.
Skeletal muscles attach to the bones and are used for voluntary movements.
A muscle spasm happens when skeletal muscle contracts and does not go back to its relaxed state. Spasms are forceful and involuntary. A muscle spasm that sustains/continues is a muscle cramp. The leg muscles, especially the quadriceps/thigh, hamstrings/back of the thigh, and gastrocnemius/calves, are prone to cramping, but any skeletal muscle can cramp. Charley horse is another name for a muscle cramp.
Causes
There can be a variety of causes for muscle cramps. This includes:
Physical exertion in hot weather
Overexertion
Dehydration
Electrolyte imbalance
Physical deconditioning
Certain medications and supplements could contribute to muscle cramping.
They can interfere with electrolyte levels, contribute to the breakdown of muscle tissue, and/or interfere with blood circulation. Any medication-related muscle cramping should be reported to a doctor.
Night Cramping
Night cramping, especially in the calves, is common and affects up to 60% of adults. Women are more prone to night-leg cramps than men. They are also common with age and a common contributor to insomnia. Muscle fatigue and nerve dysfunction are believed to be a factor. Management remedies include:
Stretching
Self-Massage
Topical muscle pain ointments/creams
Ice therapy
Remedies and Treatment
The majority of cramps resolve on their own within a few minutes without treatment.
It is recommended that as soon as a cramp begins, stop the activity.
Stretch and massage the area,
Hydrate with water and, if necessary healthy sports drink to replenish sodium, vitamins, electrolytes, and more.
Apply heat to help relax the muscle.
Apply an ice pack.
Nonsteroidal anti-inflammatory medications (NSAIDs) can help if the pain is substantial.
Consult a doctor if cramps are severe or are recurring often.
Prevention
Strategies for reducing the risk include:
To vary exercise routines
Maintain proper hydration
Maintain proper levels of electrolytes. Sodium and potassium are lost during physical activity, especially in the heat and with consistent sweating.
Regular Stretching
Warm-up with a quick jog or quick walk before stretching the body.
Body Composition
Insulin and the body
Insulin assists the transport and storage of energy glucose to cells, tissues, and organs. These include the body’s glucose storage like the skeletal muscles and liver. Once the blood sugar returns to a base level as the glucose is absorbed, the pancreas begins producing glucagon instead of insulin. Glucagontells the liver to release the stored sugar, which typically happens between meals. What happens to the body when eating too much sugar and carbohydrates than the glucose-storing organs can handle?
Individuals with Type 1 diabetes have a pancreas that does not produce insulin. Type 1 diabetics need to control their glucose levels with lifelong insulin therapy.
With Type 2 diabetes, the pancreas ends up producing insulin through frequent outbursts. When this starts to happen more than normal, the cells eventually lessen their insulin sensitivity. The body becomes numb to the signaling that there is excess blood sugar in the body. This is what happens in individuals with insulin resistance or Type 2 diabetes. This type of diabetes can be managed or prevented with diet adjustments.
References
AAOS: “Muscle Cramps.” Jun. 2017.
American Academy of Orthopedic Surgeons: “Muscle Cramp.”
American Academy Physician: “AAN Recommendations on Symptomatic Treatment for Muscle Cramps.”
American Family Physician: “Nocturnal Leg Cramps.”
American Osteopathic Association: “Muscle Cramp – A Common Pain.”
Journal of the American Academy of Orthopedic Surgeons: “The Athlete With Muscular Cramps: Clinical Approach.”
National Cancer Institute: “Muscle Types.”
National Institute of Mental Health: “What Is Generalized Anxiety Disorder?”
Getting dizzy can happen, usually after standing up too fast or staring at an optical illusion then looking away. The unsteadiness can be troubling but is minimal when compared to vertigo symptoms. Vertigo is a symptom rather than a condition that causes dizziness combined with a spinning sensation, even when an individual stands completely still. Vertigo can make everyday life a debilitating nightmare:
It causes individuals to feel nauseous.
It makes it difficult to walk.
It interrupts vision and hearing.
Vertigo symptoms usually begin with a communication issue with the inner ear and brain. This neurological connection involves the spinal cord, which chiropractic can treat and cure. A chiropractor will implement the necessary techniques to help alleviate vertigo symptoms.
Causes
The most common signs and symptoms are dizziness accompanied by a spinning sensation. Vertigo symptoms can also include:
Vertigo is a common symptom in individuals that have gone through trauma to the neck and/or head. A disturbance/interruption occurs in the nerve pathways in the spinal column. Disruption, injury, or damage to the vestibular system/inner ear also causes vertigo symptoms. Other causes include:
Ear infections
Pressure changes
Movement of particles within the inner ear
Chiropractic Treatment
Chiropractic treatment can cure vertigo symptoms through various exercises and spinal adjustments. When nerve signals don’t transmit correctly, it can cause a feeling of dizziness along with the other symptoms. Adjustments or manipulations help alleviate the symptoms by allowing nerve energy to circulate properly. Spinal adjustments realign the joints and vertebrae in the cervical spine. This opens the nerves pathways and allows for clear communication.
A common type of vertigo is known as benign paroxysmal positional vertigo or BPPV. This is the movement of particles around the inner ear. These particles come from otolith organs. The particles break loose and fall into other parts of the vestibular labyrinth. This alters the center of balance and can cause dizziness. A chiropractor may use the Epley maneuver, which maneuvers the head into different positions. A chiropractor will recommend specific exercises at home to benefit the vestibular system and its communication with the brain.
Body Composition
A Common Cold
The common cold, aka upper respiratory tract inflammation. It is the most common infectious respiratory disease. It is called this because of the effects on the nose and throat. According to the Center for Disease Control and Prevention, an adult will catch 2–3 colds a year. A cold-causing virus enters the respiratory tract directly when an individual inhales droplets or direct skin contact from an infected person. Cold symptoms include:
Runny nose
Stuffy nose
Sneezing
Coughing
Headaches
Body aches
The duration of a cold differs, but most individuals with a healthy immune system recover in 7–10 days. However, individuals with compromised immune systems, asthma, or COPD have an increased risk of developing serious illnesses like bronchitis or pneumonia. Quickly recovering from a cold requires boosting the immune system with proper rest, a nutritious diet, and drinking plenty of water.
References
Collins, Matthew E, and Tom M Misukanis. “Chiropractic management of a patient with post-traumatic vertigo of complex origin.” Journal of chiropractic medicine vol. 4,1 (2005): 32-8. doi:10.1016/S0899-3467(07)60110-4
Dalby, B J. “Chiropractic diagnosis and treatment of closed head trauma.” Journal of manipulative and physiological therapeutics vol. 16,6 (1993): 392-400.
Sajko, Sandy S et al. “Chiropractic management of benign paroxysmal positional vertigo using the Epley maneuver: a case series.” Journal of manipulative and physiological therapeutics vol. 36,2 (2013): 119-26. doi:10.1016/j.jmpt.2012.12.011
Poor spinal health in adolescence can lead to chronic pain in adulthood. Teenagers, just like adults, can experience back pain from accidents, sports injuries, a sedentary lifestyle, part-time jobs, chores, etc. However, sitting too long in school along with heavy backpacks can also contribute to compromised spinal health. Chiropractic professionals can help these young individuals address and prevent spinal issues/injuries to maintain a healthy spine.
Teenagers Spine Issues
If discomfort or pain is present, much push through, as they and their spines are young. There are common spinal dysfunctions that teens and parents should be aware of. These include:
Disc injuries
Teenagers can put a serious strain on the spine from various forms of physical activity, jumping, dancing, and playing. This pressure gets transmitted through the spine. During a teenager’s development, this can result in permanent disc damage.
Scoliosis
A spinal deformity or exaggerated curvature of the spine is common and affects young children and teens. It usually happens during the growth spurt just before puberty. This is why it is important to have a teenager’s spine checked regularly and analyzed for signs/symptoms of scoliosis.
Spondylolysis
This condition is often associated with sports injuries. It happens when teenagers overextend/overreach their backs. It’s most common in gymnastics, weight lifting, tennis, football, diving, and other similar sports.
Protection and Prevention
There are several ways that parents and healthcare providers can help teenagers make healthy decisions to achieve and maintain optimal spinal health.
Sitting less, moving more.
Children are taught to sit from a very young age. In school, watching t.v., or doing homework, teenagers spend more time sitting than their bodies should. Teenagers need to stand, walk and move around just like adults to protect their spines from degeneration and injury.
Playing sports is healthy. However, there is a risk associated with teen sports. Although they are taught to play safely, encourage them to continue to educate themselves about sports injuries and know how to address them.
Chiropractic Support
At Injury Medical Chiropractic and Functional Medicine Clinic, we’re committed to helping young adults and adolescents overcome and prevent spinal injuries that could turn into chronic pain conditions. We are continually developing our chiropractic, and physical therapy treatment approaches to achieve optimal results.
Body Composition
Sleep and Growth Hormone In Children
Growth hormones primarily control growth. The hypothalamus and the pituitary gland regulate this hormone. Sleep plays an important role in the proper function of these glands. A review showed that:
Growth hormone levels rise and peak at the onset of deep sleep
Multiple but smaller peaks were seen during other sleep stages
Individuals that have a delay in the onset of deep sleep have delayed peaks in growth hormone levels
For children to grow properly, they need to have adequate levels of growth hormone. This means they need to have a sufficient amount of sleep. The proper amount of sleep is vital for healthy body composition. A study measured the body composition of preschool-aged children. The study found that children who had proper sleep levels had less overall fat mass and reduced body fat. Children and teenagers need to get the proper amounts of sleep for their bodies to grow healthily.
References
Clement, R Carter et al. “What are normal radiographic spine and shoulder balance parameters among adolescent patients?.” Spine deformity vol. 8,4 (2020): 621-627. doi:10.1007/s43390-020-00074-9
Driehuis, Femke et al. “Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique, and outcomes.” PloS one vol. 14,6 e0218940. 25 Jun. 2019, doi:10.1371/journal.pone.0218940
Manansala, Christian et al. “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” Complementary therapies in clinical practice vol. 35 (2019): 301-307. doi:10.1016/j.ctcp.2019.03.013
A non-invasive method of treating scoliosis. Yoga Has Been Shown To Help Reverse Scoliosis. Scoliosis is the lateral curvature of the spine. The spine bends inward toward the front of the body at the neck region and lower back region. This curve is known as lordosis and bows outward in the middle-back region. This is known as kyphosis. If the spine curves to the side, this could indicate curvature that could be scoliosis. It can be painful and often can affect an individual’s appearance once the measurement goes beyond 25 – 30 degrees. One shoulder is usually higher than the other, and clothing cannot fit properly. If the curve goes beyond 60 degrees, it can affect breathing and cardiac function.
Idiopathic Causes Unknown
This condition can consist of various components, especially with more intense curves. The ribs can shift backward on the side where the curve bulges. Most cases consist of adolescent idiopathic (without a known cause) scoliosis. Because the cause is unknown, there are not a variety of effective treatment besides surgery. Physicians carefully keep an eye for:
Curves under 25 degrees.
Bracing between 25 and 45 degrees.
Consider surgery for intense curvature.
Curves in individuals typically appear between 12 and 20 years old.
Yoga Shown To Reverse Scoliosis
Individuals are recommended to do just one yoga pose daily. However, depending on the type and severity of the curves, it could be more than one. They are asked to perform the pose for 5 minutes or less, depending on the condition. A yoga therapist, chiropractor, and physical therapist can generate significant spinal improvement. This could mean that a curve of 30 degrees could be reduced to around 18 degrees in 10-12 months. Individuals that do the poses at least 4 times a week have shown 80-90% improvement. The pose can be done at work during breaks, etc.
The biggest advantage of this technique is that it is non-invasive; it can help individuals with developing curves, reversing the curvature early. Most curves do not reach the point of surgery. In late adolescence and teen years, the spine is still quite flexible. This can help accelerate the effectiveness of the yoga pose to straighten the spine. The technique reduces the curve from worsening. X-rays will show if the curvature has improved or not. Patients could be asked to do the pose/s twice or more daily depending on the direction the condition is taking.
Body Composition
Gluten Effects
Gluten causes digestive issues for individuals that have celiac disease or autoimmune thyroid disease. Individuals with these conditions could experience a variety of uncomfortable and/or painful effects. These symptoms can vary based on their presentation. They fall into classifications.
Classical Celiac Disease
With classical celiac disease, symptoms include:
Diarrhea
Discolored stools
Constipation
Abdominal bloating and pain
Weight loss
However, these symptoms are more common in children than adults. In adults, symptoms are more similar to non-classical celiac disease.
Non-Classical Celiac Disease
With non-classical celiac disease, severe digestive symptoms may not present as classic celiac disease symptoms but develop other symptoms. These include:
Silent celiac disease is less visible. Individuals might not see any symptoms. However, damage to the intestines is still happening from gluten consumption.
Autoimmune Thyroid Disease
Autoimmune Thyroid Disease or ATD. Autoimmune thyroid disease includes conditions like Hashimoto’s disease. This affects the thyroid gland and causes:
Extreme fatigue
Sensitivity to cold
Hair loss
Body aches
Joint aches
Negative health effects
Studies have shown that gluten-free helps alleviate symptoms.
References
Loren M. Fishman, M.D., B.Phil. (oxon). Healing Yoga. (New York: W.W. Norton, 2014).
Loren M. Fishman, M.D., B.Phil. (oxon). “Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial.” Global Advances in Health and Medicine. February 24, 2021. https://journals.sagepub.com/doi/full/10.1177/2164956120988259
Fishman LM, Groessl EJ, Sherman KJ, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis.” Global Advances in Health and Medicine. September 1, 2014. https://journals.sagepub.com/doi/10.7453/gahmj.2013.064
Scoliosis in adolescents and teens can be corrected with proper bracing, adjustments and lead a normal life. For adult scoliosis correcting the problem is more difficult. Fortunately, cases of adult scoliosis are rare. Scoliosis cases that follow from childhood into adulthood require a comprehensive diagnosis to determine severity. Thoracolumbar scoliosis adult-onset scoliosis requires an understanding of the catalysts to develop an effective treatment plan. Chiropractors use a full range of diagnostic tools to measure the severity of adult scoliosis.
Diagnosis
Adult scoliosis is the presentation of abnormal curvature of the spine. It can happen in the thoracic, lumbar spine, or both. This can have varying degrees of severity. Severe adult scoliosis can be apparent through visual assessment and examination. Cases that are not as obvious require utilizing diagnostic tools. These include:
Imaging
X-rays will show any asymmetry that is associated with scoliosis. This asymmetry can be present in the hips or shoulder and is usually qualified by spinal misalignment.
Walking Gait Examination
Inspecting how worn out an individual’s shoe/s are and having them perform various walking tests can reveal problems with gait. In adults, this can present instability. For example, having problems with balance or fast-twitch muscle response.
Neuromotor Exams
These exams are general and first performed to get a baseline diagnosis for the presence of adult scoliosis. Tests look at the left and right coordination along with the sense of touch capabilities. This measures the severity of the improper spinal curvature and how much it has affected the development of an individual’s motor functions. It is also done in the context of how it’s affecting the body’s biomechanics. Following these exams are quantitative tools/techniques for measuring the severity of adult thoracolumbar scoliosis. These include:
Cobb Angle Measurement
This tool determines the maximum degree of spinal curvature variation and provides a context for severity.
King Classification Tool
This examines the vertebral alignment to determine the spinal variance in specific vertebrae from the neutral center position.
Lenke Classification Tool
This spinal exam relies on measurements of three positions and looks for flexibility.
Combined Approaches
When assessing adult scoliosis, this is important to understand and helps determine how to proceed with treatment. The body is no longer in development as an adolescent. This means bracing does not come with a one-size-fits-all approach. Chiropractic can help with the assessment modalities used to investigate adult scoliosis cases. These measurement and analyses tools are often used in combination to develop a complete picture of what is going on.
Body Composition
Fill Up With Prebiotics
Individuals can help their gut bacteria thrive in the digestive tract by consuming prebiotics. Prebiotics are a form of soluble fiber. The body cannot digest these prebiotics, but gut bacteria can. Recommended sources of fiber-rich prebiotics can be found in nutrient-dense foods like:
Leeks
Garlic
Onions
Fruits
Legumes
Raw chicory
A diet with various fiber types has been shown to reduce the risk of obesity and prevent weight gain. Resistant starches like plantains, green bananas, and cooled potatoes have increased beneficial bacteria in the colon. Barley, oats, and wheat bran are insoluble high-fiber grains that are also recommended sources.
References
Aebi, Max. “The adult scoliosis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 14,10 (2005): 925-48. doi:10.1007/s00586-005-1053-9
Haenen, Daniëlle et al. “A diet high in resistant starch modulates microbiota composition, SCFA concentrations, and gene expression in pig intestine.” The Journal of nutrition vol. 143,3 (2013): 274-83. doi:10.3945/jn.112.169672
Lowe, Thomas et al. “The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems.” Spine vol. 31,19 Suppl (2006): S119-25. doi:10.1097/01.brs.0000232709.48446.be
Surgery options when back pain is becoming chronic or so severe that an individual cannot function normally and negatively affects their life. Pretty much everyone experiences back pain at some point. This is often from:
Lifting heavy/non-heavy objects incorrectly
Improper posture
Twisting in an awkward way
Overreaching
Muscle spasms
Physical activity the body is not used to doing
Most cases of backaches and pain go away by themselves or with conservative treatment. But sometimes, surgery is necessary.
When Surgery Is Necessary
Acute back pain can last for days or weeks and can often resolve with physical therapy, chiropractic, and self-care. Back pain that continues for 12 weeks or longer is considered chronic. Around twenty percent of individuals who experience acute low back pain after a year begin developing chronic back pain. Doctors try to treat most back pain cases with non-surgical approaches.
They usually begin with physical therapy/chiropractic.
If that doesn’t work, then medication is incorporated.
However, many individuals do not want to take long-term medication, which is when surgery may be recommended.
In most cases, surgery is a last resort.
When the pain radiates to the legs or if it is causing problems with bladder and/or bowel function, these are definite signs/symptoms that surgery is needed. If the pain/dysfunction continues after thorough and effective non-surgical treatment, surgery could be recommended to preserve the spine to improve spinal strength and function before the problem worsens, causing further injury and damage. Some of the most common and effective spine surgery options include.
Surgery Options
Microdiscectomy
Microdiscectomy is the most common back surgery in the United States. It is minimally invasive spine surgery. Microdiscectomy patients have low back pain combined with leg pain, tingling, numbness, and weakness. In between the vertebrae are the body’s shock-absorbing discs. The discs can begin to bulge out, a bulging or herniated disc, and press on the surrounding nerve roots, causing pain, tingling, numbness, or weakness. A microdiscectomy removes the portions of the disc pressing on the nerve.
It is called micro because the surgeon wears specialized glasses known as loupes that act as microscopes. This is so the surgeon can see the details when they’re operating. The surgery is performed through a small incision in the middle of the back or on the affected side. Patients can go home a few hours after the surgery and return to normal activities within two weeks. The success rate is 85 – 95%, especially if the surgery is done early before the damage begins to spread out.
Laminectomy
The spinal canal contains a special lining. This is where the nerves and ligaments run through. Age, along with normal wear and tear on the body, causes the ligaments to thicken. This is when bone spurs can develop from osteoarthritis, and the discs can begin to bulge or rupture/herniate. This clogs and impinges the space where the nerves should easily flow through. This narrowing is called spinal stenosis. A laminectomy opens up the space relieving the compression/pressure. The procedure requires removing part of the back of a vertebra called the lamina. This enlarges the spinal canal and relieves the pressure on the nerves. The procedure is done through a small incision in the middle of the back but can also be done through a minimal incision. Leg pain improves after surgery. A traditional incision full recovery takes 6 to 12 weeks. The success rate is around 85 percent.
Spinal Fusion
A spinal fusion joins/fuses two or more bones in the spine. This is done when an individual has severe compression of the nerves, severe instability, or spinal revision surgery. A fusion can help stabilize spinal fractures. Other reasons for a spinal fusion are spine deformity, cancer of the spine, and sometimes used for intractable pain. A fusion stabilizes the spine with screws and rods. The disc causing the compression is replaced with a fusion device and bone graft. The surgery is often performed in combination with a laminectomy. Recovery and returning to activities can take around 3-4 months after the procedure. The success rate is 85-90% with pain improvement.
Kyphoplasty
Spinal compression fractures are common in individuals with osteoporosis. When they happen, the pain can be so intense that braces and medication don’t help. Kyphoplasty can bring pain relief. It can be performed by a pain management doctor, interventional radiologist, or surgeon in an outpatient X-ray facility and operating room. The procedure involves conscious sedation, sometimes accompanied by general anesthesia. A small instrument is inserted into the vertebra, and a balloon is inflated to make room for bone cement. After the bone cement is injected, patients can go home within a few hours. The success rate is around 85%, and recovery time could be several days.
Disc Replacement
This is a procedure that can replace spinal fusion for certain cases. A disc replacement can be done in the lumbar/low back or the cervical/neck spine. This procedure is performed to treat a pinched nerve and/or spinal cord compression. The injured/damaged disc is removed and is replaced with an artificial disc. The device allows for motion, whereas fusion procedures fuse the bones to stabilize and immobilize the area. Disc replacement is recommended for younger patients that don’t have serious arthritis. This is because they still have mobility. If significant arthritis is present, the patient could experience more pain and require spinal fusion. Recovery takes around six weeks. Intense physical activity is off-limits for two or three weeks after the initial recovery period. The success rate is more than 90%.
Anterior Cervical Discectomy and Fusion – ACDF
This is a common neck/cervical spine procedure. This surgery is for pain relief, weakness, tingling, and numbness of the arms caused by a pinched nerve or stenosis. The damaged disc is removed through a small incision in the side of the front of the neck. The disc is replaced with a bone graft or specialized spacer and a small plate with screws. This is to stabilize the spine. It is highly effective in relieving pain and in preventing neurological decline from spinal cord compression. Recovery time is around 12 weeks before a full return to normal activities. However, individuals report feeling better after two weeks.
Back Surgery Options
The majority of cases involving back pain get better on their own or with conservative treatment. But if an individual cannot find relief, there are safe and effective surgery options that can help.
Body Composition
When The Immune System Activates
When the body gets sick from a bacterial infection, virus, etc., the body’s defense system activates, causing inflammation. This immune response serves as the first wave of defense against foreign invaders. The infected area becomes red and swollen from increased blood flow. For example, when the nose gets red from a cold, this is inflammation. The reaction is caused by white blood cells known as macrophages, and the proteins they emit called cytokines encourage inflammation. Inflammation that’s triggered by the immune system is normally a good thing. It means the body is releasing a proper amount of hormones and proteins. These activate the white blood cells to start the healing process and work to fight the infection.
References
Low Back Pain Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
A review of complication rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019. https://pubmed.ncbi.nlm.nih.gov/31528438/
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