Most Spine Related Problems Are Treatable

Detroit News 10/16/2009, Page C04

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BY MOLLY BELMONT Albany Times Union You felt it as soon as you did it. You twisted wrong in aerobics class, you picked up your child too fast on the playground or you were bent over too long doing laundry. And when you stood up — whoa! The pain was excruciating.

You know you hurt your back, but what’s really going on back there, physically, and, more importantly, how do you get better from it? Your back is a complicated network of nerves, bones and musculature, at the center of which is your spine, the body’s main structural support. The spine is composed of 24 small bones called vertebrae, which sit on top of one another and are held together by ligaments. When the vertebrae are stacked, they form a hollow column, inside which is the spinal cord, a dense bundle of nerves that control move ment and feeli ng throughout the body. In between each vertebra is a spongy, gel-like cushion called a disk, which keeps the bones from rubbing against one another. The spine also consists of joints, or facets, which allow for flexible movement, and tendons that connect to back muscles that keep your disks in alignment and further stabilize this network. Your spine has to bear the entire load of your body, protect the main nerve center of your body and resist gravity to keep you standing. It should be no shock when pain ful back injuries occur. In fact, back pain is one of the most common complaints in the United States.

According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, back pain accounts for 40 percent of all time taken off work The most common back injury? A strained muscle due to overuse, says Brian Gordon, a physician with New York Spine and Neurosurgery in Latham, N.Y. Every year, about 80 p ercent of people suffer from simple strained back muscles, he says. When people overdo it at the gym or overload themselves during a move to a new house, the muscles in their back can become inflamed. This type of injury lasts a couple of weeks, and provided the person takes it easy and rests up, it will usually resolve itself on its own, he says. Another frequent but more serious injury is a herniated disk. Herniated disks are the second-most common back injury. Affecting about 30 percent of people, herniated disks occur with repeated heavy lifting, repeated strains and are often associated with heavy duty labor, says Edward Scheid, a physician with Capital Region Neurosurgery in Alba ny, N.Y. However, they are also a result of sedentary professions that require long periods of standing or sitting at a desk,. Over time or with repeated stress, a disk will degenerate. When it breaks down, it loses its shock absorbency, and the spongy cen ter of the disk protrudes through the outer covering of the disk, pushing up against the larger nervous system. This is known as a herniated disk, or slipped or ruptured disk, and it causes acute pain throughout the back.

Common treatments

What are the treatment options for com mon injuries like these? More and more, doctors are recommending conservative treatments, including physical therapy, chiropractic manipulation and, if pain per sists, pain medication or steroids. A great deal can be accomplished with these less invasive methods of treatment, Gordon says. Physical therapy works by strengthening surrounding muscles to compensate for damaged disks and help realign the back. Epidural injections can diminish inflammation and pain. “People are always concerned about spine surgery,” Gor don says. “Everyone knows someone who’s had a bad exper i ence.” In many cases, this apprehension keeps people from seeing a specialist, and getting help with their injury, he says. Surgery is only recommended in cases where the injury is causing neurological deficits, like numbness or weakness in the limbs, Gordon says. In those cases, patients may lose bowel or bladder control, or have trouble walking. And if surgery is recommended, know that surgical tech niques have advanced considerably, even in the last 10 years, Gordon says. Back surgery is currently in a “rapid phase of evolution,” he says, and today’s surgical procedures are less invasive than ever before, with most patients enjoying a rela tively speedy recovery.

New surgical techniques

Gone are screws and rods and large incisions of yesterday, Scheid says, describing current surgical procedures. Today’s surgeons are using inch-long incisions, ope rating through tiny tubes and installing advanced plastic spinal implants to stabilize the spine and electrodes to alter pain signals. These advances are helping people get back on the job in no time, lifting and sitting again with ease.