Back Pain FAQs
Is Back Pain Common?
Yes, back pain is very common. In fact, over 31 million Americans have low-back pain at any given time. Back pain is also one of the most common reasons people miss work and also one of the most common reasons why people visit doctor’s offices. Over 80% of the United States will experience back pain problems sometime in their lives and over $50 billion dollars is spent on just treating back pain alone.
- 29% of people in the U.S. think back pain is a cause of their stress
- More than 10% of the world’s population is affected from lower back pain
- 1 out of every 3 adults says that back pain is an issue in their everyday lives
What are the causes of Back Pain?
There are many causes of back pain, the most common is either a sprain or a strain. The lower back is the most common area of injury due to its function holding the upper half of your body to the lower half. Since your lower back can twist, turn, and bend it makes it easier to be sprained or strained.
- A Strain is caused by your back muscles getting stretched abnormally or even torn.
- A Sprain is caused when your ligaments are torn from where they were attached
Injuries such as a strain or a sprain is considered to be acute injuries that can heal with time. Some of the symptoms that you may have from this acute pain are
- Limited Range of Motion
- Pain that last for under 2 weeks
- Muscle Spasms
- Muscle Aches
More severe causes of back pain that is considered chronic pain can be caused by damaged discs. Aging is a big factor in causing this type of chronic pain.
There are many terms that can describe slipped discs such as a bulging disc, ruptured disc, herniated disc, or collapsed disc. All of these terms are used to describe different types of disc related problems. It is easy to get these disc issues as you age and your discs structure weakens. A simple strain or sprain and aggravate the jelly like disc and cause these issues.
Inside your each disc is the jelly like liquid that is called the nucleus. The outside of the disc that holds the nucleus inside is called the annulus. If the nucleus is pushed out of the annulus and goes to into the spinal canal it starts to press on the spinal nerves or cord. This is what you call a herniated disc. The symptoms of a herniated disc can be chronic, lasting for longer than a few weeks.
Some of the symptoms of a Herniated Disc can be radiating pain from your buttocks all the way down to your foot. Sciatica is a term used to describe this condition. Coughing and Sneezing can also be painful. If there is a herniated disc in the neck the radiating pain and travel from your shoulders all the way down your hands. Sneezing and Coughing can also be painful. Numbness and weakness of the extremities are common. It may be hard to hold and lift heavy objects because of the muscle weakness the herniation causes.
Many people think bulging discs are the same as a herniated disc, but the two conditions are not alike. The main difference of a bulging disc is that the outer layer or annulus fibrous is not cracked where the nucleus is allowed to exit. A bulging disc is a deformity inside the wall of the disc that causes the annulus fibrous to protrude. Since the nucleus is still contained within the disc there is less likely of a chance that you will experience any back pain issues with a bulging disc.
Not everyone who has a bulging disc will experience pain, but if you do here are some of the symptoms.
- Muscle Weakness
- Numbness and Tingling from your buttocks down to your legs (Lumbar)
- Numbness and Tingling from your shoulder to your arms (Cervical)
Degenerative Disc Disease
One Third of people from the ages of 40 – 59 have signs of degenerative disc disease
As we age the discs that is in between our vertebrae slowly degenerate. These jelly-like discs are shock absorbers that protect your spine. When we are young the discs are healthy and plump, but the water content when we age reduces causing the disc to lose its plump form. The discs becomes flat and the shock absorbing capabilities are weakened causing your vertebrae to rub together. The result of aging and that discs thinning causes the two vertebrae bones to start rubbing against one another. Bone Spurs result due to the friction of the bones and these fragments can potentially cause intense pain.
As your vertebrae bones grind, the body tries to repair itself by strengthening the area of bones where the friction is being created. This is how bone spurs are made, the calcium deposits as the bones grow can become irregular. If the bone spurs grow enough it can also lead to spinal stenosis which is a narrowing of your spinal canal.
In the spinal column there are open spaces that created passage ways for the spinal cord and the spinal nerves. These passages can then start to narrow which compressed the nerves. As these nerves start to compress, it can pinch your spinal nerves causing sharp pain signals to be delivered to your brain. These pinched nerves get worse as it progresses and it cannot go away unless you get surgical intervention.
- Stop Smoking – Cigarettes is linked to causing chronic back pain issues. Discs degenerate faster when your smoke because of the diminished blood flow to your spine. It also reduces oxygen that is getting into your system which hinders the process of your spine getting the right nutrition it needs.
- Good Posture – Practicing good posture when you walk, stand, and sit helps maintain the curve of your spine and causes less stress on your ligaments and muscles. Proper posture when lifting heavy objects is to use your legs and not your back to lift.
- Exercise – This keeps your muscles strong which in return helps support your spine. As you exercise make sure to warm up by stretching your muscles and ligaments to keep them flexible.
- Well Balanced Diet– A proper well balanced diet will help your spine stay healthy by providing the correct nutrients and also maintain a healthy weight.
- Calcium – helps your bones to be strong and prevents loss of bone mass as you age.
Iron – Important for cells to utilize oxygen. Also helps produce myoglobin which promotes muscle health.
- Vitamin A – antioxidant vitamin that boosts the immune system, aids protein to help the body repair damaged tissue and form bone.
- Vitamin C – aids in the development of collagen so cells can turn into tissue (tendons, ligaments, and vertebral discs)
- Calcium – helps your bones to be strong and prevents loss of bone mass as you age.
Treatment options other than surgery for back pain
Chiropractic Care – Chiropractic doctors are professionals when it comes to spinal manipulation. It is more than just cracking your back, it is conservative care that adjusts the spine to keep it properly aligned. The goal if you have back pain is to keep you from having to get surgery or take pain medication. In America over 22% of people visit chiropractors for keeping their spine aligned and healthy. Of those people seeking treatment 35% are going to chiropractors to get relief from back pain.
- Ice and Heat Packs – Ice reduces swelling and helps relieve pain because of the reduction in inflammation. While heat packs draws blood to the area to slowly help repair the injury
- TENS Unit – Small electrical pulses are sent through a battery operated device creating endorphins which are natural pain relievers.
- Ultrasound – Vibration that delivers heat / energy to where the back pain is located. The goal is to speed up the healing process and reduce pain.
Medication – There are several forms of medications that may be recommended by a doctor to help your back pain.
- Over the counter pain relievers – These are medications such as ibuprofen or naproxen sodium. The more common names for these medications are (Advil, Aleve, Tylenol, or Motrin) These are anti-inflammatory medications which can reduce inflammation in your back.
- Topical Pain Relievers – There are some creams that your doctor can prescribe that have lidocaine to numb your pain.
- Muscle Relaxers– This type of medication makes your muscles less stiff which can help the movement of the area in your back that is sprained or strained
- Narcotics – At Florida Surgery Consultants we only prescribe narcotics for post surgical patients. Our doctors do not believe in Narcotics to mask back pain symptoms. Narcotics have dangerous side effects that can be very addictive.
- Injections – Our neurosurgeons use Epidural Steroid Injections that is an anti-inflammatory numbing medication which can be injected into the epidural space near the spinal cord where the site of the pain is. This procedure generally relieves back pain but may only last for a few months and you will have to eventually get another injection. These injections can be done in the cervical and lumbar areas of your spine.
What is Minimally Invasive Surgery?
Minimally Invasive – This is a term that is basically marketing for spine surgeons. Here are some of the main points for a surgery to be considered “minimally invasive”
- Not having to stay overnight after your surgery
- Recovery time being less than half of traditional surgery
- Incisions being less than 1 ½ inches which is a smaller scar and has less risk in damaging the muscle tissues
- Risk of infection is less due to the incision being smaller
- Less anesthesia required
Types of Minimally Invasive procedures to treat back pain
- Kyphoplasty – Surgery to fix spinal fractures. Surgeon goes in and inflates a balloon like object into the fracture and injects bone cement to fix the bone fracture.
- Micro-discectomy– A Tiny hole in the neck is made and the surgeon removes the bulging portion of the herniated disc.
- Percutaneous Disc – Surgeon uses a small cut to go in and remove the portion of herniated disc that is impinging on the nerve root or spinal cord
- Medial Branch Block – a strong anesthetic is injected in the medial nerves that is connected to the facet joints to numb the area of pain
- Radio-Frequency Ablation– Heat is used to burn the nerves that are transmitting pain to the brain to cure your back pain
Types of Spine Surgeries
- ACDF (Anterior Cervical Discectomy Fusion) – Technically this procedure is still considered to be minimally invasive because the incision is small. The surgeon removes the herniated disc and replaces it with artificial bone graft and uses a metal plate and screws it to fuse the vertebrae in a proper position
- Co Flex – Procedure used to treat Spinal Stenosis. It still allows your spine to move without having to fuse your spine together. The titanium Co Flex implant is inserted in between the spinous process and takes the load giving space in between your vertebrae.
- Artificial Disc Replacement – An alternative to a fusion surgery, the Neurosurgeon removes the herniated disc and replaces it with an artificial disc that acts similarly to a natural disc.
- Laminectomy – A Neurosurgeon removes the lamina so there is more room for the nerves. It is also known as decompression surgery. This is a popular surgery to fix spinal stenosis
- TLIF (Transformational Lumbar Interbody Fusion) – This fusion surgery permanently fuses bones in the lumbar region of your spine. The surgeon goes in through the foramina where the nerves exit the spine and removes the portion of the bone and disc.