Year: 2014

The Most Common Question About Back Pain

How can I relieve my lower back pain?

I am asked this question regularly in both social and medical situations. It seems that the majority of the population suffers from lower back pain at some point in their lives. The first step to treating lower back pain is to rule out deterioration in the back disks and joints. Ruling out spinal degeneration and fractures is key to determining the proper treatment of lower back pain. X-rays or an MRI scan may be necessary to figure out if the problem is caused by a spinal issue.

Other causes may include muscle knots (myofascial trigger points) or spasms, a misaligned or abnormally shaped spine (spondylolithesis, scoliosis). In my practice, I often find that arthritic facet joints are very common cause of back pain and are readily treated with an endoscopic rhizotomy. I would recommend seeing your physician to determine the cause of your back pain. Sometimes pain issues can be resolved simply by stretching more and strengthening the postural muscles. While surgical intervention is not always needed, this is not a problem that should be neglected, as even non-surgical problems can continue to worsen and cause a great deal of pain.

10 Frequently Asked Questions About Scoliosis

1. Does scoliosis cause other health problems?

If scoliosis is severe it can affect your heart, lungs, gut, spinal cord and nerves, producing a large range of problems ranging from difficulty to breathing to difficulty walking. Fortunately this is not common. Many cases of scoliosis respond to conservative treatment (such as bracing) and do not require surgery.

2. Is there a link between muscle strength and the development of scoliosis?

Scoliosis is the curvature of the spine. The spine may look like a “C” or “S” on x-ray. Scoliosis may result from juvenile scoliosis in children (unknown cause), diseases or injury of the spine, arthritis, neurological disease, surgery, etc. Neurological disease such as a spine tumor may cause back muscle weakness, which can result in scoliosis. It is not caused from being out of shape or weak.

3. What happens if scoliosis goes untreated?

Untreated scoliosis can cause a hunch back called kyphosis. Treatment depends on the age, the severity of the scoliosis and whether it is causing problems. Children are watched for scoliosis during their growth spurts. If the scoliosis is treated early with a brace then sometimes future surgery can be prevented. If scoliosis becomes severe it can affect posture, walking, lungs, heart, gut and strength, as well as causing pain. People with significant scoliosis should be closely monitored by their doctor or spine surgeon.

4. Does scoliosis ever develop later in life?

Yes, scoliosis can develop later in life from injury, back surgery, cancer, or arthritis.

5. Can scoliosis prevent a person from being able to walk?

Severe scoliosis can cause significant spinal deformity, which alters the shape of the back, causing weakness and difficulty walking. If you think your scoliosis is hindering your movement, I would recommend seeing spine surgeon who specializes in scoliosis surgery.

6. Can scoliosis cause chronic back pain?

Yes, scoliosis can cause back pain. As you age the spine wears out in a process called degeneration. This wearing out can worsen the scoliosis. Scoliosis can cause pain and usually the pain and dysfunction is related to severity. That is the more severe the scoliosis the more pain and dysfunction.

7. How does scoliosis affect the back muscles?

The back muscles can be affected by: 1) A neurological problem such as s spinal cord tumor can cause weakness in the muscles resulting in scoliosis. 2) The curved spine can strain the back muscles. 3) The curved spine can pinch off spinal nerves, weakening the back muscles.

8. Can a chiropractor help with scoliosis?

The chiropractor may help pain, but is unlikely to improve the deformity. Brace or surgery is usually needed to correct or stop the progression of scoliosis. I would discuss it with your spine surgeon.

9. Does scoliosis progress after a person is done growing?

Typical childhood (idiopathic) scoliosis progresses during the child’s growth spurt and is less concerning after you stop growing. It may worsen from arthritis in old age. Other rare types of scoliosis may progress after you stop growing.

10. Do people that have untreated scoliosis generally become shorter over time?

Mild scoliosis has little effect on height. Severe scoliosis causes a severe curve in the back and often a hunched back (kyphosis) making the patient shorter.

What is Endoscopic Spinal Fusion?

If the spine is unstable and puts extensive stress on the facet joints, or if there is significant pain originating from the disc or other structures, the spine may still need to be fused. Fortunately, minimally invasive fusion techniques have been developed, which allow for less pain and quicker healing times for the patient, this is known as endoscopic fusion of the spine. Endoscopic fusion treats degenerative spinal disease and instability that cause back and leg pain. In most cases an endoscopic discectomy is necessary. The damaged disc is removed through the endoscope, and spinal endplates are prepared for fusion under direct visualization. Endoscopic fusion is performed under general anesthetic to facilitate the insertion of spinal instrumentation. Patients are usually discharged on the same day as the surgery, and have much less pain and a quicker recovery than those who undergo traditional spinal fusion surgery. Patients can usually begin physical therapy within a month after fusion surgery.