June 2018 - Carl Spivak, MD - Executive Spine Surgery

June 27, 2018

By Staff Writer Pain

How to Soothe Spinal Arthritis Pain Before Your Treatment

Arthritis, which affects some 54 million American adults, is the leading cause of disability. If you are among those patients who have been diagnosed with spinal arthritis, you likely experience back pain on a regular basis — and perhaps you are even scheduled for non-invasive back surgery.

Having surgery or another treatment scheduled can give you peace of mind, knowing that there is relief in sight. In the meantime, there are a variety of ways you can ease your aching back. Let’s take a look at some of the most common.

Heat or Ice?

Chances are you have a heating pad or a hot water bottle lying around, in which case you should press them into service right away. If not, it’s pretty easy to make your own or pick up a reusable heat pack at the pharmacy. The soothing effect of the heat can help you live with lower or upper back pain.

Ice is generally used for acute injuries, to reduce swelling and help numb pain. Chronic arthritis pain tends to respond better to heat. However, use whichever one brings relief; just don’t use an ice pack for more than 20 minutes at a stretch.

Water Feels Wonderful

Many spinal arthritis patients find that it feels wonderful to be immersed in water. The buoyancy helps ease pressure on aching muscles. Taking warm baths, attending gentle aqua fitness classes, or sitting in a jacuzzi are all great ways to soothe your spine pain.

Massage Therapy

Is there anyone who doesn’t enjoy getting a nice massage? Aside from the blissful feeling of having your knots and kinks worked out, massage can also provide lasting pain relief for anyone with arthritis.

Yes, it’s true that arthritis directly affects the joints, not the muscles, but remember that everything in your body is connected. If you have joint pain, your muscles will do extra duty to help move your body — and they can get pretty sore as a result.

Chiropractic Care

Similarly, your knees, hips, feet, and other joints may suffer due to spinal arthritis. A chiropractic session may help realign your body and temporarily take away the pain.

Be sure to inform your chiropractor of your arthritis diagnosis. First-timer and nervous about the adjustment? It’s OK to ask that your chiropractor go easy on you, or to find one who uses spinal mobilization rather than spinal manipulation.

Acupuncture

Like chiropractic care, acupuncture can sound a little scary. Who would choose to have needles jabbed into them? In fact, plenty of people not only make this choice but report tremendous benefits from this ancient practice.

Ensure that your acupuncturist is licensed in your state and certified by the National Certification Commission for Acupuncture and Oriental Medicine. They should also use only disposable, single-use needles.

Gentle Exercises

No matter how active you were pre-diagnosis, the pain from spinal arthritis is probably restricting your mobility and activity level. High-impact exercises like running or playing basketball will have to wait. In the meantime, try two ancient and very gentle forms of movement: yoga or tai chi.

Both disciplines emphasize breathwork as well as slow, steady movements. They can improve your balance, flexibility, and overall well being, too. Start out slowly with videos for beginners, and make sure to get your doctor’s approval beforehand.

Get Some Rest — But Not Too Much

It would be nice to use your spine pain as an excuse to lie in bed or camp out on the couch, catching up on the latest Netflix offerings. However, too much inactivity won’t do you any favors. The human body is designed to move, after all.

Do what you can within the limits of your pain. It’s important to find a balance between your activity level and the signals your back sends you to be still.

Shed Those Extra Pounds

Nor is this the time to engage in emotional eating. If spinal problems have you temporarily sidelined, make sure to adjust your calorie intake downward to avoid gaining weight.

Anyone who is already overweight would do well to drop a few pounds prior to spinal surgery. Control your portion sizes, and choose foods that are nutrient-rich instead of processed junk. Slimming down somewhat will help your body feel better in general, and can speed up recovery time, too.

Find New Ways to Relax

This tip for spinal arthritis patients is especially important if lying down and taking it easy are hard for you to do. Maybe you’re accustomed to relieving stress by playing a sport or heading to Zumba class three times a week. Or, at the other end of the spectrum, your go-to in times of tension is a date with Ben and Jerry.

There are plenty of relaxation techniques to try. Journaling, coloring or sketching, guided meditation, and self-hypnosis are all healthy ways to chill out.

Pain Medication

Some people are hesitant to start taking medication for their pain — and that’s understandable, given how serious the opioid crisis in the United States has become. In some cases, however, prescription medication is a viable option. There are a number of drugs you can try before restoring to highly addictive painkillers.

Over-the-counter NSAIDs like ibuprofen or analgesics such as Tylenol are a good place to start. If those don’t do the trick, your doctor may prescribe a muscle relaxer or non-opioid pain medication.

Topical Treatments

Another way to get relief is by using topical preparations. These include Ben-Gay, Aspercreme, Tiger Balm, IcyHot, and BioFreeze. You can find them at the drugstore, and some even come in roll-on or spray versions for easier application.

Spinal Arthritis Pain? Not Anymore!

As you can see, there are many approaches to pain relief that you can try while you’re waiting for more serious treatments, like spinal arthritis surgery. No two back pain patients are the same, so it may take some experimentation to see what works for you.

Have you found relief from any of these non-invasive spinal pain treatments? What has worked best for you? Let us know in the comments!

June 27, 2018

By Staff Writer Pain

What Are the Best Sleeping Positions to Reduce Back Pain at Night?

The American Association of Neurological Surgeons estimates that 75 to 85 percent of Americans face back pain at some point in their lives. That’s a pretty alarming number!

Back pain can prevent you from doing many things you enjoy such as sleeping, working out, or traveling.

Does your back pain keep you up at night? Is it hard to find the perfect position that gives you the best pain relief?

Here are some helpful sleeping positions that will reduce back pain so you can rest easy.

1. On Your Side with a Pillow Between Your Knees

Try shifting to your side instead of laying flat on your back.

Your shoulder and side of the body you sleep on should touch the mattress
Put the pillow between your knees
If your waist does not touch the mattress, add a small pillow
Don’t always sleep on the same side – rotate

Why the side position? It’s not sleeping on your side that makes you feel better – it’s the pillow that aligns your pelvis, hips, and spine.

2. On Side in the Fetal Position

If you have a herniated disk, you should try this position. It gives a little extra support.

Start on your back and then roll to your side gently
Tuck your knees into your chest
Curl your torso toward your knees
Switch sides regularly to prevent imbalance

Each of your disks has soft cushions between them. When your disk becomes herniated, the disk is out of its normal spot which causes the pain and weakness. This position helps your disk by opening up space between each of vertebrae.

3. On Your Stomach with a Pillow Under Abdomen

Sleeping on your stomach can be uncomfortable if you have back pain. It could add stress to your neck.

If you love sleeping on your stomach, you can try:

Putting a pillow under your pelvis and lower abdomen
Removing the pillow from under your head

You can feel the pressure in your neck if you turn your head to the side. To relieve pressure on your neck, use a small pillow or rolled-up towel under your forehead. Facing your head down is best for your neck.

If you have degenerative disk disease, you may benefit the most from stomach sleeping with a pillow. It relieves the stress pushing on the space between your disks.

4. On Your Back with a Pillow Under Your Knees

Sleeping on your back may be your best option for pain relief. To get the most support:

Lay straight on your back
Put a pillow below knees
Use a small rolled up towel under back for additional support

This position helps because your weight is distributed evenly. Your weight is also spread across the widest part of your body.

This allows your spine and organs to be aligned and relieves strain on the pressure points. The pillow is key to keeping your lower back in a curve.

5. On Your Back Reclining Position

Have you slept in a recliner? This position can be beneficial if you have isthmic spondylolisthesis, which is a condition causing one of your vertebra to slip over the next vertebra underneath.

Reclining helps because it creates an angle between your trunk and thighs, which reduces pressure on the spine.

You can also choose to invest in an adjustable bed for additional support and the best alignment.

Alignment is Key

As you can see, there are a variety of sleep position options if you have back pain. Keeping proper alignment is the most important part of getting a comfortable night’s sleep.

Be sure you align your ears, hips, and shoulders. Add any pillows to fill gaps between your body and the bed. These gaps strain your muscles and spine.

You can also mess up your alignment when you turn in bed. Try to keep your entire body together as you move. Keep your core tight and pull your belly button in.

If needed, you may bring your knees to your chest to roll over for added support.

Key Points About Choosing a Pillow

Now that we have discussed sleep positions – it’s important to talk about your pillow. There are a variety of pillows and some are better suited for different sleep positions.

Your main head pillow should promote the natural neck posture. It should also support your spine.

You want this pillow to not only be comfortable but also adaptable. It should keep its shape after use.

You should change your pillow every 12-18 months.

If you sleep on your back, a thinner pillow may be the best option because it doesn’t raise the head too much. Memory foam is a suitable option because it forms into the shape of the neck and head.

If you sleep on your side, you should consider a thick pillow. You want this pillow to completely fill in the space between the mattress and the neck.

Stomach sleepers should also consider a thin pillow or forego having a pillow. If your pillow is too thick, it will put pressure on your neck by pushing the head back. A small firm pillow can be used to support the forehead.

How to Choose a Mattress

Your mattress needs to be supportive and comfortable. People with lower back pain may want to consider a medium-firm mattress. If your mattress is too firm, it will put strain on your pressure points and get your body out of alignment.

Your size, shape, and proportions determine the amount of support you need. You want to feel like you are floating on air with no pressure on your body.

If your mattress is too soft, it can twist your joints and get your spine out of alignment.

There are several mattress styles to choose from including innerspring, memory foam, latex, and air.

You should replace your mattress every 10-15 years.

Still Looking to Reduce Back Pain?

It’s hard to get a good night’s sleep when you have back pain. If you feel like you need more help to reduce back pain, contact Dr. Carl Spivak today for a no-cost MRI review.

He will work with you to see if you are a candidate for his minimally invasive procedures to reduce your back pain.

June 20, 2018

By Staff Writer Surgery

Are You a Good Candidate for Artificial Disk Replacement?

Chronic back pain will affect 80-90% of people at some point in their lives. Almost 2% of our country’s workforce deals with debilitating back pain. Many conditions can cause pain and require surgery.

When your pain becomes so severe that you cant control it with conservative treatments, you’ll need to be evaluated by a spine surgeon.

Spinal surgery has advanced a lot in the last few years, including FDA improved devices that can replace damaged spinal disks.

But the conditions that disk replacement surgery can treat are limited by a variety of factors. To learn more about artificial disk replacement and whether or not you would be a good candidate, read on.

What is Artificial Disk Replacement?

Before we talk about what makes a person a good candidate for this surgery, you should understand exactly what this surgery is.

Artificial disk replacement surgery is when worn or damaged disk material between the small bones in your spine are removed and replaced with synthetic or artificial disks. The goal of this procedure is to relieve back pain and maintain normal motion.

In other procedures, like spinal fusion, your movement would be much more limited.

Although many people will deal with low back pain in their lives, most people won’t need surgery to correct it. Surgery is only considered when back pain doesn’t improve with treatment.

For patients who have tried all nonsurgical options and are still in pain, lumbar fusion surgery is the most common option for treating lower back pain. Fusion is pretty much what it sounds like, a “welding” process that fuses the painful vertebrae together so they heal in a single, solid bone.

Lumbar fusion helps many people, but the results vary. Also, some people who heal in the most ideal way still have no improvement in their back pain.

Some doctors believe that this is due to the fact that fusion prevents normal motion in the spine. Because of this, artificial disk replacement has come forward as an alternative treatment option.

Artifical disk replacement gained FDA approval in 2004 and over the past years, scientists discovered new designs that are being developed today.

Who is a Good Candidate for Artifical Disk Replacement?

In order to make sure you are the best possible candidate for disk replacement, your surgeon might want you to go through a few tests. Some of these tests include:

Magnetic resonance imaging (MRI) scans
Discography
Computed tomography (CT) scans
X-rays

The information they learn from these tests will help your surgeon determine whether or not you’re a good candidate for the surgery as well as pinpointing the source of your back pain.

As beneficial as this surgery is for many, it is not appropriate for everyone with low back pain. For the most part, good candidates have a few characteristics in common. They are:

Back pain caused by one or two intervertebral disks in the lumbar spine
No significant facet joint disease
No bony compression on spinal nerves
Not excessively overweight
No major surgery has been performed on the lumbar pine before
No deformity of the spine, like scoliosis

As long as you meet these criteria, and are in otherwise good health, you should qualify for the surgery.

The Procedure

For the most part, artificial disk replacement surgery will take between 2 and 3 hours.

Your surgeon will approach your lower back from the front through an incision in your abdomen. This way, the organs and blood vessels must move to the side, but it also allows your surgeon to access your spine without disturbing the nerves.

Typically, a vascular surgeon will assist the orthopedic surgeon with opening and exposing the disk space.

During the procedure, the surgeon will take your problematic disk out and insert an artificial disk into that space.

Artificial Disk Design

Some disk replacement devices make up the center of the intervertebral disk while leaving the outer ring in place, but this technology is still in the investigative process.

Mostly, the artificial disk will replace the outer ring and the center with a mechanical device that will stimulate the spine to function.

There are a bunch of different disk designs, all of them unique but maintaining a similar goal of reproducing the size and function of a normal disk.

There are disks made of metal and some made of metal and plastic both. This is similar to joint replacements in the knee and hip. These disks are made with medical grade plastic and medical grade cobalt chromium or titanium alloy.

Make sure you and your surgeon decide what disk is best for you.

Recovery

For the most part, patients stay in the hospital for 1 to 3 days after the surgery. The length of your stay depends on how well controlled your pain is and whether or not you can function.

Patients are encouraged to stand and walk the day after surgery. With artificial disk replacement, bone healing isn’t required after the replacement, so usually, patients are encouraged to move in their midsection too. Early motion in this area can lead to faster recovery.

You will perform your basic routine during the first several weeks after surgery, just make sure you don’t hyperextend your back.

Outcomes

For the most part, patients can expect improvement of lower back pain in weeks or months after surgery.

This procedure will improve, but not completely eliminate, back pain. Make sure you have realistic expectations before going into surgery

Artificial Disk Replacement Research on the Horizon

The future of this procedure will likely have advancements in implant design and tools for diagnosing pain sources. It’ll also include ways to return the disk to normal function without needing to add any biomechanical device.

Artificial disk replacement isn’t considered a new technology, but the research continues on the outcomes of the procedure.

If you think you would be a good candidate for this procedure, visit us today to learn more.

June 13, 2018

By Staff Writer Scoliosis

Can Scoliosis be Cured?

The transition between our early childhood and teenage years is a complicated weave of emotions, hormones, and life transitions. Yet that period can be far more stressful when combined with scoliosis.

A condition most often diagnosed during the puberty stage of one’s life, scoliosis can range from mild to severe. Left untreated, it can impact your posture and even endanger your health.

But what is it, exactly?

More importantly, can scoliosis be cured?

What is Scoliosis?

Scoliosis is a condition where the spine curves as it grows. It affects both the neurological and the muscular systems. This curve can either form in a “C” shape or back and forth like an “S”.

There are four different types of scoliosis:

Idiopathic Scoliosis, which has no known origin
Neuromuscular Scoliosis, which is caused by neuromuscular disorders
Congenital Scoliosis, which is a rare genetic defect
Degenerative Scoliosis, which develops in older adults

Most patients start to see symptoms of this abnormality between the ages of 10 and 14. This is because your body is growing and developing. Typically, you’ll see the most impact of your scoliosis during these formative years, but it can progress even after your teens.

This condition can occur in both male and female patients. However, it is more common amidst women.

What are the Symptoms of Scoliosis?

There are various signs of scoliosis. Some of them you can feel, while others you can see with the naked eye or on a medical scan. The most common include:

Seemingly Ill-fitting Clothes

Sometimes the symptom is as subtle as looking in the mirror and noticing your clothes don’t fit right.

You squint at your reflection, wondering why your shirt looks tighter in some areas than others, or why the edge of your shirt looks uneven compared to the opposite side.

This is caused by the tilt of your frame due to your spine’s curvature.

An Asymmetrical Back

Perhaps you are wearing a tank top or bathing suit when you, a friend, or family member notices your shoulders or back appear asymmetrical. This is another indicator of scoliosis.

A Change in Gait

Have you noticed yourself having trouble walking? Maybe your legs can’t seem to find the proper rhythm or one feels longer than the other. Scoliosis’ impact on your spin can misalign your hips, causing you to walk differently than normal.

You may even find yourself growing more fatigued since your body has to work harder to maintain balance.

A Noticeable Decrease in Range of Motion

As the spine begins to curve, it reduces its flexibility. Patients find it harder to bend their torso front to back or side to side.

An Increase in Back Pain

In severe cases of scoliosis, the curvature can lead to painful muscle spasms in the back, as well as deterioration of various discs and joints due to the strain.

Dangerous Levels of Pressure on Internal Organs

Scoliosis doesn’t just impact your skeletal frame. The sharp twists and angles can also cause pressure on your lungs and heart, hampering their function and creating hazardous health problems.

What are the Causes of Scoliosis?

While some cases of scoliosis may be caused by neuromuscular conditions like genetic defects, muscular dystrophy, or cerebral palsy, most cases have no defined cause.

Doctors have identified age, genetics, and sex as factors that play a role in how high a patient’s risk factor is in developing scoliosis. While most scoliosis patients have no prior history of it in their family, those whose family members have developed this condition are at a higher risk of doing so themselves.

Most cases develop during puberty, so young adults are less likely to receive scoliosis as a diagnosis. However, elderly adults may develop degenerative scoliosis after the age of 65.

Women are more likely to have this condition than men, but why it occurs still remains a mystery in most cases.

Can Scoliosis Be Cured?

While there is no cure for scoliosis, there are multiple scoliosis treatment options available on a case-by-case basis. First, a doctor must diagnose a patient’s scoliosis as well as his or her degree of severity.

This is done through imaging tests in order to identify the shape of your spine, as well as any underlying causes, such as an injury or the growth of a tumor.

For mild cases, your doctor may simply suggest monitoring your scoliosis, especially during your teen years. Since your body grows so rapidly during this period, your scoliosis also evolves rapidly.

If this is the case for you, your doctor will expect to schedule an appointment about once every six months.

Left unattended, scoliosis can damage the heart and lungs, cause severe back problems, and misalign your skeleton. If the scoliosis is severe then your doctor may require medical intervention.

This could include a brace or even surgery to help slow or reduce your spine’s curve. A brace is typically worn during a patient’s pubescent period in order to guide the spine into better alignment as it grows. This brace isn’t required after your bones have finished their growth period.

If surgery is required, this is typically done through a spinal fusion or installation of a metal rod. Although similar, these two forms of surgery implement a different approach to spinal realignment.

Spinal fusion uses small rods, wires, or other metal pieces to fuse certain vertebrae together. While this stiffens the back, it can improve the overall alignment.

The rod installation is a larger piece of hardware that is adjusted as the patient grows. Like the check-up appointments, these adjustments are made approximately once every six months.

Do You Think You Might Have Scoliosis?

While the answer to “Can scoliosis be cured?” may not be the one you were looking for, the good news is that there are many treatment options. If caught early enough, most patients can go on to lead normal, healthy, happy lives.

If you or a loved one are experiencing symptoms of scoliosis, contact your doctor. Patients in Hackettstown and Newton, New Jersey can book an appointment with our spinal surgery office without ever leaving their computer chair.

June 6, 2018

By Staff Writer Lower back pain

Everything You Need to Know About Degenerative Disc Disease

Back pain is a problem that affects millions of people in America. As of 2017, nearly 55% of American adults were living with a back-related problem. Roughly 30% of these individuals believed their pain was stress-related, 26% felt it was due to weak muscles, and the same amount blamed physical work.

However, whatever the source of your back pain, it’s essential to have it checked out to ensure it’s not serious. There are many things that can go wrong with your spine that may require surgery or extensive physical therapy.

This includes lumbar degenerative disc disease (DDD). This condition is quite prominent among both men and women and deserves looking into if you have lower back pain.

Let’s review more about this condition.

What is Lumbar Degenerative Disc Disease?

Lumbar DDD is a form of spinal degeneration that can occur as a person ages or when trauma occurs. Any of the discs in your spine can begin degenerating. However, lumbar degeneration takes place in the lower back region.

It’s very common for these areas to degenerate after you develop bulging or herniated discs.

It’s also prominent in those diagnosed with scoliosis. The symptoms of disc degenerative disease vary from person to person. For instance, some may feel tingling and numbness in their buttocks and legs.

Then those who have disc injuries in the shoulders and neck may have numbness and tingling in the arms. In severe cases, it can lead to temporary paralysis in the arms or in one or both legs.

Degeneration in the discs located in the upper back can cause symptoms like severe migraines and headaches. Limb weakness, memory loss, and muscle spasms are other symptoms to watch for.

The Anatomy of Your Spine

Now, it’s important to note that DDD isn’t actually a disease. Nor is it guaranteed to worsen over time. Everyone experiences disc degeneration at some time in their life and in some cases.

There are three main parts of intervertebral discs. The first is annulus fibrosis, which consists of concentric collagen rings that bend and twist as you move. The second is the nucleus pulposus, which is the inside of the disc.

It has a gel-like consistency that’s made with water and proteins. The purpose of this is to provide a cushion between the discs.

And last, there are the cartilaginous endplates, which is located between vertebral bodies and discs. It’s made with cartilage that’s attached to the disc. In a way, it acts like a gatekeeper, controlling the number of nutrients and oxygen that passes through the disc space.

What Are the Symptoms of Degenerative Disc Disease?

In many cases, the onset of degenerative disc disease is low-grade. Some will feel no back pain and others will have a continuous but tolerable amount of pain in the region. In these individuals, it’s common for the pain to flare up for a few days or so.

Moderate Low Back Pain

Those living with moderate, continuous lower back pain tend to have pain in the area where the discs are damaged. The pain can generate in the groin, buttocks, and upper thighs. The type of pain reported by pain sufferers include dull aches that are mild to severe.

Pain Flare-ups

The individuals that have occasional pain flare-ups tend to suffer from increased aches for days or even weeks on end. After a while, the pain reduces to a moderate level. Then as the disc degenerates and gradually stabilizes, these flare-ups happen again.

Flare-ups are known to be sudden and severe, and in some instances can cause reduced mobility.

Localized Pain

If you’re feeling localized tenderness in your lower back, then this a potential sign of lumbar disc disease. It’s common for the disc that’s degenerating to become too sensitive to touch. This is because there’s inflammation and tension in the muscle around the damaged disc.

Leg Pain

All of your nerves coursing through your body connect through your spine. It’s not uncommon for low back pain to extend to other parts of the body, such as the legs. You may feel numbness, sharp shooting pains or numbness in your buttocks or back of your leg.

This tends to happen once the disc space collapses onto a nerve root, causing it to pinch. Some back pain sufferers complain of pinching in their neck and shoulders after sitting upright for too long.

Pain While Sitting

Ironically, a lot of back pain sufferers have issues with sitting for too long. It can lead to severe low back pain and stiffness, requiring you to change positions or stand up to alleviate the pain. The best way to sit for long periods of time is to sit in a chair that reclines and offers good lumbar support.

Walking and changing positions can help with the pain because you’re removing the pressure from the discs onto your joints and muscles.

Treatment Options for Degenerative Disc Disease

Now that you have a better idea of what DDD is, it’s time to look at some of the treatment options that are available.

Short-term treatment options include OTC and prescription pain medications. Using the heat and ice method, massage therapy, and chiropractic care are natural ways you can alleviate the pain. However, these are all for temporary relief and won’t treat the root problem.

This includes using epidural steroid injections, which reduce pain signals and inflammation. In many cases, patients use these injections with physical therapy.

But if your case is severe enough, surgery is a great option to consider. One type is lumbar spinal fusion surgery. It’s the standard procedure that grafts together two vertebrae to help reduce the pain by removing the motion of that part of the spine.

During surgery, the surgeon removes the entire disc from the space, then they either attach instruments or bone graft to the two vertebrae that will fuse together. This can take months to occur following the surgical procedure.

If this is something you’re interested in having done to treat your lumbar degenerative disc disease, then we can help. At Executive Spine Surgery, we offer surgical treatments and pain management services.

Month: June 2018