lumbar degenerative disc disease

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.

Contact us today to see how we can help you lead a life free of back pain!

PRP

What Is the Role of PRP in Sacroiliitis?

Are you struggling with lower back pain? Do you deal with constant sciatic nerve pain? Does climbing stairs make your back hurt?

You’re not alone. You might be among the 40% of Americans who will suffer from this pain at some point in their lives.

Luckily, there’s a solution. It comes in the form of PRP, or Platelet Rich Plasma, injections.

Keep reading to find out everything you need to know about Sacroiliitis and PRP.

What Is Sacroiliitis?

First of all, let’s define Sacroiliitis. Sacroiliitis is the inflammation of both or one of the sacroiliac joints. These joints are situated in the spot where your pelvis connects to your lower spine– your lower back.

These joints are vertical and about 6 or 7 inches long. They’re held together by ligaments that contain tons of nerve receptors.

Since the sacrum is often subject to lots of stress as you go through your daily motions, the sacroiliac joints can become inflamed. This is what leads to Sacroiliitis. The many nerve receptors in the surrounding ligaments are responsible for the pangs of back pain that you may feel.

Sacroiliitis can cause pain in your back, buttocks, and can even extend all the way down your legs. It can also be hard to diagnose. Back pain is finicky, and the pain symptom is really the only telling symptom for sacroiliitis diagnosis.

Oftentimes, patients will come back with normal EMG studies, MRI scans, and lumbar spine scans. Yet they’ll still experience pain. Your doctor needs to be looking for Sacroiliitis to find it.

This is why it often takes time to diagnose. Usually, it’s a last resort diagnosis, after other scans have come back normal.

If your lower back pain gets worse when you climb stairs, stand for a prolonged period of time, or go for a run, you may have Sacroiliitis.

How Is It Caused?

There are five potential causes of sacroiliitis.

Traumatic injury is the first. This includes injuring your sacroiliac joints while lifting heavy items. It also includes injury from falling or getting into a car or bike accident.

A biomechanical injury is the second. This includes sacroiliac joint dysfunction manifesting from a previous lumbar infusion, or a discrepancy in leg length.

Hormonal imbalances or changes are the third. This includes hormonal changes due to medication, or natural hormonal changes due to pregnancy or childbirth.

Inflammation is the fourth. This is when your tissues become swollen, red, and painful.

The fifth is normal age-related degeneration, usually brought on by normal wear and tear over the years.

How Is It Diagnosed?

To diagnose sacroiliitis, you’ll need to first schedule doctor’s appointment. They’ll probably press on points of your lower back, including your buttocks, to try to put a finger on the location of the pain. Your doctor may order x-rays or an MRI of your back and sacroiliac joints to show if your sacroiliac joint is injured and to make sure the low back is not the cause of the pain. Another method your doctor will confirm the diagnose Sacroiliitis is anesthetic injections. This involves your doctor injecting the affected area with a numbing injection. If the pain stops, it’s likely that your sacroiliac joint is the problem.
The one caveat with this method of diagnosis is The anesthetic injection can leak into a surrounding area, making it unclear whether or not your sacroiliac joint is really the problem.

What Can You Do?

Physical therapy is an option. It’ll include plenty of strengthening and stretching exercises. If physical therapy doesn’t alleviate your symptoms, you might be a candidate for PRP, or Platelet Rich Plasma, injections.

How Does It Work?

Spinal injections are an effective pain management tool. PRP injections work to aid your boby in its natural healing process.

Platelets begin repairing your tissue by releasing growth factors. Growth factors are a substance, such as a hormone or a vitamin, that’s necessary to stimulate the growth of living cells.

The growth factors initiate the process of healing by attracting reparative cells, especially critical stem cells. Without PRP injections, your body would have far fewer platelets, meaning a slower healing time.

Once the platelets have been injected into your bloodstream, a sample of your blood will be taken and put into a centrifuge. The centrifuge will then separate the added platelets from the rest of your blood. Then, that concentration of PRP is re-injected into your body, specifically into your lower back.

Now, your lower back has tons of tools to begin healing– all naturally. After the injection, it takes around six weeks for your body to reduce inflammation and rebuild tissue within your sacroiliac joints. After six weeks, you’ll feel good as new.

When PRP Injections Aren’t Enough

You might get the PRP injections and find that your Sacroiliitis is just too far gone. While PRP injections are certainly effective for pain management, they can’t reverse degeneration or injury.

If this sounds like you, you might be a candidate for spinal surgery. If so, you should opt for a minimally invasive one.

Why? Because traditional surgery requires a very large incision. That means extensive tissue damage, and a subsequent long time recovering.

Why go the traditional route when a minimally invasive option is available?

Today, the minimally invasive procedure is as simple as placing three titanium implants on your sacroiliac joint. These implants will fuse and therefore stabilize the connection between the joints, your spine, and your pelvis.

It only takes around an hour, and you might even be discharged to go home the same day. That’s far preferable to weeks recovering in the hospital.

Are You a Candidate?

If you’re experiencing lower back pain, you could be struggling with Sacroiliitis and not know it yet. Oftentimes, sciatic nerve pain can go untreated for too long, and improperly diagnosed once you find the time to visit the doctor.

Don’t let this be you. If you’re in Hackettstown, Cedar Knolls, or Whiting, New Jersey, get in touch. We would love to get you on the road to recovery.

stem cell for back pain

Stem Cell for Back Pain: What Is It and How Exactly Does It Work?

Almost eighty percent of all adults in the US experience low back pain at some point.

Low back pain is the leading cause of disability of people under the age of forty-five.

For some, this pain takes the form of a dull, constant ache. For others, this condition causes sudden pain that can make it difficult to move.

Because low back pain is a daily challenge for so many people, there are all kinds of different treatments. Unfortunately, many forms of treatment are very invasive and may ultimately fail to provide any relief.

The need for better ways to treat back pain has inspired a lot of ongoing medical research. Stem cell for back pain is one of the most promising new treatments.

Before we look at how that treatment works and why it’s so promising, it’s helpful to understand exactly what’s at the root of most back pain.

What Causes Back Pain?

One of the reasons back pain is such a prevalent condition is there are many different causes. The first cause is intervertebral disc degeneration. This degeneration occurs as people get older.

Instead of discs remaining flexible, degeneration means they lose their ability to provide cushioning. Back pain can also stem from a ruptured or herniated disc. These conditions cause discs to compress and bulge.

Radiculopathy is another cause of back pain. This condition arises when the spinal nerve root gets inflamed or compressed. Sciatica is a similar cause and may also result in pain shooting down one leg.

Traumatic injuries, spinal stenosis, sprains, strains, and spondylosis are all other possible causes of back pain. With any of these causes, the resulting back pain can take a significant toll on your daily quality of life.

The Problem with Traditional Back Surgery

A common approach to back surgery is removing a degenerated disc and then fusing the spine. The fusing is done in an attempt to eliminate motion which can cause additional pain.

Although traditional back surgery works for some people, there are a number of problems and risks associated with this procedure. The first is that it’s very invasive.

The second issue is at least twenty percent of traditional back surgeries fail to provide any pain relief. Another potential complication is the need for a repeat surgery if a cage or graft subsides.

The invasive nature of this type of surgery can also cause nerve damage. That damage may create problems with leg strength or bowel control.

After learning about all of those risks, many individuals suffering from back pain pursue other forms of treatment. Those treatments can include massage therapy or chiropractic care.

While those treatments are less invasive, they often fail to provide any significant pain relief. Actually providing real relief in a minimally invasive way is what makes stem cell treatment so exciting for back pain sufferers.

Understanding How Stem Cell for Back Pain Works

The term stem cell refers to a cell that’s located within the body. What makes a stem cell different is it hasn’t yet transformed to perform a specific function.

When a stem cell is extracted from the body and then injected into a different area, it can transform based on the needs of that specific area.

In the case of stem cell for back pain, bone marrow is extracted from a patient’s hip bone. This marrow contains multiple stem cells. The cells are isolated by placing the marrow in a centrifuge.

Once the stem cells are isolated, a board-certified surgeon can use an x-ray to guide the cells’ injection back into the body. The x-ray provides the precision needed to target a specific disc in the spine.

After an injection is complete, the stem cell will start to promote healing of the degenerated disc. As injured disc tissue begins getting repaired through growth, the back pain a patient feels will start going away.

Although everyone heals differently, many patients who get this type of treatment experience major pain reductions in just a matter of months. The ongoing effects of stem cell for back pain can provide complete relief over the course of a year.

In some cases, the most effective approach to stem cell treatment may involve two or three injections. This is especially true for patients who are dealing with multiple disc problems along their spine.

A patient who has stem cell treatment in their back can support their recovery by doing therapy exercises. Simple exercises focused on posture and core-strengthening will work in conjunction with the stem cell towards a healthy spine.

The Benefits of Choosing Stem Cell for Back Pain

The first benefit of stem cell treatment is studies have confirmed its effectiveness. Out of one hundred back pain patients in a North Carolina study, sixty-nine of the patients experienced pain reduction.

Not only did the study note that the pain reduction was at least a fifty percent improvement for every patient, but it came after just one treatment session.

A shorter recovery time is the next benefit of stem cell for back pain. Traditional back surgery requires six to eight weeks to recover. It’s generally possible to resume light activity after a stem cell treatment within just a few days.

Using stem cell to address back pain is also far less invasive than traditional surgery. This procedure doesn’t involve any tissue removal, cutting or scars.

Instead, you’ll only experience temporary discomfort as bone marrow is extracted from your hip bone. The same is true when the stem cells are injected into one of your discs.

Is Stem Cell Treatment Right for You?

Stem cell for back pain can provide real relief from this challenging condition. It can also help a degenerated disc heal itself over the course of three to twelve months.

If you’re currently struggling with back pain, Executive Spine Surgery makes it easy to find out if you’re a candidate for stem cell treatment.

All you need to do is fill out our online consultation form and we’ll be in touch with soon about the next step towards stem cell for back pain.

6 Signs of Herniated Disk or Slipped Disk

 

  1. Leg pain – this may be pain radiating down the back or the side of the leg to the knee or foot.   Sometimes this pain is felt in the front or inner thigh or even the groin.  The pain may worsen with straightening the leg or siting up.   Arthritis pain is different from slipped disk.  arthritis pain  is usually only found in the hip, knees or ankle and does not radiate down the whole leg.
  2. Numbness and tingling – this may be felt as pins and needles, burning or decreased or absent feeling in the area of the pain or beyond it.  Sometimes numbness may appear without pain.
  3. Weakness – the leg may give out or drag.  You may have problems getting up from sitting, stepping onto a stool or moving your foot.
  4. Reflex loss – patients may loose reflexes at their knee or ankle or from the bottom of their foot.  Usually this is picked up from your doctor.
  5. Walking – the leg may drag or catch on the floor, you may have to lift the leg high to avoid this
  6. Bowel and bladder – if the disk compresses the cauda equina (the nerves to the bowel and bladder)  the bowel and bladder may stop working.  You may retention of pee or bowel movements or become incontinent of them.  If this happens you should seek medical attention immediately.

About Dr. Carl Spivak

Dr. Spivak is the president of Executive Spine Surgery and has offices in New York and New Jersey.  He is well known for his cutting-edge, minimally invasive endoscopic spine surgeries and regularly teaches courses throughout the USA.  For more information please call 908-452-5612 or click on schedule-an-appointment.

6 Best Treatments for Back Pain

1. Physical therapy focusing on core strength and flexibility.

2. Weight loss.  Weight loss alleviates back pain by reducing stress and strain on your back and decreases damage to disks and joints.

3. Steroid injections may relieve back pain.  Steroids and local anesthetics work to decrease inflammation, washout chemicals that cause pain and directly reduce pain often breaking the destructive pain cycle.  Steroid injections are an effective treatment for conditions that cause back pain such as arthritis of the spine (called facet arthropathy) and disk disease.

4. Stem Cell Therapy.  Disk regeneration is a new therapy where stem cells taken from your hip are injected  into your damaged disk to regenerate the disk.  The stem cells make new disk cells increasing the fluid and size of the disk reducing back pain and suffering.

5. Endoscopic Laser Discectomy.  As the disk wears out, or degenerates, it turns black on MRI, collapses, bulges and may tear causing back pain.  Removal of the degenerated disk and treatment of the annular tear has been found to reduce back pain and suffering.   The discectomy and annuloplasty can be done with the spinal endoscope.  A scope the size of a pencil can be placed through an incision the size of your finger nail.  The disk is found and repaired under direct visualization.

6. Endoscopic Fusion. Painful degenerated disks, spinal instability, spondylolithesis may lead to severe back and/or leg pain.  This pain can be disabling.  Patients that have failed other treatments may be a candidate for fusion surgery.  Today fusion surgery can be done through a very small incision with the aid of an spinal endoscopic to reduce soft tissue and bone damage and quicken recovery.

ABOUT US:

Dr. Spivak is the President of Executive Spine Surgery and is a leader in Endoscopic Laser Spine Surgery.  He see patients in New York and New Jersey and teaches doctors his advanced surgical techniques throughout the United States.  For more information please call 908-452-5612 or click schedule-an-appointment.

Can spinal epidural steroid injection hurt my brain?

Spinal epidural injections are very common treatments for back pain and sciatica.  Sciatica is leg pain running down the back of your leg caused by a slipped disk pinching a nerve.  Imagine the disk is a marshmallow (even though it really isn’t).  The disk like a marshmallow may expand out if you squeeze it.

HOMEWORK:

You can try this at home – take a marshmallow and squeeze it from the top and bottom.  See how the marshmallow expands out as you flatten it.  This is similar to a herniated disk .  The bulging disk may pinch a nerve causing the nerve to swell up and get “hot” called inflammation causing back and leg pain.

Spinal epidural steroid injections are the placement of steroid medicine into the spine onto the hot and swollen nerve to cool down the inflammation and relieve the pain and suffering.  Think of it like putting an aspirin on the nerve.

Even though spinal injections are generally safe there are risks and side effects to all medical procedures. These include bleeding, infection, dural puncture or “wet tap” causing headaches and nerve damage.  Patients may also experience increased pain, headaches, red face, anxiety, problems sleeping, fever, high blood sugar, decreased immunity, stomach ulcers, severe arthritis, cataracts and menstrual irregularities.

TO ANSWER YOUR QUESTION the most common way spinal epidural steroid injections affect your brain is through headaches.  Usually these headaches will resolve with time.  If they are related to “wet tap” you may require bed rest, caffeine, fluids and rarely blood patch.  Blood patch is the injection of blood into the spine to stop spinal fluid leak and “plug” the hole from the “wet tap”.

ABOUT DR CARL SPIVAK

Dr. Spivak is a neurosurgeon fellowship trained in minimally invasive spine surgery and spinal epidural steroid injections.  He has practices in New York and New Jersey.  For more information on spinal epidural injections or laser endoscopic spine surgery please call Executive Spine Surgery at 908-452-5612 or click schedule-an-appointment.

How can I get relief from my bad back pain?

Sorry to hear about your back and sciatica. The L5-S1 disk is probably pinching your sciatic nerve causing leg pain called sciatica. Lumbar disk surgery may be considered if steroid injections have not relieved the pain. Traditionally lumbar disk surgery was done through a large incision with significant muscle retraction, damage and bone removal to get to the disk. Today most lumbar disk herniations can be removed minimally invasively with the spine endoscope. This outpatient surgery is done with a small camera the size of a pen through an incision the size of your finger nail. Most people have quick relief from their pain and decreased recovery.

Patients are admitted to the hospital or surgery center for same day surgery.  They change into a gown and IV and EKG stickers are placed by the nurse and taken to the preoperative area.  The patient is seen by the surgeon, anesthesia and nursing.  The risks and benefits of surgery are explained to the patient if not already done.  The patient then signs an informed consent sheet verifying they understand the risks and benefits of surgery and want to go ahead with surgery. The patient is then taken into the operating room.  The patient is sedated (called conscious sedation) or put to sleep (general anesthesia) by the anesthesiologist and then position face down onto the operating room bed. The back is cleaned with a disinfectant and then a drape is placed over the patient.  X-ray machine and endoscopic equipment are brought to the bed.  After the surgery is completed the patient is transferred back onto their bed and taken to the recovery room.

For more information on minimally invasive spine surgery (MISS), endoscopic spine surgery or laser spine surgery please call Executive Spine Surgery at 908-452-5612 or click on schedule-an-appointment.

Can scoliosis cause chronic back pain?

The spine is made up of a stacked alternating vertebral bodies and disks.  The spine is usually straight on anterior posterior x-ray.  Scoliosis is an abnormal curvature of the spine.  The spine may look like a C or S on X-ray. Scoliosis may arise from birth abnormalities where the spine was formed wrong, such as missing half of a vertebrae or from changes resulting from arthritis.  The cause of scoliosis in young people is unknown and is called idopathic even though certain genetic traits have been defined.

Children are commonly screened at school for scoliosis, especially at the time of the growth spurt when the development and progression is most common.  Patients suspected of having scoliosis undergo a history and physical and relevant laboratory investigations.  This may include x-rays, serial x-rays, CT and MRI.  Patients found to have a spinal curvature of greater than 10 degrees are diagnosed as scoliosis.

Scoliosis alters the mechanics of the back and puts significant strain on the vertebral bodies, disks, muscles and even the nerves leading to chronic pain and suffering.

Treatment is complex and requires individualization.  Smaller curvatures are watched while larger curvatures greater then 20 to 30 degrees may require bracing. Surgery is usually reserved for very large curvatures greater then 45 to 50 degrees which have high likelihood to progress even more.  Other indications for surgery include pain, weakness, difficult mobilizing and breathing.  Surgery usually involves spinal fusion surgery, this may be done through the front (anterior), side (lateral) or back (posterior) combined with spinal instrumentation (screws and rods).

Overall prognosis of scoliosis depends on the likelihood to progress.  Patients with larger curvatures, thoracic curves, double curves and immature spines (such as adolescents) have higher chance or progressing.

ABOUT DR CARL SPIVAK.

Dr Spivak is a neurosurgeon who specialized in minimally invasive endoscopic spine surgery.  He is a well known teacher and speaker in laser spine surgery.  For more information on scoliosis, other spinal disorders or laser spine surgery please call 908-452-5612 or click schedule-an-appointment.

Why do I have a pain in the butt?

Butt pain commonly arises from the sacroiliac joint (SI joint).  This pain is called sacroiliitis.   SI joint pain maybe felt under your jean pocket.    SI joint may cause back, buttock and leg pain. The pain is worse sitting especially on the butt cheek and with activity.

Causes of SI joint pain include arthritis (degenerative sacroiliitis), separation or weakness of the joint (SI joint disruption or laxity), abnormal joint from birth (sacral dysgenesis), inflammation and swelling (ankylosing spondylitis, Reiter’s syndrome or inflammatory bowel disease (IBD)), break or fracture, infection, bone disease and tumor.

The sacroiliac joint is the located between the spine (sacrum)  and the hips (ilium).  It is a large joint held together by strong muscles and ligaments.

SI joint pain can be difficult to diagnose and often is associated with spinal disease.  SI joint pain can be diagnosed by careful history, physical examination and diagnostic injections.  A needle is placed into the joint under x-ray or CT scan and steroid and pain medicine is injected.   Pain relief confirms the diagnosis of SI joint pain.

People may benefit from physical therapy, anti-inflammatory medicine and steroid injections. Patients who fail conservative treatment may consider fusion surgery.   Fusion surgery “fuses” the sacrum to the ilium to prevent pain.  This is done by surgically placed implants.  Many  people will have coexisting spinal disease requiring spinal surgery.

ABOUT DR. SPIVAK

Dr. Spivak is a neurosurgeon who is fellowship trained in minimally invasive spinal surgery (MISS).  He treats a variety of disorders of the neck, back and SI joints. For more information on spine or SI joint treatment please call 908-452-5612 or click schedule-an-appointment.