My lower back is in pain all the time and my doctor did an x-ray of my lower back and it came back fine, what else could be wrong?

Low back pain is a common complaint in America.  It may arise as result of injury but ususally there is no specific cause.  There are many potential causes of low back pain.   The pain may originate from many different structures including your spine bones, disks, facet joints, muscles, ligaments,chest and abdomen, etc.  Please see What Causes Back Pain?  for more information.

X-ray is not a sufficient workup for back pain, most people need at least an MRI scan to properly evaluate their back.  Sometimes they need special diagnostic injections called pain mapping.  This may include diagnostic transforaminal nerve blocks, medial branch blocks and discogram.

Unless a serious cause of back pain is found most doctors recommend to start with conservative treatment, such as rest, physical therapy to improve core muscle strength and flexibility, non steroidal anti-inflammatory medications, pain medicine and steroid injections. Patients who do not improve may benefit from surgery.  Please see When Should I Consider Back Surgery?

Depending on the cause of the pain patients may benefit from disk surgery (What is Sciatica?), lumbar laminectomy (Overview of Spinal Stenosis), lumbar fusion (Spinal Fusion and alternate Options) or vertebroplasty or kyphoplasty (Kyphoplasty – what is it?).

For more information please Schedule an Appointment. Good Luck!

Do I have to wear my back brace at night?

Back brace is used to stabilize your spine after spinal fusion surgery.   These braces are used to hold the spine together until fusion occurs.  Spinal Fusion is the joining of one vertebrae to another vertebrae by bone bridge.  The two vertebrae and the bone graft eventually become one solid bone.  Spinal instrumentation acts as a internal brace to hold the fusion together.  This may consist of rods, screws, plates, clamps or wires.

The rate of spinal fusion depends on many factors including age, activity, size, location.  Spinal fusion is decreased by smoking and usage of non-steroidal anti-inflammatory medications.

Spine braces can be in the form of a neck collar after anterior cervical discectomy and fusion (ACDF), thoracic lumbar sacral orthosis (TLSO) after treatment of a thoraco-lumbar burst fracture or lumbar sacral orthosis (LSO) after lumbar fusion.

For more information on back braces please see the following blog posts:

Is it bad to use a back brace?

Should I be wearing a back brace if I have a disc injury?

Back braces are not usually worn in bed because there are less forces being applied across the surgical site and less chance of damaging the fusion and instrumentation holding the spine together.

For more information please Schedule an Appointment.   Good Luck!

What is the recovery time for lumbar fusion?

Spinal Fusion is the joining together of the spinal vertebrae with bone.  This is usually done through the disk space [called anterior lumbar interbody fusion (ALIF), direct lateral interbody fusion (DLIF) / extreme lateral interbody fusion (XLIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) or endoscopic lumbar interbody fusion (ELIF)] but can be done posteriorly over the lamina (posterior fusion), in the facet joints (facet fusion) or transverse processes [posterolateral fusion (PLF)].

The Endoscopic Lumbar Interbody Fusion is the newest development in fusion techniques and many believe will cause the least damage and pain and have the quickest recovery.   Endoscopic fusion is done through a small tube with the aid of an endoscope.   This endoscopic area of spine surgery is generally called Laser spine surgery, even though lasers are rarely used today.

Recovery time varies from person to person and from procedure to procedure. The larger the procedure (that is more exposure and therefore tissue damage and the greater number of levels fused) the longer the recovery. People recover quicker from minimally invasive procedures.  Recovery can take from a couple weeks to many months.  Most people can return to light activity (no strenuous lifting or exertion) in few weeks.

Schedule an Appointment to learn more about endoscopic lumbar interbody fusion (ELIF).

I have tailbone pain, making sitting and standing up very uncomfortable.

Tailbone pain often results form falls or injuries to your coccyx.  Rarely pain may arise from lesions in the tail bone such as cancer.  Many traumatic injuries to the tailbone may respond to hemorrhoid cushion (which takes pressure off the tailbone and helps pain and swelling settle), anti-inflammatory medicine or steroid injections, rarely patients may need tailbone surgery.  For treatment options for back pain please click Read More.  Good Luck!

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

Scoliosis is the curvature of the spine.  Scoliosis may result from juvenile scoliosis in kids (unknown cause), spine, arthritis, neurologic disease, surgery, injury, etc.  Neurologic disease such as a spine tumor may cause back muscle weakness resulting in scoliosis. Scoliosis is not caused from being out of shape or not working out at the gym (that is being weak).  I hope this information answers your question.

For more information please click on Does scoliosis cause pain?  Good luck!

Is it bad to use a back brace?

Frequent use of a back brace may lead to weakening of your back muscles and the development of increased back pain. It is best to strengthen your core muscles to stabilize your back to decrease back pain.  I recommend starting Yoga.  Yoga is a great exercise to strengthen your abdomen and back, improve flexibility and loose weight!  For more information please contact Executive Spine Surgery.  Good Luck!

Does everyone eventually get some form of spondylosis?

Spondylosis is degenerative arthritis of the spine.  Most, if not all, people develop evidence of spondylosis on X-rays, CT or MRI, since it is normal wear and tear changes of the spine.   Fortunately many people do not develop significant pain or other symptoms from it.  For more information click on Back arthritis or Sciatica.  Good Luck!

Does everyone eventually suffer from degenerative disc disease?

Degenerative disk disease is the wearing out of your disks in your back.  This is a slow process resulting from drying out of the nucleus pulposus changing how the disk manage forces. Over time the disk may darkens, collapse, bulge, tear and rupture producing leg pain called Sciatica.

Everyone or at least most people develop radiologic evidence of degenerative disk disease if they live long enough, but not everyone will have pain and suffering as a result of it.  There are many new treatments for degenerative disk disease including artificial disk replacement, endoscopic discectomy and annuloplasty,  Endoscopic Spinal Fusion (that is Endoscopic Lumbar Interbody Fusion or ELIF). 

Schedule an Appointment to learn more how Executive Spine Surgery can help.  Good Luck!

I broke my back. Who do I see for vertebroplasty and kyphoplasty?

I would recommend seeing a spine surgeon if you are considering vertebroplasty or kyphoplasty.    You should bring your x-rays, CT and MRI to be reviewed and interpreted to determine the best treatment for you.  For more information about spinal compression fractures, vertebroplasty and kyphoplasty  please click Kyphoplasty.

Click Schedule an Appointment to learn more how Executive Spine Surgery can help you.  Good Luck!

Will my pain go away after L4-L5 spinal fusion surgery?

Pain may improve, stay the same or worsen after fusion surgery.  The majority of people will see improvement in there pain, but few people will have complete pain relief.  Unfortunately spine surgery does not give you a new uninjured back.   I would discuss what the likelihood of you improving with your surgeon.

Spinal fusion surgery  is usually done through an open traditional technique causing significant skin, muscle and bone damage.  Recently open traditional fusion surgery is being replaced by percutaneous endoscopic fusion techniques I call Endoscopic Lumbar Interbody Fusion (ELIF).  These surgeries appear to have less bleeding, soft tissue and bone damage compared to open traditional fusion surgery.  Due to less soft tissue and bone damage these endoscopic surgeries appear to have less post-operative pain and a quicker recovery.

For more information on percutaneous endoscopic fusion surgery please contact Executive Spine Surgery.   Good Luck!