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!

What are the Risks of Vertebroplasty and Kyphoplasty?

Vertebroplasty and kyphoplasty are common, safe, and helpful procedures, but like any other procedure or medication, there are many risks.  Some of the risks are related to fracture, a person’s health, anesthesia, and procedure.  Fortunately, the risk of these procedures are generally low, but risks include death, stroke, heart attack, pneumonia, blood clots in lungs and legs, fat embolus, plastic spreading to the lungs, lung collapse, spinal cord or nerve injury causing pain, numbness, weakness, bowel and bladder incontinence or paralysis, infection, bleeding, but not limited to these complications. People with one fracture are at increased risk of future fractures.

For more information on vertebroplasty and kyphoplasty please click on Kyphoplasty.

arthritis of the spine

8 Amazing Exercises to Alleviate Arthritis of the Spine

There are no bones about it: arthritis of the spine is a tough break. The condition is painful and it often takes a combination of treatments to ease the pain.

If you’re suffering from arthritis of the spine, we have good news! There are easy exercises you can do at home to reduce your pain. Some of them focus on good posture, and others focus on strengthening your core. All of them, however, can lead to a healthier life with less pain.

Exercises to Reduce Arthritis of the Spine

The right exercises can reduce the pain of arthritis at any stage. Whether it’s just begun or you’ve spent years trying treatment after treatment, these exercises can complement any treatment plan.

1. Master Good Posture

This isn’t an exercise per se, but it can make a world of difference. You’ll also use it in other exercises, so it’s important to learn.

To improve your posture, imagine an invisible string holding you up. It starts at your hips and runs up through your spine and comes out the top of your head. Be sure to keep your shoulders down.

Practicing good posture helps your arthritis of the spine in several ways. First, it reduces the chances that a spinal misalignment will add to your discomfort. Second, it strengthens your core muscles. These muscles protect your spine, reducing your arthritis symptoms.

2. Perform Side Lifts

This exercise builds your back muscles to protect your spine and soothe arthritis pain. To start, stand with proper posture and put your hands at your sides. Your feet should be shoulder-width apart.

Without moving the lower half of your body, bend at the waist to one side. Bend as far as you can without pain, although you should feel your muscles stretching. Use your back muscles to stand back up straight.

You should perform this exercise ten times on each side. As you get stronger, you can increase the difficulty with weights. Hold a small weight in your hand on the side you’re exercising.

3. Go on Regular Walks

It sounds simple, but walking is a great exercise for arthritis of the spine. Walk lightly so you keep the impact on your back to a minimum. Try to walk on surfaces with some “give” like an athletic track.

For further improvement, practice good posture as you walk. Gently engage your core muscles throughout your exercise. In fact, you should also mind your posture as you do chores and move around your house.

4. Practice Tai Chi

Many people talk about yoga as an exercise plan to reduce arthritis. While it can be effective, it tends to put more pressure on your joints than people expect. Even beginners’ yoga can also be too much of a challenge for some people.

Try tai chi instead. Tai chi is an exercise form that’s gentle on your joints. It focuses on slow movements that stretch your muscles and improve your balance.

Depending on how much guidance you want, you can find tai chi classes in most towns. If you prefer to try it at home, there are plenty of tai chi videos on YouTube. Look for routines that are designed for arthritis relief.

5. Try Planking

You might remember planking as an internet trend from several years ago. People would take pictures and videos of themselves laying straight like a board in crazy places. The planking we’re talking about, on the other hand, is a type of exercise.

Start by getting on the floor on your hands and knees with your back straight. If you’re familiar with yoga, this is the tabletop pose. Be sure to use a yoga mat or find another way to cushion your knees.

From this position, straighten one leg and lift it so it forms a straight line with your back. Keep your head facing forward. Hold this position for six seconds before putting your leg back down. Do this for ten reps on each side.

As you get stronger, you can increase the difficulty. While you extend one leg, try extending the opposite arm straight forward. You can also start holding the position for longer.

6. Use a Stability Ball to Do Half Crunches

A stability ball is a large inflatable ball, usually about the height of your knee. You can use it for many types of exercises, but this one is great for people with arthritis.

Sit on the ball with your feet flat on the floor. Lay back until your back is supported by the ball at around a 45-degree angle. You might need to walk your feet forward t reach this angle.

From this position, use your abdominal muscles to lift your upper body. It’s as if you’re doing the second half of a sit-up, and it’s easier on your back than laying on the floor. Do as many of these half crunches as you can, increasing the number as you get stronger.

7. Try the W Stretch

This stretch targets your back in a direct, easy way to relieve your arthritis pain. Stand with food posture with your feet shoulder-width apart. Bend your arms and hold them out with your palms facing forward. Your arms should form a “W” shape.

In this position, squeeze your shoulder blades together as much as you can without pain. Hold this stretch for three seconds before returning to your original position. Repeat the exercise ten times. As you get stronger, you can increase the holding time or the number of repetitions.

8. Perform Pelvic Tilts

To do a pelvic tilt, lay on the floor with your knees bent like triangles. You’ll look like you’re about to do a sit-up but your arms are at your sides.

Use your abdominal muscles to tilt your pelvis toward your head without leaving the floor. You won’t see much movement but you’ll feel your core muscles engaging. Repeat this exercise ten times.

Treating Your Arthritis of the Spine

Arthritis of the spine doesn’t have a one-and-done treatment method. It’s a matter of staying on top of your condition and finding the combination of treatments that work for you. Any and all of the exercises above can complement almost any medical treatment.

If you’re looking for more direct treatment options, schedule an appointment with our spinal surgeons.

Sacroiliac Joint Fusion with The iFuse Implant


The Sacroiliac (SI) joint may be a pain generator in 15-30% of patients with chronic lower back pain and even higher (up to 43%) for patients with continued or new onset low back pain after a previous lumbar fusion.* Learn about SI joint dysfunction and treatment options from Dr. Carl Spivak, MD, a Neurosurgeon at Executive Spine Surgery.
*Rashbaum – Clin Spine Surg 2016
This event is co-sponsored by SI-BONE, Inc.
Important Safety Information: https://si-bone.com/risks

how to deal with a pinched nerve

How To Deal With a Pinched Nerve

As you get older, it is inevitable that your body will begin to change. Your muscles, joints, and bones may not be as lithe and flexible as they once were.

As you get older, it is also easier to injure yourself. And unlike in your younger days, you may find that it takes longer and longer for your body to heal from those injuries.

One common injury people experience as they get older is a pinched nerve. Nerves exist throughout our entire body. Every once in a while, one of those nerves can become pinched. A pinched nerve is both painful and uncomfortable.

Read on for information on how to deal with a pinched nerve until you can get the medical help you need.

Symptoms of a Pinched Nerve

A pinched nerve is when there is damage to a nerve or a group of nerves. There can be many causes for it, such as when a disc, bone, or muscle places increased pressure on a nerve.

Below are some of the most common symptoms of a pinched nerve:

Pins and Needles

A pinched nerve can lead to tingly sensations that feel like “pins and needles”. These feelings can sometimes lead to a feeling of numbness or a burning sensation and usually radiate from the source of the pinched nerve.

Radiating Pain

One of the most common symptoms of a pinched nerve is pain that radiates from the source. Usually, you will feel a concentrated pain from the source, and then feel the pain start to radiate in other directions from that source.

Muscle Weakness

Muscle weakness is also a common symptom of a pinched nerve. If the pinched nerve is in your neck or shoulders, it may affect your grip. Many people have reported that their arm or hand becomes stiff.

How to Deal With a Pinched Nerve?

A pinched nerve can be painful and uncomfortable. How to deal with a pinched nerve? There are many things that you can do that will help alleviate your symptoms and also help with preventing it from happening again.


Adjusting your posture can relieve a lot of pain caused by a pinched nerve. Proper posture is crucial for taking stress off of delicate joints. Sitting or standing with incorrect posture for long periods of time may damage the spine and muscles, leading to a pinched nerve.

You need to find the most comfortable position for yourself, whether you are standing or sitting. Using cushions, adjustable chairs, and neck rests when sitting can also be a great idea to allow the nerve to heal.

Ergonomic Workstation

An ergonomic workstation is a workstation that is designed for efficiency and comfort. Things like your chair, the height of your desk, and monitor all contribute to your workstation.

Ergonomic workstations have been gaining popularity rapidly because of various health benefits. For those who spend most of their day in an office, there is a lot of time spent at a workstation.

If you are dealing with pinched nerves, you could try making changes to your workstation. For example, using an ergonomic mouse and keyboard may help reduce pressure in the hands and wrists. Raising your computer monitor to eye level may help reduce neck pain.

Standing workstations have also become popular in the workplace as they can help keep the spine moving and flexible. Mobility and standing throughout the day can be crucial to preventing and treating a pinched nerve.

Sleep and Rest

Sleep and rest are one of the best ways on how to deal with a pinched nerve. Sleep is essential for healing a pinched nerve. The body repairs itself during sleep, so making sure you are getting as much rest as possible will ensure a faster healing process.

If you have the luxury to do so, take a couple days off work so that you can rest properly. Ideally, you should rest until all of your symptoms have gone away.

Overusing a pinched nerve can lead to even more severe nerve damage. If you have a pinched nerve, try to stay away from movements that irritate the nerve. Also, try to sleep in a position that relieves pressure on the pinched nerve.

Massage and Physical Therapy

Getting a massage or seeing a physical therapist may also help reduce physical pain and stress. Applying gentle pressure around the pinched nerve may help relieve tension. Massages can also be very effective in helping tense muscles relax.


Gentle stretching can provide great relief for a pinched nerve. It is important to listen to your body and make sure you are not stretching too deeply, which may make your symptoms worse.

Yoga is a great way to relax and stretch. Stretching out the affected area can help relieve tension and pressure. If you experience any pain or discomfort, you should stop immediately to avoid damaging the nerve any further.

Apply Heat or Ice

Applying heat or ice to the pinched nerve can also be helpful in alleviating any symptoms. Heat relaxes tense muscles and also increases blood flow. Heating pads in various sizes can be found at your local pharmacy or drugstore.

Ice can reduce swelling and inflammation. This can also be very beneficial for a pinched nerve. Many doctors will recommend alternating between heat and ice. The combination of hot and cold increases the circulation of fresh blood to the area, which helps relieve pain and also speeds up the healing process.

Over-the-counter Pain Relievers

If your symptoms are too painful or uncomfortable to go about your daily routine, then you may want to try an over-the-counter pain reliever. There are many anti-inflammatory drugs, like ibuprofen or aspirin, that can be found at any local pharmacy. You should always check with your doctor before taking any new medications.


Antioxidants have anti-inflammatory properties that help reduce stress and supply minerals that can help your body recover. Making sure you are eating antioxidant-rich foods can help prevent you from getting a pinched nerve in the future.

When to See a Doctor

While a pinched nerve may go away on its own, it is important that anyone that continues to feel pain after regular treatments or for more than a few days should see a doctor as soon as possible.

Here are a few symptoms that require medical attention as soon as possible:

  • affecting your bowel or bladder
  • inability to grip objects
  • causing a whole limb to be weak or give out

Your doctor may prescribe a stronger anti-inflammatory medication, suggest additional testing, or have you see a physical therapist. Pinched nerves can also be easily treated with a minimally invasive procedure called an endoscopic discectomy.

Ready to Feel Better from a Pinched Nerve?

A pinched nerve can affect your daily schedule and routine quite a bit. It may seem overwhelming to figure out how to deal with a pinched nerve.

However, there are many things you can do to help alleviate your symptoms and hopefully speed up the healing process. Making sure you are listening to your body and getting the rest you need will ensure that you will be back to your normal self in no time.

Check us out for more information if you have a pinched nerve or back pain.

back pain massage

How Back Pain Massage Therapy Can Help You Feel Better

Ever feel like you’re in more pain every single day?

A surprising cause for your pain might come from your back. This discomfort can affect you while you sit at work, while you walk around, and even while you try to sleep at night.

Back pain massage may be the key to a healthier and happier you. Recent studies show 50% of participants who get regular massages report significant improvement of their pain symptoms.

Some felt such pain relief that they were no longer considered clinically disabled!

Before deciding if massage therapy is right for you, you need to understand what it is.

What Is Back Pain Massage?

Back pain massage is a specialized form of neuromuscular massage therapy. It concentrates on pain in your back. The act of massaging the affected area can bring immediate pain relief, and provide longer-term benefits as well.

In the same study we mentioned earlier, 75% of those who reported improvement after their massage therapy said they still felt better three months later without further therapy sessions.

Pleasure or Pain

As with any other neuromuscular massage, there is the potential for mild pain during a session.

Intense back pain sometimes requires intense massage to induce relief. However, the overall experience is pleasurable, and it can bring you a number of surprise benefits.

Headache Relief

You may be surprised to learn that a back massage can actually relieve your headaches, too.

Recent research discovered it only takes one session of massage therapy to ease the pain of patients, including those who regularly suffer from headaches.

The reason behind this discovery? Many headaches are caused by tension in different muscles within your body. Back pain massage helps to ease that tension and relieve pressure on your nerves, leading to instant relief.

Natural Muscle Relaxer

Much of the pain in your back and other parts of your body comes from having sore or tense muscles.

Massaging the affected areas can provide immediate relief in a way similar to rubbing your elbows after banging them on a hard surface.

Back pain massage provides a healthy and natural way of relieving your muscles and making you feel better.

The Cure to Posture Pain

We now understand the different kinds of muscle pain associated with sitting in the same position for long periods of time.

However, not everyone has the money or space to install something like a standing desk to counteract this pain.

Back pain massage helps provide immense relief to pain in your neck and shoulders, areas of your body most affected by sitting at a desk all day.

Massage restores your body and posture back to its proper balance and can make you both healthier and more productive.

Improved Immunity

Going into the winter season, many people are concerned about catching a cold or the flu. Another surprising benefit of massage therapy is that it boosts your immunity and helps you ward off sickness.

Your immunity is powered by white blood cells within your body. The act of massage and other forms of this therapy serves to increase the number of white blood cells within your body.

This uptick gives you a healthy and natural defense against all kinds of illnesses.

Less Anxiety

In addition to physical problems such as back pain and sore muscles, many people suffer anxiety and depression. A massage serves to provide relief for both of these maladies almost instantly.

Human touch releases oxytocin and other chemicals within your body. Patients who regularly get massages have reduced feelings of depression and anxiety. They also report an increase in their overall happiness.

Better Sleep

A good night’s sleep is difficult for many people to obtain. Busy work schedules and family lives make it hard to catch enough Zs. Many people struggle to get to sleep and stay that way the entire night.

Massage therapy has been shown to help patients sleep better, particularly those who have difficulty falling asleep. Research has shown regular massages work on patients of varying age levels, including young infants.

Patients undergoing stressful treatments such as chemotherapy also find massages helpful. This therapy provides a healthy and natural way to relax. It also reduces anxiety and provides a better sleeping experience.

No Lengthy Recovery Time

Those experiencing back pain often worry about treatment involving surgery. Surgeries often have lengthy recovery times, greatly impacting your family life and workplace productivity. Fortunately, back pain massage provides a better alternative.

It’s a completely outpatient procedure, offering a personalized treatment for your pain, getting you back to enjoying your life. You’ll also have peace of mind as trusted massage professionals help you find pain relief.

Treat Yourself to Expert Care

For Dr. Carl Spivak, your back pain relief is his profession. He’s both a neurosurgeon and the President of Executive Spine Surgery P.C. He offers a wide variety of treatments and surgeries.

Dr. Spivak is highly trained and belongs to a number of prestigious organizations, including the North American Spine Society, the American Association of Neurological Surgeons, and the Royal College of Physicians and Surgeons of Canada.

One look at his patient’s testimonials and you will see Dr. Spivak’s ability to take away your back pain and transform your life for the better.

To begin your journey toward being free of back pain, call Dr. Spivak’s office at 908-452-5612 today or book online. With his expert care, you’ll become healthier, happier, and more productive. Come find out what it means to be flexible and pain-free!

Can Pilates Help My Back Pain?

Many patients experience relief from their back pain through physical therapy, but I have had patients ask me if they could substitute Pilates for physical therapy. While I always recommend speaking to your doctor and physical therapist before trying a new exercise routine, Pilates does seem to help many patients strengthen an ailing back and gain flexibility.

What is now known as Pilates was developed by Joseph Pilates during World War I. He rigged springs to hospital beds, which allowed bed-bound patients to exercise. This form of rehabilitation has been taken up by many athletes and dancers, and is particularly popular in the dance community.

If you have a back injury or have recently had back surgery, it is important to practice Pilates under the supervision of a qualified instructor, after the activity has been approved by your doctor or surgeon. It is often best for those suffering from chronic back ailments to take a few one-on-one classes with a certified Pilates instructor to better understand the form of the exercises, as well as the patient’s own limitations. After this introductory period, the patient might be able to move on to either online or in-person mat classes. Some exercises may be too challenging or damaging to those with specific back problems, so it is best to learn what movements to avoid before practicing alone or in a large class.

Pilates can be greatly beneficial to those suffering from back pain, as it strengthens the postural muscles and promotes the awareness of neutral spine alignment. It also increases the strength and flexibility of the shoulder and pelvic girdles, improving overall posture. Many Pilates exercises are full body movements which engage both the back and core. Strengthening these muscles can be very helpful to those with chronic back pain, as it can decrease gradual wear and tear by improving posture, as well as by strengthening the crucial supportive muscles of the back. If there is degeneration between vertebrae, strengthening the surrounding muscle can help support the ailing spine.

Back patients should make sure to avoid movements that include either extreme flexion or extension of the spine, as well as side bending with flexion or twisting. Your physician or physical therapist should be able to help you determine which movements should be restricted so that you can enjoy the benefits of Pilates without injury.

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.

Will a back brace help alleviate my lower back pain?

Back braces are commonly used for back pain.  They provide support for the back and may relieve pain.  They are best used to help brace the back to prevent injury (such as a work belt) rather to treat pain.  They may be useful during flareups, but wearing a back brace all the time can lead to weakening of the back muscles and increased ironically more back pain.

A properly fitted back brace will limits spinal movement. It may affect participation in sports, especially if a lot of back movements are involved.

Back braces are commonly used after spinal surgery, especially fusion surgery.  They limit movement, support and most importantly remind patients to not over do it.

Back surgery today is not like 10 or even 5 years ago.  Most back surgeries can be done using a small spinal endoscope through an incision the size of your fingernail (index.php).  Since the surgery is minimally invasive their is less tissue damage and as a result pain.  Patients may forget they just had surgery and over do it.  Heavy lifting, strenuous activity or running may re-injure their back.  Wearing  back brace may remind the patient to take it easy.

About US:  Dr. Spivak is president of Executive Spine Surgery.  He specializes in extremely minimally invasive spine surgery utilizing new endoscopic technology recently introduced from Germany. Dr. Spivak has offices in Manhattan, NY, West Orange, NJ and Hackettstown, NJ.  Please call 908-452-5623 or click on schedule-an-appointment.

Do I need rehab after spinal fusion?

Spinal fusion surgery is the joining one spinal vertebrae to another.  This is usually done by placing bone in between the vertebrae and then connecting the vertebrae together with screws and rods, hooks, wires or clamps.

Even though spinal fusion surgery can be painful and initially limit activity, the main reason for rehabilitation after surgery is general weakness and reconditioning.  Severe back pain may lead to decreased level of functioning and de-conditioning.   Rehab also helps people to manage with activities of daily living (eating, preparing food, bathing, dressing, cleaning, etc), proper usage of assistive devices such as canes, walkers, wheelchairs and usage of spinal braces.  Sometimes back braces can be tricky to take off and put on, especially for people who have weakness or arthritis in there hands.  Rehab is also more common with big surgeries.

The amount of rehab depends on general health, functional ability, severity of the disease, the type of surgery done and the number levels fused. Rehab can vary from none to inpatient. People who need rehab usual need outpatient physical therapy 2 to 3 times per week. Elderly patients may require in patient for many days to weeks depending on their physical condition and the level of support they have at home.

Please see Spinal Fusion and Options for more information.

To set up a consultation please call 908-452-5612 or schedule-an-appointment online.

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