Back To Basics
Back pain is one of the most common ailments sending Americans to their doctor’s o ce for treatment. According to some medical authorities, the odds are you’ll have an episode of back pain severe enough that you seek medical attention about once every 15 years.
COMMON CAUSES
Back pain often develops suddenly without a specific cause your doctor can easily identify, but conditions commonly linked to back pain include the following.
• Muscle or ligament strain
Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments.
• Bulging or ruptured disks
The disks in your spine act as cushions between the vertebrae, and the soft tissue inside a disk can bulge or rupture, placing pressure on a nerve. However, you can have a bulging or ruptured disk without back pain.
• Arthritis
In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
• Skeletal irregularities
Scoliosis, a condition in which the spine curves to the side, can cause pain—but usually only if the curvature is severe.
• Osteoporosis
The spine’s vertebrae can develop compression fractures, especially if your bones become porous or brittle.
RISK FACTORS
Anyone, even children and teens, can develop back pain. But there are a variety of factors that can put you at greater risk.
• Age
The chances of having back pain increase around age 30 to 40.
• Lack of exercise
Weak, unused muscles in the back can lead to pain.
• Excess weight
Being too heavy puts extra stress on your back.
• Improper lifting
Using your back instead of your legs can cause back pain.
• Disease
Some types of arthritis and cancer can contribute to back pain.
• Psychological factors
People prone to depression and anxiety seem to be at greater risk for back pain.
• Smoking
This habit can prevent your body from delivering enough nutrients to the disks in your back. For many reasons, if you’re a smoker, please stop!
Nearly 95 percent of lower back pain can be treated without surgery through a combination of anti-inflammatory medications, heat, physical therapy, exercise and weight loss, and tobacco abstinence.
When conservative treatment doesn’t work and the pain is persistent and disabling, surgery might well be your next option.
COMMON SURGICAL PROCEDURES FOR THE BACK
DISCECTOMY
This procedure involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve.
LAMINECTOMY
The surgeon removes bone to enlarge the spinal canal and relieve nerve pressure caused by spinal stenosis.
FUSION
This procedure permanently connects two or more bones in your spine to relieve pain by adding stability to a spinal fracture. It’s sometimes used to relieve pain caused by a degenerated or injured disk.
ARTIFICIAL DISKS
For some, implanting artificial disks is an alternative to spinal fusion for painful movement between two vertebrae caused by a degenerated or injured disk.
WHAT TYPE OF SURGERY?
Surgical procedures for the spine are often referred to as an open procedure or minimally invasive surgery (MIS). With the traditional open method, the surgeon cuts through muscle to get to the problem area. The procedure can take up to three hours.
In contrast, MIS uses portals or tiny incisions in the skin, and the surgeon inserts small, microsurgical instruments to complete the procedure—which may take as little as 75 minutes.
Some MIS surgeons also use lasers to separate or eliminate tissue, but even when using a laser, the surgeon must make an incision in your back. There is no incision-free back surgery.
There are proponents of both surgical techniques, and before surgery you probably should chose a surgeon trained in both. Discuss and carefully consider all options, get more than one opinion, and don’t give in to any marketing pressure.
It’s your back and your life, so choose the option you truly believe is best for you.
