Prevention and nonsurgical treatment options to prevent low back pain and protect spine

Apr 24 2010

Back and neck problems can be caused by a herniated disc, spinal stenosis, injury, strain or osteoarthritis. "Although more than 75 percent of Americans will experience some back pain during their lifetime, about 90 percent of cases are resolved without surgery," stated John K. Ratliff, MD, FACS, a Philadelphia spine surgeon and American Association of Neurological Surgeons (AANS) spokesperson. The good news is that there are some ways to help prevent low back pain and protect your spine. Prevention tips from the AANS:

•Maintain a healthy body weight and if you smoke, quit. Smoking and extra weight can not only damage the spine, but are factors that can negatively impact spine surgery.

•Maintain proper posture while sitting, standing and walking.

•Use proper lifting techniques to avoid injury. Bend your knees when picking up and lowering the object, keep a straight back, and do not twist. Do not lift heavy objects that are beyond your strength ability.

•Make sure your mattress and bed pillow support your neck and back.

•Do exercises that stretch and strengthen the muscles of your abdomen and spine. Strong back and abdominal muscles can help you maintain good posture and keep your spine in its correct position.

•If you suffer from persistent, chronic, or recurring back pain, consult your doctor. In most cases there is a conservative, nonsurgical treatment that can resolve the pain. However, if left untreated or allowed to progress, back pain may lead to serious and severe disability.

Back Pain Causes

A herniated disc is a fragment of the disc nucleus which is pushed out of the annulus into the spinal canal, through a tear or rupture. Discs that become herniated are usually in an early stage of degeneration. The spinal canal has limited space, which becomes inadequate for the spinal nerve when a disc fragment herniates into the space. Herniated discs can occur in any part of the spine. They are more common in the lower back (lumbar spine), but also occur in the neck (cervical spine). The area in which you experience pain depends on what part of your spine is affected.

Spinal stenosis occurs when the spinal canal narrows and compresses the spinal cord and/or the nerve roots, and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebrae shrinks, and the discs lose their ability to act as shock absorbers. This can lead to disc degeneration, bone spurs, or pinched nerves, causing impaired function and pain. Lumbar spinal stenosis is more common than cervical spinal stenosis.

Back and neck injuries are commonly caused by motor vehicle accidents, falls, other trauma, or sports. Pain from these injuries may be caused by tears in muscles or injuries to the joints between vertebrae. Other causes of pain are ligament rupture or damage to a disc. Conservative treatment of these injuries includes pain medication, bed rest, reduction of physical activity, and physical therapy.

Consult a Board-Certified Neurosurgeon

When people hear the word neurosurgeon, most think brain surgeon. However, neurosurgeons are medical specialists who diagnose and treat disorders of the entire nervous system. Neurosurgeons are trained to treat diseases of the spine throughout their seven-year residency. In fact, they are the only physicians who treat the entire spine - both the spinal cord itself and the structures that can exert pressure on the spinal cord and nerve roots.

Neurosurgeons first try conservative treatment options on patients who have not previously been treated specifically for back or neck problems. In some cases, a patient may seek consultation for the first time with a neurosurgeon after he or she has been treated by another medical specialist without achieving adequate pain relief. An exception is when a patient suffers severe traumatic injury or has a severe neurological deficit, which usually requires immediate surgical intervention.

Nonsurgical treatment options include physical therapy, weight reduction, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, rehabilitation, and limiting activity. All of these treatment options are aimed at relieving the inflammation and strengthening the back.

There are several surgical treatment options, depending on the patient's specific condition and overall health. Recent advances include artificial cervical and lumbar discs and minimally invasive spine surgery (MIS). Patients must meet specific criteria to be candidates for these procedures and there needs to be certainty that the same or better results can be achieved through these techniques as with the respective traditional procedure. With MIS procedures, there is the potential for quicker recovery, decreased operative blood loss, and speedier patient return to normal function.

SOURCE American Association of Neurological Surgeons