FAQ Category: General Spine

Yes and no. Physical activity has been shown to maintain good health and prevent injuries. Using proper lifting techniques and setting up your workspace to prevent back problems are also important. The physical therapist can help you in both of these areas.

The specific exercises prescribed by a physical therapist during the early weeks after an injury are usually changed or modified over time. The therapist will progress the exercises as your symptoms improve. New exercises will be added to strengthen the muscles that move and hold the back and upper body.

When your symptoms are gone and you’ve started increasing daily activities, the therapist will help you begin (or restart) a regular exercise program. This may include a few exercises to maintain the back posture and strength you have gained during therapy for your injury.

There are some relatively new techniques that may improve your chances of spinal fusion–or getting the bones to grow together–after surgery. Electrical stimulation is one of them. This technique was first used in the 1950s but has only recently been used for spinal fusion. It has had especially good results for smokers and other high-risk patients.

Surgeons can implant a device that delivers a mild electrical current directly to the healing site. Or you could wear a pulsing device on your skin after surgery. Depending on the type of electrical current, you would need to wear the device anywhere from eight to 24 hours a day.

The first method really targets the fusion site, but it’s also more invasive. The second method is a little less direct. Its success depends on how regularly you wear the device. Another device that uses ultrasound waves has also been shown to promote bone growth. Ask your doctor whether any of these alternatives may be helpful in your case.

Not exactly. Your doctor may be referring to the proteins that exist naturally in the body. These proteins make new cells and help existing cells to do their jobs.

Researchers have recently discovered that using these proteins in spine surgery may stimulate bone growth, giving spinal fusion a boost. Researchers are especially excited about bone morphogenic proteins (BMPs). BMPs may speed the healing of bone grafts from the patient’s own body or from transplants.

So far, BMPs and other proteins have mainly been tested on animals. And they haven’t gained FDA approval. There is much research to be done. Still, this looks to be a promising new development for patients in need of added help with spinal fusion.

Electrical stimulation has been shown to promote bone growth that leads to spinal fusion. This technique was first used in the 1950s but has only recently been applied to the spine. It seems to be especially helpful for high-risk patients like smokers, patients who are overweight, and those who need fusions at multiple levels of the spine.

There are a couple of ways to get electrical stimulation. Your surgeon can implant a device that delivers a mild electrical current directly to the healing site. Or you could wear a pulsing device over your skin after surgery. Depending on the type of electrical current, you would need to wear the device anywhere from eight to 24 hours a day. This would last for six to eight months, or until healing occurred.

The first method really targets the fusion site, but it’s also more invasive. The second method is a little less direct. Its success depends on how regularly you wear the device. Talk to your doctor about which method he or she suggests in your case.

A recent study asked this very question. Nearly 350 nurses and nurses’ aides were put in three different groups, with either low, medium, or high access to patient handling equipment. The group with the most access to this equipment (mechanical lifts, sliding devices) did indeed use it. And they were better off for it.

After a year, nurses and aides who used patient handling equipment weren’t as tired after their shifts. They had less back and shoulder pain. They also had less physical discomfort and fatigue. Though both groups who used this equipment saw improvements in these areas, nurses who had the most access to the equipment saw the biggest improvements. They were also more comfortable with patient handling tasks.

Using special equipment didn’t reduce the number of injuries health care workers had from moving patients. However, nurses and aides who used mechanical lifting equipment didn’t hurt their backs as often. They were more likely to injure their arms or necks instead. When workers who didn’t use the equipment were injured, they hurt their backs 75 percent of the time.
 
The authors think that the benefits of this kind of equipment outweigh the costs. With faster patient turnover, nurses are required to move patients more frequently. Patient handling equipment may protect health care workers from the heavier workloads of hospitals today.

Not necessarily. A recent study compared three groups of nurses and nurses’ aides who had different access to patient handling equipment. The first group relied heavily on patient handling equipment. They didn’t do any strenuous lifting for a year. The second group used some equipment and practiced safe lifting for a year. The last group did their jobs as usual, without special equipment.

Nurses and aides who didn’t do any strenuous lifting had the same number of injuries as the other groups. However, their injuries were less likely to affect the back or torso. Workers in this group more often injured their arms or necks. In contrast, 75 percent of injuries among nurses who didn’t use the devices were back injuries.

Though the number of injuries didn’t change, the authors found that patient handling equipment created a healthier work environment overall. Nurses and aides who used this equipment were less worn out from their jobs. They also felt safer and more comfortable while they worked.

Researchers followed two groups of nurses and nurses’ aides who used patient handling equipment. One group mostly used manual equipment, such as transfer belts and sliding devices. The other group used mechanical lifting devices in addition to manual equipment.

After a year, nurses and aides in both groups had less back and shoulder pain. They also had less physical discomfort and fatigue. However, the group that used mechanical devices improved the most in these areas.

There were no differences between groups in the overall number of injuries. But the main kind of injury changed depending on the equipment used. Nurses and aides who used mechanical equipment had fewer back injuries. They were more likely to injure their arms or necks. Meanwhile, 75 percent of injuries among those who didn’t use the equipment were back injuries.

The authors feel that patient handling equipment makes hospitals healthier places to work. Any kind of patient handling equipment is better than none at all. But mechanical equipment takes a bigger load off health care workers. This kind of equipment may go farther in preventing back injuries among nurses and their aides.

Back and neck pain can be physically and emotionally draining. Battling the effects of pain while doing routine tasks can take a toll on your stamina. Using certain prescription medications, such as muscle relaxants, can also add to the sense of “tiredness.” Muscles that are tired may not be working their best, which can lead to feelings of discomfort and eventually pain.

Try to avoid staying in one posture for too long, as this tends to fatigue muscles and increase soreness. You may also benefit from conditioning exercises for the heart and lungs. Done safely, conditioning exercises can decrease pain, boost your outlook, and improve your ability to do activities with stamina and ease. If your doctor approves, an exercise program may give you the energy boost needed to avoid feeling worn out all the time.

More than most people realize. Low back pain usually starts at an early age. It can even be found in young children, who may have slight pain that doesn’t last very long. By age nine or 10, 10 percent of kids have low back pain. By age 13, low back pain becomes as common as it is for adults. When it comes to back pain, it seems kids grow up fast.

The solution? Education and practice. Most low back pain results from poor bending and lifting techniques. If children are taught good habits early, they’re less likely to suffer from low back pain. A doctor or physical therapist can “coach” kids on good technique and recommend exercises to strengthen the low back.

Unfortunately, yes. In a recent study of 32 jockeys of all ages, nearly half reported some pain in physical activities as a result of their riding. This pain was mostly in the low back, or in both the lower and upper back. Back problems were the most pronounced for jockeys who were over age 35 and had been racing an average of 24 years.  

Even though you didn’t have any serious injuries, the rigors of horse racing may have stressed your spine in ways that can lead to problems over time. A doctor or physical therapist can help you learn ways keep your pain under control.

In a way, you’re both right. Horse racing can be a dangerous sport, right up there with motor sports, diving, and rugby. In addition to the risk of falling from a fast-moving horse, there’s the stress that riding puts on your back and neck over time. 

A recent study showed that jockeys had more low back and neck problems than people the same age who didn’t ride. The study didn’t look at whether older or younger jockeys had more injuries. However, it did show that jockeys over 35 had more back and neck pain than their younger counterparts. This is probably because the older jockeys had been riding an average of 24 years while the younger jockeys had only been riding an average of four to 12 years. 

The longer you ride, the more the sport takes its toll on your body. In the meantime, ride carefully, and give your back periods of rest.

It’s true that professional horseback riders generally have more back problems than people who don’t ride horses. Research has shown that horse riding can affect the way the spine ages and changes as a result of physical strain on the spine from riding. This is especially true for riders over age 35. These older riders tend to have more low back and neck problems than younger riders. 

Horseback riding can be a dangerous sport. However, its dangers to the spine seem to be related to the total time and years spent riding. In other words, the longer your daughter rides, the greater her risk for back and neck problems. In the meantime, a trainer or physical therapist can suggest ways to minimize the stress that riding places on your daughter’s back.

Scientists are trying to understand that very question. In a recent study scientists examined whether, as with osteoporosis, exercising or taking calcium could make a difference. But unlike osteoporosis, these things did not seem to make any difference. However, since dowager’s hump (kyphosis) and osteoporosis are related, it would be a good idea to work on preventing osteoporosis by exercising, abstaining from cigarettes, and taking calcium. Until we know more about what causes kyphosis, this is the best available advice.

The nicotine that enters your bloodstream when you smoke or chew tobacco makes your blood vessels narrower. This is called vasoconstriction. Vasoconstriction slows the flow of blood throughout your body.

A good blood supply is vital for proper healing. Blood carries oxygen, nutrients, white blood cells, and other crucial agents to the injured tissues. Blood also carries away waste by-products of healing. Many parts of the spine, especially in the lower back, don’t have very good blood supply even at the best of times. After surgery, your healing spine needs all the blood it can get. The vasoconstriction caused by smoking means your spine will not get the blood it needs.

Smoking after surgery can slow your recovery time, and it may even contribute to other complications after surgery. To ensure that you heal as well as possible, stop smoking for before surgery, and don’t smoke again until you are fully healed. Or better yet, don’t ever start again. Your doctor can help you find ways to kick the habit.

Your husband may very well be right. Radiculopathy is the medical term used to describe pressure on one or more nerves in of the spine. This can cause numbness, weakness, and a loss of reflexes. Radiculopathy can have many causes, including herniated discs, bone spurs, tumors, or fractures.

Doing ultrasound treatments over the center of the spine is tricky. In rare cases, a patient has a small spinal defect in the lower thoracic or lumbar vertebrae. These people were born with a spinal vertebra that was not completely formed. The incomplete formation could allow sound waves from the ultrasound to reach the nerves in the spinal canal. Too many sound waves could damage these nerves.

Sometimes people with this condition have a darker patch of skin or a tuft of hair on the center part of the spine. But this isn’t always the case. It is better to be cautious and apply ultrasound treatments along the edges of the spine rather than over the center.

No. You could be getting a build-up of heat in the deeper tissues of the back. As the temperature rises, it can irritate the pain sensors on the covering of the bone in your spine or ribs. This deep, achy pain is called periostial sensation.

There are no heat sensors in the soft tissues below the skin surface. The periostial sensation may be your only sign that the heat is building up too much in your tissues. So make sure to tell your therapist right away.

Probably not. Fusion surgery can effectively relieve the pain of your condition. Pedicle screws are sometimes used in fusion surgery, but most studies suggest that they don’t add benefits for people with spondylolisthesis.

The pedicle screw is inserted in the bony point–the pedicle–that connects the ring of bone around the spinal canal to the vertebral body. The theory behind pedicle screws is that extra fixation will help the fusion heal more effectively. In fact, using a pedicle screw involves higher risks during the surgery. The surgery takes longer, and patients lose more blood during surgery. Research suggests that pedicle screws don’t show better fusion success or have any benefits in easing pain or getting patients with spondylolisthesis back to their activities.

Yes. You can take some steps to counteract the extra back strain that is sometimes felt during pregnancy. A careful exercise program can help. The program should build your endurance, strength, and flexibility. Exercises that focus on the lower back and abdomen can help take the strain off your lower back. Strengthening the muscles of your thighs can help them take some of the strain off the back, too. Don’t forget to do mild cardiovascular exercises too, such as walking or swimming.

Whatever you do, don’t overdo it. Don’t do too much or ignore symptoms of fatigue, dizziness, or pain. Make sure you tell your doctor about your exercise program. You might find it helpful to work with a physical or occupational therapist to develop an exercise program just for you.

You might need to get some help to make the pain go away. Pregnancy can be very tough on your body. The extra weight and new back alignment may have actually injured your back. Your doctor can suggest ways to manage the pain. It might be useful to see a physical or occupational therapist. A therapist can suggest exercises and stretches to return your back to its pre-pregnancy shape.