FAQ Category: General Spine

Probably more than you think. Picture the back muscles as rubber bands. When you bend forward, you stretch them out. It takes time for the muscles to recover their strength afterward. Without adequate recovery, they’re not able to properly support the vertebrae in the spine. This makes the spine loose and unstable, setting the stage for back injury.

A recent study looked at back muscle recovery after just 20 minutes of uninterrupted bending. Researchers found that even seven hours of rest weren’t enough to return the back muscles to 100 percent. After seven hours, the muscles had only reached 79 percent of their normal elasticity. (Most of this recovery happened within the first ten minutes of rest.) Researchers suspect that 24 hours may be needed for muscles to recover fully after keeping the spine bent forward for long periods.

You may not have 24 hours to rest between bending movements. Still, it’s important to take precautions. Talk with a doctor or physical therapist about specific things you can do to protect your low back.

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.

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.

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.

The goal of therapy is to get you back to speed and control your pain. It might be unrealistic to expect your pain to go completely away during the course of your treatment. It is hard to predict when back pain will go away. But your therapist can help you find ways to control your pain better.

In most cases, your visits to the therapist will end when you can manage your pain and you are moving much better. Your therapist will develop a home program of exercises and stretches. The home program is an important part of your treatment. Stick with it. Recovering from back problems is a long-term process. Keeping your back strong and improving your fitness level will help you avoid–or at least minimize–future back problems.

Epidural stimulators are devices that send electrical currents to the nerve roots that are causing your pain. They can work, but they are invasive treatments. You will need surgery to permanently place electrodes in the sleeve of the nerve roots. Most of the time, doctors will have you try a temporary stimulator to make sure it helps you before placing a permanent device.

Epidural stimulators work by the “gate theory” of pain. The principle of the gate theory is that if you can make the nerve recognize a sensation other than pain–such as heat, rubbing, or electrical current–your central nervous system “closes the gate” on any other sensations. This means the pain doesn’t register. Electrical currents get to the spinal column much faster than pain impulses, so they are pretty effective at closing that gate.

Eiduralysis is a treatment for people who have scar tissue around the nerve roots of their spine. This scar tissue sometimes forms after injury or surgery. It can cause back pain and pain down the leg. Doctors use special dye that shows up on a special imaging test in order to see where scar tissue has built up around the nerve roots of the spine. Then they inject either a corticosteroid, a saline solution, or a special enzyme called hyaluronidase into the area.

Epiduralysis has been used for about 10 years. It generally gives good short-term relief for people with severe back pain and pain that shoots down the leg. The pain relief can last from three to twelve months people. However, epiduralysis treatments don’t last forever. Many people need more than one treatment. Epiduralysis is also more effective when it is used along with other strategies to manage pain.