What is a discogram?

A discogram gives a picture of an injured disc. A special kind of dye is injected into the discs before you get an X-ray. The dye shows up on a fluoroscope screen. Discograms work better than a plain X-ray or other tests because they give a better picture of the disc.

My young daughter wants to compete in gymnastics. Will it hurt her low back?

Intense athletic training and competition can hurt children’s spines. This is especially true in gymnastics. Pay attention to how much time she spends training. A recent study suggests that adolescents who spend long hours doing gymnastics are at risk for developing too much bend in the curves of their spines. This was most true in adolescents who trained hard more than 400 hours per year. 

I am going to have surgery for a bulging disc. My doctor wants to do a procedure called IDET. What is IDET?

Interdiscal electrothermal therapy (IDET) is a fairly new type of procedure used for outpatient disc surgery. The surgeon uses X-rays to guide a special needle into the disc. A catheter is then put through the needle into the disc, and the needle is heated over 30 minutes. The heat makes the disc material shrink, which reduces the bulge or closes off the torn part of the disc. After surgery, patients are usually monitored for 90 minutes and then sent home. Sometimes doctors have their patients do a rehabilitation program afterwards.

Because it is a new treatment, long-term results are not known. But IDET has been shown to have good short-term benefits. IDET is most effective when the disc is definitely the painful tissue. Pain from other spinal joints or nerves aren’t helped by IDET surgery.

Do doctors use lasers for spine surgery?

Yes. At this point, laser surgery for the spine is used primarily for disc problems. Lasers are not widely used now, but they appear to leave less scarring after spine surgery. A procedure called thermodiskoplasty uses lasers to shrink collagen and fibrocartilage to change the shape of the disc.

My back is really hurting. Should I just stay in bed?

No. Bed rest is rarely prescribed and even then should only be used for very short periods, usually two days at most.  Too much bed rest can actually make your problem worse, as your muscles and joints get weaker and stiffer. The key is to help you get back to doing normal activities as early as possible.  Also, gentle exercises can actually help your pain go away. You need to work with a doctor or physical therapist to come up with a plan to help you gain confidence with exercise, movement, and activity.

My back hurts when I lay down, and I can’t get any sleep. Would a special mattress help me?

Maybe. Firm mattresses are usually the best choice for people with back pain. Very soft mattresses or waterbeds don’t give the spine enough support. But there are some ways that may help you get the support you need without buying a new mattress.

To support your lower back, you can lie on your side and put a small pillow or rolled up towel just above your waist and a pillow between your knees. If you lie on your back, put a small pillow under your knees. To support your neck, you can try rolling a bath towel and sliding it in the pillowcase, on top of the pillow. This roll supports your neck when you lie on your back or side. (You can also find many neck cushions, neck rolls, and pillows in stores that are made to support your neck.) If you lie on your stomach, situate your pillow so that your neck isn’t craned all the way to one side. Don’t use foam pillows; they tend to be too firm and push against your head, keeping your neck muscles from resting. Feather or softer fill pillows will be more comfortable.

I have so much back pain. How do I get through my day?

When you are fighting pain, it is tempting to just give up and lay in bed all day. However, that will make things worse in the long run. It is important to keep doing as many of your daily tasks as possible, even if you need to do them a bit differently. Take frequent breaks. Reorganize your day to include periods of rest, and rest in comfortable positions that take the strain off your body. While you are resting, use ice or heat to soothe sore areas. Pay attention to your posture and your body alignment while you move. Using healthy alignment and standing and sitting up straight can help you get things done with less pain.

If you can’t manage to continue doing certain things, talk to your doctor, physical therapist, or occupational therapist. They can give you suggestions about special ways or devices that can help you accomplish your tasks, and the information you give them will help them tailor an exercise or rehabilitation program that can better meet your goals.

My back started hurting last week. What exercises should I avoid?

Avoid doing anything that makes the pain worse or carries the risk of re-injuring your back. What exercises are safe to do depends on the activity and on what exactly is wrong with your back. Your best bet is to start slowly and gradually begin doing your usual activities. If you normally do intense exercise or sports that involve twisting your back, like golf, you need to wait until your back is better. Walking and swimming are probably the best exercises for rehabilitating your back. They keep you from putting too much stress on your body, yet they get your entire body moving.

Talk with your doctor and physical therapist about how to get started on a program of exercise to help you get back to full function.

I’m resigned to living with back pain. How can I keep it from getting worse?

You can learn to move in ways that don’t strain your back.
* To get in and out of bed, do the “log roll” technique. When you are lying down, roll your whole body to the side, as if your body were a log. Then gently raise your torso and move your feet to the floor.
* When you sit or stand, keep your back straight and bend from the hips.
* Instead of bending at the waist, use a grabber to pick things up from the floor or putting on shoes or socks.
* When you have to bend over, don’t bend at the waist. Keep your back straight and bend forward at the hips.
* Don’t ever test your back by carrying or lifting something that’s too heavy.
* Even when you are lifting lightweight items, keep your back straight and bend your knees so that you can lift with your legs. Hold the item close to your body, no matter how light it is.

I have a desk job. How can I lower my chances of having back problems from sitting down all day?

There are several precautions you can take. Stay in good physical shape. Take breaks, and do some regular stretching. It is crucial for you to use good posture. You need to set up your work station in a way that lets your spine stay in proper alignment. A physical or occupational therapist or another ergonomics specialist can help you design your work station. Finally, avoid injuries to your back, and don’t smoke.

A disc in my low back is causing pain. I’m scheduled to have a surgical procedure called interdiscal electrothermal therapy. Will this surgery make my back weaker?

Surgeons use interdiscal electrothermal therapy (IDET) to treat sore discs without harming the surrounding tissues. Because the muscles and joints stay intact, you shouldn’t lose strength in your spine. Scientists have done studies to see whether the spine weakens after a surgery like this. So far, the results suggest that spines have the same strength after IDET. You should still make sure to do the exercises your doctor prescribes after surgery. Your rehabilitation program is planned to maximize the health and strength of your back and help you avoid future problems.