FAQ Category: Spine

I am an athlete. When can I get back to my sport after low back surgery?

It depends on a couple factors. First, it depends on what type of surgery you had. A micro-discectomy, for example, heals faster and involves less recovery time than a fusion surgery.


Second, it depends on how stressful your sports activities are. No matter what you do, you will need to work up to your activities gradually and gently. You don’t want to re-injure your spine. Follow your rehabilitation plan carefully. Your doctor or therapist has recommended it to give you the best chance of making a full recovery.

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.

I have low back pain. If I just use a brace, will it go away?

A brace all by itself will not heal your back. Supportive braces can help, especially if you have severe pain. However, long-term use of a brace can lead to a weakening of muscles around the spine. This can make your problem worse.


You may need the support of a brace, but don’t wear it for long periods of time. Take it off to do gentle stretches and exercises prescribed to you by a doctor or therapist. They can also suggest ways to control your pain, including cold and heat treatments and medications. All these therapies together can help heal your back. Don’t depend on just one method of treatment.

I’m using a back support belt for my intense low back pain. It helps so much. Why can’t I wear it all the time?

That’s not a good idea. A support belt can improve your posture and limit your movements, which can help calm pain. It can create abdominal pressure, easing the pressure around painful discs in the lower back. But if your wear the brace all the time, the muscles of your abdomen and lower back start to rely on it. Eventually they atrophy–they get weaker and smaller. This will just make your problem worse.


So follow your doctor’s or therapist’s guidelines about when and how much to use your brace. Take it off to do stretches and other exercises. And once your pain starts to go away, you should use your brace less.  



 


Some of my co-workers use back support belts when they lift at work. Should I use one?

Probably not. Back support belts can provide muscle support, but they can also make you more likely to overdo it. Long-term use of back support belts can also cause the muscles of the abdomen and lower back to weaken, making back problems more likely.


Medical research has shown that back support belts can help men when they catch an unexpected load that comes directly from the front. However, the benefit was small, and women did not receive the same benefits from the belt. In the same study, support belts actually hurt people who caught unexpected loads from the side. The belts kept key muscles from responding appropriately.


Back support belts may be appropriate for some people who have had back injuries.  However, a support belt should only be used for short periods.  It should be removed often to do a program of exercise to improve abdominal muscle strength.

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 feel like my low back pain is going to last forever. When will it go away?

It’s hard to tell. Sometimes low back pain goes away quickly, and other times it sticks around for months. In people suffering their first bout with low back pain, it often goes away completely within two months, even without treatment. But for some people low back pain becomes a chronic, recurring problem.


There is no way to predict which group you will fall into. The best bet is to get medical attention for your pain. Your doctor can recommend ways to manage your pain, and suggest ways to help you avoid problems in the future. Even if your pain doesn’t go away completely, there are many strategies for controlling it so that it doesn’t control you.


What is arachnoiditis?

Arachnoiditis is the name for inflammation of the arachnoid layer of the meninges, a lining that covers the brain and spinal cord. This condition can happen after surgery, spine injury, or infection. Any time the meninges is punctured, even for medical procedures such as injections and spinal taps, the risks of arachnoiditis increase.


There are no good treatments for arachnoiditis. The pain can be managed, but the condition is never really cured. Some people find effective methods to handle their pain, but others find that the problem gets worse over time.


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.


I’ve been diagnosed with degenerative disc disease. How fast can I expect my pain to increase as my discs degenerate?

Your pain won’t necessarily increase. Changes in the spine are part of aging. Sometimes the changes cause more pain, but often they don’t. Even if you have spurs in your neck and back, the result is not necessarily increased pain. In some ways, the aging process actually can help stop pain. As your tissues lose water content and become stiffer, they generally don’t move as much. Body parts that don’t move usually don’t cause as much pain.


You are more likely to handle the changes in your spine without increased pain if you stay fit and use good posture. If you have increasing pain, make sure to see your doctor before it gets out of control.


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.


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.


I know it’s supposed to be better to lift with bent legs. But it’s easier and faster to keep my legs straight. Is lifting with straight legs really so bad?

Yes. When your knees are straight, your lower back carries most of the stress. When you bend your knees and lift with your legs, your hip and thigh muscles do most of the work.


You are right that lifting with straight legs is in some ways easier. It doesn’t take as much energy, and your heartbeat doesn’t rise as much. But to help keep your back healthy, you need to lift with your legs. It’s especially important if the load is big, but it’s also important when you’re lifting something small.


Even if you are strong and in great shape, unsafe lifting postures can cause small injuries to the soft tissues of the spine. These “microtraumas” can eventually add up to one big back problem. 


I drive a forklift, and my neck is really getting sore from always turning my neck to see behind me. What can I do to keep my neck pain from getting worse?

Warm up before you start work by doing some gentle neck, back, and shoulder stretches. Sit with good upright posture while you drive. Keep your chest up and shoulders back. Try to avoid straining your neck when you turn to see behind you. As much as possible, turn your shoulders with your head, so that you aren’t just craning your neck. Assess whether rearview mirrors on the forklift could help you see behind you without having to turn your head as often.


Take frequent breaks as you work. Do some gentle stretching or walk around a bit. During your breaks or after work, try using a cold pack on the sore area. This can help control the pain. 


 If your neck pain continues, see a doctor. Your doctor can help control the pain, and he may be able to help you come up with exercises to help strengthen your neck muscles and improve your posture.


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 am almost 70, and I’ve gotten used to the arthritis pain in my right hip. But now I have pain that goes from my low back to my knee along the front of my thigh. What is the causing this pain?

You will need help from your doctor to determine whether the pain comes from your arthritic hip or a new problem in your low back. Your doctor will probably inject a numbing medication such as lidocaine into your hip. If the pain in your thigh goes away, you know the hip is the problem. You will need to look at different treatments for your hip problem.


If the injection doesn’t take the pain away, you will need to do tests to determine what type of problem you have with your back. Your doctor will help you control the pain and get you started on a treatment plan for your low back problem. 

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.


I know it’s important to bend my knees when I lift heavy things. But I’ve had surgery on both of my knees, and they really hurt when they bend too far. How can I protect my knees and my back when I lift?

That can be difficult. It would be best to lift heavy items from waist level so you don’t have to bend your knees. If you have to lift heavy items from the ground, try to bend your knees only as far as they can go without hurting. Then lower your body by bending at the hips and keeping your hips back. Your low back should be arched in slightly. Grab the item without rounding your back. Without holding your breath, tense your abdominal muscles and lift. Straighten up from your hips. The idea is that your hip muscles will take most of the load, rather than your knees or low back.