Archives: FAQs

What will happen on my first visit to the doctor?

The goals of your first doctor’s visit are to get to know each other and to communicate all the information you have about your symptoms and condition. This includes asking any questions you have, even if you are a little embarrassed to ask.


The first step in the exam is a health history. Your doctor will probably have you fill out a form about your pain, your symptoms, and your medical history. You will also be asked questions about your family’s medical history. Typical questions include:
*Does anyone in your family have similar problems?
*Do you have any other medical conditions?
*Are you taking any medications?


After your doctor looks at the form, he or she will ask you more questions. These tend to be more specific to the pain and other symptoms you are having right now. Typical questions include:
*When did your pain start?
*Did it start because of an injury?
*Where exactly is the pain located?
*Have you ever been injured in that spot?
*How strong is your pain? (You may be asked to rate it on a scale of one to 10.)
*What makes the pain go away?
*What makes the pain worse?


Your doctor will then physically examine you, concentrating on the area of pain. Your doctor will prod the sore area and move it. The prodding and movement may hurt, but it is important that your doctor know exactly where and when you feel pain.


The first exam is just the beginning. Try to be as open with your doctor as possible. Express your worries and concerns right away. They better you communicate with your doctor, the easier it will be for the two of you to develop a treatment plan for your pain. 

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’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 doctor has prescribed a COX-2 inhibitor for my pain and inflammation. What is it? Will it work?

COX-2 inhibitors is the short name for a class of medications called cyclooxygenase-2 inhibitors. These fairly new medications stop the pain-causing enzyme cyclooxygenase. They can be very effective in relieving pain and inflammation. Vioxx and Celebrex, two COX-2 drugs, have been shown to be more effective in treating osteoarthritis than more familiar nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. And COX-2 inhibitors don’t seem to cause the stomach upset of NSAIDs.

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.


Why do muscles shrink after surgery or if a cast is applied?

The process of muscle wasting after surgery or casting is called disuse atrophy. Muscles require a balance of enzymes and hormones that is constantly adjusted according to how much the muscle is being used. Unused muscles shrink because this balance is thrown off. The more a muscle is stressed or used, the more muscle-building enzymes are active. When a muscle is not used regularly, muscle-degrading enzymes take over and cause the muscle to shrink. In other words, muscles work on the “use it or lose it” principle.


What can be done to keep my leg muscles from shrinking after knee surgery?

A new technique called vascular occlusion has been found to help reduce the amount of muscle wasting that follows surgery. This technique involves applying five minutes of squeezing pressure to the thigh muscles several times a day in the first week or two after surgery. A large blood pressure cuff can be used to put the squeeze on the thigh. The pressure triggers the muscle to produce enzymes and hormones that actually promote muscle development.


Vascular occlusion by itself will not completely stop muscle wasting. But it can slow the process down. Low-intensity resistance exercises, such as straightening the leg over a pillow, or straight leg raises can also help reduce muscle shrinkage.


Can what I do at work affect my chances of having low back pain?

Available science isn’t clear about conclusions that job tasks, even heavy types of work, cause pain.  Actually, activities like heavy lifting and prolonged sitting may be connected because back pain may simply be aggravated in people who do these activities. Low back pain may have more of an affect on people who have to do a lot of lifting. This is because they more commonly stay off work or require a longer period before getting back on the job.


Jobs that involve whole-body vibrations (such as heavy equipment operation) seem to pose some added risk for low back pain.


Good physical conditioning, weight management, routine stretching, and using safe body movements can reduce the chances of having back problems, as can avoiding injuries and not smoking. People with one back injury are more likely to have another. And people who smoke run a higher risk of having back problems.

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.

Are men and women equally at risk for developing low back pain?

Generally speaking, yes. Heavy physical work or very sedentary work contributes to low back pain in both sexes. Studies have shown that some risk factors are different for men and women. For men, doing heavy activities outside of work, and a job with poor social relations and lots of overtime are connected with a higher risk for low back pain. For women, smoking and work that involves whole-body vibrations and gives little influence over work conditions create a high risk of low back pain.

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.


Can a stretching program lower the chances that my elderly mother will fall?

There is evidence that limitations in hip flexibility could impair walking ability in the elderly. This increases the risk of falling. As you walk, the hip extends in the back leg. A new study showed that the hip joint doesn’t extend as far back in the elderly as in younger people. Elderly people at a high risk for falls showed even less hip extension.


So a stretching program that helps improve hip extension could potentially help elderly people avoid falling–and the pain and hospital stays that falling can cause. Before starting any form of treatment, your mother should talk to her doctor. She also needs to address any other problems that may put her at risk for falling. These can include balance, strength, or vision problems.