Pain in the neck: Local doctors, therapists and chiropractors offer tips on preventing back and neck pain
Monday, August 2, 2010
If you've got an ache in your back or a pain in your neck, don't brush it off as a natural part of aging. At a July 14 seminar at Saint Francis Medical Center, four local experts reviewed proper prevention, care and treatment when it comes to back and neck pain.
STOP THE PAIN IN ITS TRACKS
Dr. Aaron Andrews, chiropractor at Jackson Healing Arts, said the first step is to know how the back and spine work so you can recognize any problems. The body is flexible and adapts easily, but it can only take so much -- that's why easy, everyday moves can set off sudden, severe back pain, he explained. One of the most common problems at Andrews' practice are vertebral subluxations, in which out-of-place vertebrae cause the muscles to tighten and spasm. Subluxations have a number of causes, from car accidents and improper lifting to falls and poor posture. Left untreated, they degenerate, causing more pain and possibly permanent damage.
The first chiropractic visit involves a discussion of symptoms as well as nutrition and weight loss. Many patients find that once they lose a few pounds, their pain goes away without any treatment, said Andrews. Smoking complicates every medical condition, especially back pain, he added.
"You need to get the little problems diagnosed to avoid bigger problems later," said Andrews. "If it's too late, some things can't be fixed. You're never too old to invest in your health."
To prevent back pain, Andrews said exercise, a healthy diet and regular chiropractic care will keep the joints moving and improve stability and range of motion.
"If you keep preventing and maintaining, it will save you time and money," he said.
Todd Wasilewski, physical therapist at Saint Francis, said the most common problems for patients age 50 and up are muscle strains, disc bulges and herniations, and osteoarthritis. While muscular strains usually resolve on their own or with muscle relaxers and rest, the other two conditions likely require more treatment, such as muscle relaxers, physical therapy and perhaps epidural spinal injections or surgery. Regardless of the situation, the goal is to keep the pain from becoming a chronic problem.
"The goal with a lot of these things is to decrease pain," said Wasilewski. "We are conscientious of your symptoms and we want to make the pain better."
According to Wasilewski, smoking and repetitive bending are two of the biggest risk factors for back pain -- the average person bends 3,000 to 5,000 times each day, and even small actions put stress on the back.
"We don't realize the repetitive stress we put on our bodies," said Wasilewski. "When patients exercise regularly, we typically see that it decreases back pain and prevents the onset of back pain."
WHEN THE PROBLEM IS MORE SEVERE
Rhonda Robert, registered nurse in the Pain Management Center at Saint Francis, said injections, like epidural spinal injections or Botox, help treat chronic muscle spasms and back pain. Though the center treats 30 to 40 diagnoses, Robert said lower back pain is one of the most common. Many patients use injections in order to stay active or begin physical therapy without pain.
"A lot of elderly patients do it to maintain their living status and stay at home," Robert added.
It might take hours, days or weeks after the injection to see improvement, and multiple injections may be needed. After three injections, Robert said, the patient may need additional diagnostic tests or could be referred to a neurosurgeon.
"We really don't give up," she said.
Dr. Franklin Hayward, neurosurgeon on staff at Saint Francis, said most doctors don't recommend surgery within the first few weeks of back pain, as they want to give the body time to heal. However, patients with "red flags" like fractures, infection, tumors, major motor weakness or difficulties with urination require treatment immediately.
"What matters is how the pain affects your life and the things you're able to do in life," said Hayward. "In most cases it's a matter of function."
Fortunately, surgeons like Hayward now have access to new, minimally invasive tools and techniques.
"The current trend is toward minimally invasive surgery and motion preservation devices," or artificial discs, said Hayward. "MIS allow faster recovery while minimally affecting normal anatomy. Traditional procedures such as fusions and discectomies can be performed via MIS. Motion preservation devices help maintain motion, thereby putting less stress on adjacent structures."
Like his colleagues, Hayward agreed that it all goes back to the basics when preventing and alleviating back and neck pain.
"Stress can aggravate back pain," said Hayward, noting that this works in reverse, too. "It's like a snowball effect." Smoking is also "notorious" for back pain, as it dries out the discs between vertebrae, he said.