Back Pain Relief Q/A: An Interview with a Neurosurgeon
Question 1: What are some non-surgical alternatives to back surgery?Answer 1: Non-surgical alternatives, also called "conservative" therapy, are typically suggested by my patients" primary physician prior to their referral to me. My patients have tried everything - and none of it worked for them, though conservative therapy does work for a large number of people.
Here are some non-surgical ideas for reducing lower back pain, but I must say that my first and foremost recommendation is that if you"re suffering from lower back pain that you visit your primary physician before attempting anything on this list.
1) Rest
One of the most common back injuries is the slipped disk - rest at the early stages of injury is one of the best recovery tools available. Lie on your back on the floor and place pillows under your knees and head. Also try placing your feet and calves on a chair.
2) Heat
Heat can help with ongoing muscle spasms. Heat the spasm for periods of 20-30 minutes at a time.
3) Stretching
Only conduct stretches with the approval of your family physician. The muscles of your back are deeply interwoven down into the muscles of your butt and legs so often a stretching regimen can reduce certain types of back pain. If your pain is chronic you may find that several months of stretching can help reduce pain.
4) Exercise
Strengthening your body core - abdomen, lower back and gluteus - can help to reduce back pain and prevent future pain from occurring. Pilates and yoga are two types of exercise that can help you achieve a stronger core, and both systems of exercise have practitioners who develop exercises specifically for stronger backs.
5) Injections
There are a number of injections that can serve to both diagnose the cause of your back pain as well as potentially treat it. The types of injections include soft tissue injections that decrease inflammation and reduce joint pain, epidural steroid injections often used for degenerative disk disease, nerve block injections which can both diagnose and treat the pain, and trigger point injections for areas that are especially sensitive.
Question 2: How effective are epidural injections for chronic pain?
Answer 2: Some people who have epidurals get better and never have problems
again. Or, they may require a set of epidural blocks once a year, or once every two or three years for flare-up. They can get away with-out surgery. We have a lot of people we are following that way. But, if all else fails, and you are hurting every day since an accident that happened over a year ago, then it is appropriate to do something more aggressive.
Question 3: What is the least invasive lower back pain surgical procedure?
Answer 3: Many people, when faced with surgery, want the least invasive procedure possible. This is often in line with what will give them the best relief for the longest period of time, and we"ve found especially good long term results using a procedure called percutaneous laser diskectomy which involves only a minor incision that a band aid can cover.
I find this percutaneous diskectomy particularly amazing because of how little we have to do to heal our patients... Especially considering the level to which they return.
With percutaneous diskectomy the patient can get completely better. He will be able to return to work and live everyday without pain or maybe occasional pain. But he still will have had an injury to his back; he will always have to be careful. He will always have to be aware of heavy lifting. I wouldn"t recommend that he play tackle football or lift weights. But the normal activities that people do like day-to-day sports, swimming and walking...all of these are OK. In a sense, the restrictions, while there, are limited.
Before resorting to any surgery, though, be sure to thoroughly discuss the procedure"s benefits and potential downsides with your surgeon. And remember the power of the second opinion - many people see this as a sign of disrespect towards their doctors, but nothing could be further from the truth.