LEADING MEDICINE
HIGH TIME TO LEARN ABOUT Low Back Pain
Do you ever wonder why you’re experiencing lower back pain? The lower back, or lumbar spine, supports the weight of your upper body and is involved in everyday movements of your hips, pelvis and lower extremities — such as bending, twisting and coordinating muscles.
“Because of its important role in movement, the lumbar spine is prone to overuse. The bones, ligaments, muscles and disks are often under strain,” said Dr. Alden Newcomb, an orthopedic spine surgeon at Houston Methodist Spine Center at Clear Lake. “Injury and deterioration over time can affect the lumbar spine and cause lower back pain.”
LOWER BACK PAIN CAUSES
A lower back strain can result from an acute injury — such as lifting something too heavy or playing sports — or develop over time due to repetitive movements or arthritis. Treatment can involve anti-inflammatory medications, muscle relaxers, physical therapy and rest until the pain subsides.
“Healing from a lower back injury can take a few days or a few months. If your pain continues or gets worse, however, there may be other factors at play,” Newcomb explained.
The source of chronic lower back pain usually involves issues with the lumbar disks, nerves or joints. Also, sciatica, or pain going down the legs, is often caused by an issue in the back.
A herniated disk can be acute or chronic and occurs when disk material bulges or presses on surrounding nerves, which often causes pain felt down the legs.
Facet joint damage happens over time when the joint cartilage connecting the five lower back vertebrae breaks down from compressive force and stress, resulting in stiffness and muscle spasms.
A spinal compression fracture occurs when a vertebra in your lumbar spine essentially collapses in on itself. Often due to osteoporosis or trauma, it results in sudden pain and limited spinal mobility.
Lumbar spinal stenosis happens when the spinal canal in your lower back narrows, placing pressure on nearby nerve roots. This can cause weakness in the legs or buttocks when walking.
One potential sign of lumbar stenosis includes needing to lean against a shopping cart to walk. Causes may include bone spurs, ligament thickening and degeneration, or herniation of disks or joints. Spondylolisthesis is when a lumbar vertebra slips forward, over the top of the vertebrae below. “Pinpointing the cause of lower back or leg pain can take a fair amount of detective work, but speaking to a doctor will help ensure you’re on the right path to feeling better,” Newcomb noted. •
NON-SURGICAL SOLUTIONS
Your mild-to-moderate neck or back pain may be relieved with rest, at-home treatments and over-thecounter pain medication. Your doctor may recommend more advanced non-operative care, such as:
• Aquatic therapy: Water exercises to improve strength and flexibility gradually
• Integrative therapies: Acupuncture and massage therapy
• Pain management techniques: Medications and injections
• Physical therapy: Strengthening exercises, stretching and ice/heat packs
Talk to an Expert
The experienced team at Houston Methodist Spine Center at Clear Lake offers the full spectrum of spine surgery, including minimally invasive techniques with small incisions and faster recovery, endoscopic spine surgery with small incisions and a camera, disk replacement, robotic-assisted and 3D navigation, and traditional open surgery. To schedule an appointment, visit houstonmethodist.org/spine/clearlake or call 281.523.3355
Dr. Alden Newcomb
Know When It’s Time for a Colonoscopy
Dr. Ronald Samuel
Don’t let assumptions stop you from preventing or detecting colorectal cancer through a colonoscopy screening. If you think you’re too young, too healthy or too nervous for the procedure, think again. Colorectal cancer is the third most common cancer in the U.S.
“Cancers of the colon or rectum aren’t exclusively tied to age,” said Dr. Ronald Samuel, a gastroenterologist at Houston Methodist Clear Lake Hospital. “Several factors play into this disease. And the number of young adults diagnosed is on the rise, so getting a colonoscopy at the right time has potentially lifesaving importance.”
How do you know when the time is right? Reflect on risk factors such as family history and symptoms you might notice, and then consider your age.
RISK FACTORS
Several risk factors are tied to colorectal cancer, no matter your age. Here are some to remember:
■ Consuming red or processed meat in excess
■ Drinking alcohol in excess
■ Family history of the disease, especially your parent(s) and grandparent(s)
■ Inflammatory bowel disease
■ Obesity
■ Smoking
If you’re concerned, talk with your primary care provider about a colonoscopy or other tests. The good news is that a healthy lifestyle and balanced diet helps — your doctor can support you in forming healthy habits that boost overall well-being.
SYMPTOMS
After you’ve thought about risks, pay attention to any physical signs. Let your doctor know if you experience symptoms such as:
■ Blood in stool (red, maroon or black)
■ Changes in bowel habits, including stool shape and texture
■ Unexplained abdominal pain
■ Unintentional weight loss
YOU’RE 45 OR OLDER
Because colorectal polyps (precancerous growths) and cancerous lesions don’t always cause symptoms, age-appropriate screenings are the key to discovering a problem. Having your first colonoscopy at age 45 establishes a baseline, as your risk naturally increases with age.
“Anyone 45 and older is considered to have an average risk of colorectal cancer,” Samuel explained. “So, a colonoscopy at this age can help catch a problem early. Even better, during the procedure, colorectal polyps can usually be removed, and any concerning lesions can be promptly diagnosed and recommended for treatment.”
A colonoscopy is the gold standard of colorectal cancer screening, whether you’re in your 20s or 80s. Reach out to your doctor to start an important conversation about colon and rectal health. •
WHAT TO EXPECT AT YOUR COLONOSCOPY SCREENING
Here’s what you might expect from this exam:
■ You will empty your bowels at home with help from a preparation solution before the procedure, giving your doctor a clear view.
■ Sedation will make you comfortable. No major anesthesia is needed.
■ The procedure is typically only 20-40 minutes with no hospital stay required.
■ You’ll likely go about your daily routine after just a few hours of rest.
■ Most people need a colonoscopy every 10 years.
Be Proactive
If it’s time to talk to your doctor about colorectal symptoms, or you need to find a provider to schedule a colonoscopy, visit houstonmethodist.org/ gastro-cl or call 713.790.3333.
PRIMARY CARE Beyond the Annual Checkup
Your primary care provider (PCP) is a long-term partner to help in your quest for better health. With regular wellness exams and age-appropriate screenings, your PCP understands your needs and can help catch harmful health issues that don’t have obvious symptoms.
“I already know your medical history and can provide the best treatment advice,” said Dr. Michael Allen, a family medicine doctor at Houston Methodist Primary Care Group. “That’s why continuing care with the same PCP is important.”
To help manage your overall health and well-being, your doctor is your best resource. Ask about a new health fad, immunizations, hurts, pains and even your worries. Your doctor is here to listen.
FOR QUESTIONS & IMMUNIZATIONS
When it comes to the latest diet trend or getting to know immunizations, instead of asking Google for advice, start with your doctor. After all, he or she understands your health history and can guide you based on clinical evidence.
“There is a lot of misinformation online regarding medication side effects, fad diet plans and advertised supplements. I am here to advise and help you understand the latest clinical guidelines to make sure you are doing no harm to your health,” Allen said.
Everyone should get an annual flu shot, as well as tetanus, diphtheria and pertussis (Tdap) or tetanus diphtheria (Td) booster every 10 years. Your doctor may also recommend vaccines depending on your age and health history, and if you have international travel plans.
Dr. Michael Allen
TO FIND A LURKING HEALTH ISSUE
There are things you can’t really miss — acid reflux, asthma, urinary tract infections.
Unfortunately, some chronic health conditions, such as high blood pressure, prediabetes and high cholesterol, can lurk quietly in the background. Having an annual wellness exam with your primary care doctor can help uncover these conditions.
Depending on your age and family health history, your PCP may recommend other health and wellness exams, such as prostate cancer screening for men or colorectal cancer screening.
“If a cancer screening comes back positive, then it’s my job to quickly coordinate with a specialist who manages that condition and make sure you’re seen by him or her in a timely manner,” Allen explained.
Navigating the health care system alone can be overwhelming. Your PCP can make it easier by briefing specialists such as cardiologists, neurologists or endocrinologists on your health challenges.
Afterward, your PCP can help with a continued care plan. “I review the specialist’s findings to have a better understanding of your condition and treatment plan,” Allen added. “Then I help navigate you through strategies and timely interventions.”
TO STAY MENTALLY WELL
Your PCP is the first person to evaluate your mental health. Health changes that can cause isolation from your daily activities as well as lead to anxiety and depression include:
■ Cancer
■ Childbirth
■ Diabetes
■ Heart attack
■ Hypertension
■ Stroke
“In primary care, we screen for those conditions and can also help with treatment — including treatment for your mental health,” Allen added. “Sometimes you are started on medications or therapy. If need be, your PCP can help find a psychiatrist or a therapist to continue the treatment plan.”
FOR OVERALL HEALTH NEEDS
Whether it’s an acute illness such as a bad cold or you’re just not feeling right, get comprehensive care from an established relationship with your PCP. “Preventive care goes beyond the wellness exam — I am here to support you throughout your life,” Allen noted. •
Find a Primary Care Provider
Houston Methodist Primary Care Group has more than 45 practices across the Greater Houston area. To find a doctor near you, visit houstonmethodist.org/pcg/southeast or call 713.441.7965 .
SEE YOUR DOCTOR VIRTUALLY
Life can get busy, and making time for a doctor’s visit doesn’t always fit into your day. That’s where virtual visits come in — a perfect option for your health and lifestyle. Whether from your bed, couch, kitchen or hotel, your doctor can see you.
Follow-up care and many common health issues can be addressed via video visits, such as:
To get quick access to care, visit houstonmethodist. org/pcg/southeast and schedule a virtual appointment with one of our primary care providers.
Keep Overuse Injuries from Disrupting Your Workouts
Overuse injuries are a frequent problem among athletes and fitness enthusiasts. They are frustrating and cause setbacks to your fitness goals.
“These injuries develop when joints or muscles get stressed by the load, frequency or repetitiveness of an exercise,” explained
Dr. Haris Vakil, a board-certified primary care sports medicine physician at Houston Methodist Clear Lake Hospital.
The most common overuse injuries include:
■ Achilles tendonitis
■ Runner’s knee
■ Shin splints
■ Stress fractures
■ Tennis elbow
These can lead to long-term damage if not addressed properly. Vakil provides some tips on how to avoid these injuries.
DON’T RUSH THINGS
You can reduce your risk of overuse injury by following the 10% rule: Increase your workout intensity — distance run, weight lifted — by no more than 10% each week.
PRIORITIZE REST AND RECOVERY
When you exercise, you create small tears in your muscles. These tears need time to heal before you resume your routine.
“Rest days don’t necessarily mean you need to do nothing,” Vakil explained. “You can participate in light activity, such as swimming, walking, yoga or stretching.”
WATCH YOUR FORM
Proper form varies depending on the exercise, but Vakil recommended watching instructional videos or working with a personal trainer to help eliminate common mistakes.
CROSS-TRAIN
Adding variety or complementary exercises can give your muscles a chance to rest while focusing on another area. This can help provide more strength and support, giving you better control of your body.
KEEP A HEALTHY LIFESTYLE
Your body is only as powerful and durable as you maintain it — sleep, nutrition and hydration are critical for continued development.
LISTEN TO YOUR BODY
“It’s important to listen to your body,” said Vakil. “If you are experiencing persistent pain that isn’t just general soreness, you shouldn’t push through the pain. A sports medicine doctor can work with you to treat your injury and provide guidance on how to avoid them in the future.” •
THE DO’S & DON’TS OF STRETCHING
Stretching is beneficial for everyone, not just athletes. It helps maintain flexibility and mobility, improves posture, and helps reduce stress and body aches. Take note of these stretching tips to avoid injury and get the most benefit:
DO stretch muscles critical for mobility, such as arms, legs, hips, neck and back.
DO hold stretches for at least 30 seconds.
DO stretch after exercise to reduce blood flow and help decrease muscle soreness.
DON’T stretch cold: Take a light jog or do jumping jacks or high knees to loosen muscles.
DON’T stretch through pain: Consult with your doctor if pain persists.
DON’T bounce while you stretch: Use a gradual, smooth movement.
DON’T stretch an injury without first speaking to your doctor.
Whether you’re suffering from simple aches and pains or dealing with a complex injury, we can get you back on your feet — to keep you moving and doing the things you love. To schedule an appointment, visit houstonmethodist.org/ sportsmed-cl or call 713.363.9090.
Dr. Haris Vakil
FIND CANCER EARLY: 6 Cancer Screenings to Know
Cancer treatment is most effective when the disease is spotted early. That’s why it’s so important to know and keep up with routine cancer screenings.
“It’s easy to forget regular screenings when you’re busy,” said Dr. Amir Salam, medical oncologist at Houston Methodist Neal Cancer Center at Clear Lake. “But some cancers may occur without symptoms, and early detection gives you the best chance of a positive treatment outcome.”
Consider these recommended screening guidelines:
BREAST
To detect changes in your breast tissue early, doctors review your mammogram history and track the results over time. That’s why it’s important to start getting annual mammograms on time — by age 40, or younger if you have a family history of breast cancer. Depending on your risk factors, including the density of your breast tissue, your doctor might recommend an MRI, too.
“You should continue to get screened even in advanced age if you’re in good health,” Salam said.
COLORECTAL
Everyone who turns 45 should talk with his or her doctor about a colonoscopy or stool-based test. If a stool-based test is abnormal, you will still need a colonoscopy. The most important thing is to get screened until you’re age 75. After that, talk with your doctor about continuing.
“Colorectal cancer is being diagnosed increasingly in younger age groups, but fortunately our surgical modalities are becoming less invasive and systemic therapies are becoming more personalized, resulting in better outcomes,” Salam said.
LUNG
If you’re between the ages of 50 and 80, you smoke or you quit smoking within the past 15 years, and you have a 20-pack-year history, you should get screened for lung cancer every year. If you smoke or used to smoke, talk with your doctor about screening for lung cancer.
PROSTATE
Men should start getting screened for prostate cancer at age 50. Start talking with your doctor by age 45 if you have a father or brother who had prostate cancer before age 65 or if you are African American. Start at age 40 if you had multiple relatives diagnosed at an early age.
ENDOMETRIAL
If you’re menopausal, you should talk with your doctor about signs of endometrial cancer, including bleeding or discharge. Call your doctor right away if you have symptoms. Depending on your risk factors, you may be referred for a biopsy.
CERVICAL
Screening for cervical cancer with your gynecologist should begin around age 25 and continue until age 65. Human papillomavirus (HPV) is related to cervical cancer, so you should get a primary HPV test or HPV test with a Pap smear every five years, or a Pap smear alone every three years. •
IF CANCER IS DETECTED
Your doctor can help you find the best treatment. In general, look for cancer centers with:
• Access to clinical trials
• Comprehensive care teams
• Leading technologies and advanced treatments
• Support for comprehensive well-being
Connect With Your Doctor
Houston Methodist provides personalized care to ensure you stay on top of your health. To schedule an appointment or find a primary care provider, visit houstonmethodist.org/pcg/southeast or call 713.441.7965
Dr. Amir Salam
HOUSTON METHODIST LEADING CARE in Clear Lake
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