North American Spine Magazine December 2012 by North American Spine

North American Spine The Leader in Minimally Invasive Spine Care

Ski Season Warm-Up

May Prevent Sciatica

Also in this issue: ›› Classical Music to Your Ears and Tears to Your Eyes ›› Spinal Stenosis Surgery Study Yields Improvement for Most ›› Diagnostic Guideline for Sciatica and Other Causes of Low Back Pain ›› Spine Surgery and Depression Connection ›› Diagnostic Tools for Sciatica and Other Conditions ›› Home Remedies for Sciatica Back Pain ›› Water Exercise for Spinal Stenosis

North American Spine Courtesy Magazine | December 2012

Ski Season Warm-Up May Prevent Sciatica

It’s certainly not too early to start preparing your body for ski season. Although ski injuries are common, most aren’t serious. However some injuries may develop into serious painful conditions like sciatica, and even require spine surgery. Happily, this fate is not completely out of your control. Advance fitness conditioning can reduce your risk for injury: Flexibility and Balance ›› Slalom turns or mogul jumping require quick maneuvers and turns. Limited flexibility will restrict your range of motion, placing tremendous stress on your joints and spinal column. Stretching will develop your flexibility. Balance exercises on rubber disks and exercise balls will prevent falls from cruising over uneven terrain. Strength ›› Strengthening core muscles will protect your spinal column, and strengthening lower extremities will help prevent injury from explosive moves. Strong glutes and legs will also support your body weight in the proper ‘squatting’ posture required for skiing. Endurance ›› Extend your daily cardio sessions. Skiing all day is extremely demanding and endurance will help sustain proper technique throughout the day, preventing fatigue related accidents. You should give yourself at least six weeks on a doctor approved, conditioning program before heading out to the slopes.

Classical Music to Your Ears

and Tears to Your Eyes It’s surprising to learn that classical musicians suffer overuse spine injuries just like athletes! Muscular and tendon problems are the most common ailments but serious spinal injuries like herniated discs and nerve disorders from compression problems occur frequently among professionals and advanced musicians.

Stringed instrumentalists like cellists, violinists and violists may develop spine issues from sitting for hours in rehearsals and performances. The challenge of holding the instrument against one side of the body worsens matters. If you’re a musician suffering with back pain from muscle strain, and hope to prevent serious injury, here are some tips to take away. Tune up your playing style: ›› Select a properly-sized instrument and use chin rests and pads ›› Learn and practice correct technique ›› Warm up and stretch before playing ›› Take regular breaks, and move around to prevent muscle tension

›› Elevate your music stand to eye level ›› Develop core and shoulder strength to prevent slouching and scrunching

Preventing injuries and pain will assure the tears in your eyes come from moving melodies.

Spinal Stenosis Surgery Study Yields Improvement for Most

As if you needed another reason to quit smoking. Research published in the October issue of Spine found spinal stenosis patients improved, to varying degrees, following surgery compared with patients treated by non-surgical methods. This held true with the exception of patients who were smokers. In cases where other treatment has failed to offer relief, or in severe cases involving nerve damage, spine decompression surgery may be warranted. Some procedures are: ›› Laminectomy: removing the protective lamina, covering the spinal canal, providing more room for the spinal cord ›› Discectomy: removing disc material pressing on the spinal cord or nerve roots ›› Foraminotomy: removing bone around the foramin (holes through which nerve roots pass) ›› Spinal Fusion: fusing bone or vertebrae to provide stability The study analyzed data from 419 patients who were treated with surgery and 235 patients who received non-operative treatment. Significant pain and function improvement was found in the surgical patients who were non-smokers. The researchers recommended that smokers headed for spine surgery stop smoking well in advance of the procedure to benefit from surgery.

Diagnostic Guideline

for Sciatica and Other Causes of Low Back Pain

Everyone complains about x-rays, CT and MRI scans they’ve received… not to mention being zapped at airport security! Believe it or not, even with a herniated disc or sciatica you may not need any images at your initial physician’s visit! An MRI scan is considered a very useful tool before spine surgery, much like an x-ray is needed for a broken bone. And unlike an x-ray, an MRI does not have radiation and therefore can be repeated without any known risk. However, like many medical tests today, it is helpful to understand when a test is really necessary. Doctors from Emory University Hospital and Georgia Health Sciences University developed new guidelines for diagnostic imaging for low back. Patients should be classified during their initial evaluation by: 1. Possible spinal nerve compression 2. Specific underlying cause or illness 3. General low back pain, possibly due to muscle strain These guidelines will help physicians to determine whether you really need that MRI or CT scan. If you get an MRI, send it over to us. North American Spine provides a free review of your MRI report.

Spine Surgery

and Depression Connection Post-partum depression may sound counter-intuitive, for many parents waiting months to meet their newborn. Similarly, recent research suggests that spine surgery may sometimes be followed by depression, despite the expectation of sudden relief.

One reason may be the realization that full recovery can take up to a few months for maximum pain relief, as swelling from the procedure subsides. It’s also believed that there is a physiological connection between the neurotransmitters communicating pain and depression. Research also indicates that mental health may also be connected to pain long before surgery. One study involving Veterans Administration patients found that 42% of pain subjects in fact had depression prior to developing pain. Another study from the University of Texas Southwestern Medical Center found that in a group of low back pain sufferers, 39% had pre-existing depression. A University of Alberta Department of Health Sciences 2004 study, published in the journal Pain confirmed earlier studies, finding that depression increases the risk for developing serious back and neck pain. If you struggle with depression and back pain, what does this mean for you? Awareness of a connection and acknowledging your depression merits medical attention is half the battle. You may not only be predisposed to chronic back pain, but it may also impede your treatment success resulting in the eventual need for spine surgery.

Diagnostic Tools for Sciatica and Other Conditions

Diagnosing pain can be difficult and tricky. Since nerves travel outward from the spinal cord into various regions of the body, pain can radiate far from the source, as in the case of sciatica. Diagnostic tools include: ›› X-Ray: This may be used to find bone fractures. ›› MRI (Magnetic Resonance Imaging) : Using radio waves and a magnet to obtain clear images of soft tissues, cross-sectional images are taken while you lie inside the machine. For claustrophobic types, this is not a favorite. This technology is often successful to identify a herniated disc that may be causing sciatica. ›› CT Scan (Computerized Tomography) : This technique involves injecting a contrasting dye into the spinal canal to provide a clear x-ray of the nerves and spinal cord. ›› Interventional Methods: Highly trained specialists utilize advanced technologies like neurostimulation together with sophisticated imaging and scoping, often while the individual is lightly sedated, to determine the precise origin of the pain. Thanks to the advances in this field, patients and doctors are able to gather useful information to avoid unnecessary procedures and identify solutions for ending chronic pain.

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Home Remedies for Sciatica Back Pain

If you received a sciatica diagnosis by your physician, don’t panic! Simply begin your treatment plan that most likely includes some home remedies. Sounds soothing, but do they actually accomplish anything? Or like comfort food, do they simply soothe our souls? Home remedies according to WebMd include: ›› Resuming activity as quickly as is possible after pain spasms subside actually helps reduce pain and prevent joints and muscles from stiffening. Also circulating oxygenated blood to the area helps in the healing process. ›› Heat applied to the area may relax the muscles, dilate blood vessels, enhance the supply of oxygen rich blood and help soothe pain. ›› Cold applied to the area reduces swelling and reverses the vascular effect from heat, but in fact this reduces inflammation and lessens pain also. ›› Over the counter medication including non-steroidal anti-inflammatories help reduce pain. ›› Gentle exercise stretches muscles, increasing mobility, reducing stiffness and strengthening surrounding muscles, which will alleviate stress on the spine as it heals. When your sciatica symptoms dissipate, if your doctor says so, you’re good to go! In most cases home remedies, like comfort foods, should certainly help you feel better.

Water Exercise for Spinal Stenosis

They bob up and down with goofy smiles and chatter at your community pool. The instructor stands on the deck performing funny dance-swimlike moves her students fellow in the water. Dance music blasts from a boombox. Water exercises aren’t only loads of fun but they are a wonderfully therapeutic exercise option for individuals with low chronic back pain due to conditions like spinal stenosis. For back pain sufferers who are prescribed gentle exercise, aqua therapy or water exercise provides an excellent low impact and low pain option. Ideally water exercise for conditions such as spinal stenosis should be conducted in warm, but not hot, water. According to the Arthritis Foundation, the benefits of warm water include the dilation of blood vessels, which allows for increased blood flow to the area, relaxation of tense muscles and increased joint flexibility and mobility. The natural resistance that water provides allows for muscle strengthening.

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