Back Pain and Surgery

Depending on the diagnosis, surgery may either be the first treatment of choice – although this is rare – or it is reserved for chronic back pain for which other treatments have failed. If you are in constant pain or if pain reoccurs frequently and interferes with your ability to sleep, to function at your job, or to perform daily activities, you may be a candidate for surgery.

In general, there are two groups of people who may require surgery to treat their spinal problems. People in the first group have chronic low back pain and sciatica, and they are often diagnosed with a herniated disc, spinal stenosis, spondylolisthesis, or vertebral fractures with nerve involvement. People in the second group are those with only predominant low back pain (without leg pain). These are people with discogenic low back pain (degenerative disc disease), in which discs wear with age. Usually, the outcome of spine surgery is much more predictable in people with sciatica than in those with predominant low back pain.

But when you opt for surgery you should always prefer the best surgeons and specialist available. For which there is only one name that can be recommended which is BackpainSurgeryLosAngeles. To know more about them and their services please visit

The Five Most Common Neck Injuries Explained

The neck is such a vital structure because it connects the head to the body. Unfortunately many experience a form of neck pain at some point in their life. There are a number of sources of pain within the neck, and oftentimes multiple structures are damaged as a result of trauma or repetitive strain injuries. Here are the five most common injuries and why they are such a pain in the neck:

5. Whiplash. Typically referred to as an injury that occurs as a result of a car accident, whiplash can occur in any instance of a collision into a stable individual. When a collision occurs, a person’s neck is violently thrust backwards before rebounding forwards. Unfortunately this type of collision can force the muscles and ligaments around the spine to stretch beyond their limits. This results in tearing and bleeding, which inevitably leads to pain. Oftentimes pain is not immediately felt due to our body’s protective response, but slowly settles in like a bruise would following an injury.

4. Herniated Intervertebral Disc. A bulged, protruded, or herniated disc refers to the degrees of severity of an injury to the disc that rests between the vertebrae, or bones of the spine. The disc is made up of two layers that help resist tensile forces, permit movement, and connect the vertebral segment. When the outer layer of the disc is torn due to violent injury or repetitive strain it can cause a bulge of material onto the nerves that exit the spinal cord. When these nerves become pinched by disc material it can lead to decreased strength in the arms, numbness, altered sensation or tingling between the shoulder blades or down the arm of the respective side of injury. It also causes loss of motion, such as turning the head over the shoulder, and considerable pain in the neck and arms.

3. Facet Strain. The facets are where each vertebrae meets the next throughout the back portion of the spinal column. They are primarily responsible for movement; for example when turning your head to look to the side, each facet joint in the neck and upper back provides a certain degree of motion to allow your head to rotate on the body. However, these joints are just like the other joints in the body where they can become strained. Typically this kind of injury causes bleeding within the joint, which leads to pain, loss of movement, and possibly scarring. A strained facet will typically cause pain in the area of injury and not down the spine or into the arms. It will also present as increased pain when moving your head in certain directions, most commonly when you tilt your head up, to the side, or rotating to the side of injury will be most painful.

2. Osteoarthritis, Degenerative Joint Disease. One of the more common neck pains can be the result of degeneration of the joint surfaces. Over years of abuse, the cartilage which provides cushion to where the bones meet along the spine becomes worn down. This process causes inflammation, and can even change the shape of the bone (commonly known as bone spurs.) The discs can also degenerate, causing them to compress and place more strain on the cartilage of the facet joints. Nerve endings within the joints sense the increased wear-and-tear, as well as inflammation, and respond by sending pain signals to our brain.

1. Postural Strain. When sitting or standing in poor posture for too long the joints and muscles become stressed. Bad positioning results in a mechanical disadvantage for the muscles and ligaments that hold us together, and forces a greater workload on these structures. This causes strain, and typically results in injury, or pain. Over long periods of misuse the joints become worn down, and muscles become tense from being overworked. The average human head weighs around 12-14 pounds. One can imagine the stress of holding a 14 pound bowling ball in an awkward position for more than a few seconds. This is what happens to the neck when the head is protruding forward in bad posture, such as when driving or working at a computer.

It is important to maintain a healthy neck in order to help prevent injury. A lifestyle consisting of frequent exercise and maintaining good postural habits may help avoid serious neck injuries. However, if you experience persistent or debilitating pain contact a physician to discuss the most appropriate treatment options.


Back Conditions Explained – Spinal Stenosis

 You have been experiencing back pain for a few weeks or months, or maybe you’ve had an acute episode that forces you to seek medical care quicker than usual. The physician examines all of your symptoms, addresses your pain, and sends you to have an x-ray or MRI. The results come back and you see the words spinal stenosis typed throughout the report. Immediate panic sets in because truthfully who knows what exactly this means? Do I need surgery, or will it ever get better are just a couple of the first questions that run through your mind. Though each person will present uniquely, this article should help answer some of those questions and give insight into what may come next.

Spinal stenosis is a term that describes narrowing of the spine, almost always due to degenerative changes. Often symptoms present insidiously over a period of time, but acute exacerbations can set off a cascade of events leading to severe pain in a short of amount of time. When the spine breaks down as we age the space where the spinal cord and the exiting nerve roots becomes smaller. This narrowing can put pressure on our nervous system, and as a result will cause serious pain. Central stenosis is a term used to describe narrowing of the canal where the spinal cord itself rests. Lateral foraminal stenosis is similar, except the narrowing occurs on either the left or right (or in some cases both) sides where the nerves exit the spinal cord and begin their course toward the legs or arms. The arms will become affected by stenosis is the cervical spine, the area closest to your head, and the legs will become affected by stenosis in the lumbar spine, or in serious cases even the cervical spine. Through degenerative processes the discs between the vertebrae lose some of their height which narrows the space for the nerves. The same occurs when the facet joints, where the vertebrae adjoin at the back side of the spine, grow larger. This is called hypertrophy and is a result of wear and tear at a specific level of the spine. Another structure that may enlarge overtime, which will cause narrowing around the nerves is the long ligaments that run vertically on the front and back side of the spinal cord to keep the vertebrae in place.

So what does all of this mean exactly? What you will be experiencing is symptoms as a result of this degenerative process that causes narrowing. The nerves or spinal cord itself will become impinged. The first symptoms may be a generalized aching pain across either side of the spine, typically in the low back. You may also experience more severe nerve symptoms that will present in the legs or arms. Typically nerve pain is referred to sensations of burning, numbness, or tingling in specific areas of the extremities. Each nerve as it exits a specific level of the spinal cord is responsible for innervating specific muscles and providing sensation in specific locations, termed myotomes and dermatomes respectively. It is hard for many patients to understand that pain in their feet is actually caused by a problem in their low back. It is fairly common to experience leg or arm symptoms without actual pain in the low back or neck due to the referral pattern of the nerves. Patients with the most severe stenosis will experience weakness in their arms or legs due to greater impingement of the nerve which does not allow efficient nerve signals to pass to the muscle. Think of this as a problem with the messenger to your body’s muscular system. Most frequently people with stenosis in their lower back will have increased pain or leg symptoms when standing or walking for long periods of time, and feel some relief upon sitting.

Once the problem is identified there are a number of treatment options available. Your physician will determine the most appropriate course of action to address why the stenosis has occurred and how to most effectively manage the condition. The first course of action is to relieve the immediate acute pain. Some physicians may prescribe medication to address pain or inflammation. The second course of action is typically a bout of physical therapy. The physical therapist will assess your spine and surrounding joints to address areas of muscle imbalance, such as shortened and tight muscles or weak muscles that may be contributing additional stress on the spine. They will also likely prescribe stretches to unload the spine, or attempt to create additional space around the nerves to alleviate your symptoms. For many this will provide considerable relief and you will have a number of exercises or postural changes kept handy in case an episode pops up in the future, which is likely to happen. However, next time you will understand how to best manage your back and quickly address the problem before it becomes too painful to function.

If physical therapy or medication does not solve your problems you may need to consult a surgeon or pain specialist. The pain specialist will use a number of more advanced methods of pain control, whether that is more effective medication, psychotherapy, or a joint injection. The surgeon may also propose a joint injection, which will bathe the nerve that is causing pain in an anti-inflammatory. Some may require up to three injections for relief, which will last for six months to a year, or in more successful cases may provide pain relief for longer. One of the final options to relieve symptoms of spinal stenosis may be surgery. There are a number of very successful surgical options, including minimally invasive spine surgery. The surgeon only needs a small incision into the back where they place a small camera and tools to clean out the area of impingement which in turn creates more space around the spinal cord or nerve roots. If the surgeon determines that there is an instability that is causing your pain, or damage is too severe for minimally invasive surgery, they may opt for an open spine surgery called a fusion. This procedure creates stability between two or more vertebrae in order to prevent movement and pinching of the nearby nerves.

As you can see spinal stenosis is no joking matter. Seeking care is the first step in pain relief and learning long term management strategies so that you can continue to live life normally. Advanced medicine has given the patient a number of options to treat symptoms caused by spinal stenosis. 

Lower back pain treatments: Non-drug therapies that work

Treatment for back pain is an expensive problem, and millions of Americans suffer from either chronic or acute lower back pain. But lower back pain isn’t something you just have to live with or treat with a lifetime of pills — there are myriad options for treatment which can help alleviate pain.

Lower back pain may be the result of many underlying causes, including aging, traumatic injury, and even diabetes — and yet most lower back pain is treated in the same way, with anti-inflammatory or narcotic medications, which can have unwanted side effects, can be expensive and habit-forming. Consult your healthcare provider to find out what issues may be at hand.

Proven-effective, non-drug-related lower back pain treatments can include physical therapy, complementary and alternative medicine, cognitive behavioral therapies or even diagnostic and therapeutic interventions that help us understand where the pain is generated and how best to treat it.  Often, the best solutions involve personalizing a plan that includes multiple approaches.

Visiting a true multidisciplinary pain management practice can help open doors to new and different methods of treatment. If you’re experiencing persistent lower back pain, consider scheduling a consultation with the board certified pain doctors at the Washington Center for Pain Management, who may be able to help you explore your options.