Often my patients ask me “What is the best method of maintaining my low back on my own to avoid pain and re-injury?”

Combining stretching and strengthening, along with cardiovascular routines for stamina, function to minimize low back pain and injuries.

Personalizing your conditioning workouts to your back condition and your goals is also essential to maintenance of a healthy spine. Runners should do more lower-extremity stretching and “cardio” workouts, where a swimmer would do more upper-extremity and possibly strengthening activities. A proper warm-up and cool-down prior to and following exercise is mandatory to reduce injury possibilities. I suggest all joints be stretched in a controlled environment, no matter what your sport preference is. A brief “cardio” warm up is always a good idea to get circulation to the body and engage the heart rat to increase in preparation for increased activity.

Always keep a good conscious focus on your body and spinal posture when exercising. Keep the curves of the spine in balance and maintain a straight spine whenever possible. Use your larger, stronger muscles such as the gluteals in the buttocks and quadriceps in the front of the legs whenever possible.

Any continuous irritation or pain should be communicated to your chiropractor to check for asymmetries or imbalances in your structure. Taking responsibility for your own health by maintaining your spine with stretching and strengthening will definitely keep your doctor bills down and enhance your quality of life.

Back Surgery: What You Need to Know

Back surgery has been known for “leaving more tragic human wreckage in its wake than any other operation in history,” according to Gordon Waddell, MD, director of an orthopedic surgical clinic for over 20 years in Glasgow, Scotland.

“Low back pain has been a 20th century health care disaster,” said Waddell. “Medical care certainly has not solved the everyday symptom of low back pain and even may be reinforcing and exacerbating the problem.”

In 2010, researchers reviewed records from 1,450 patients in the Ohio Bureau of Workers’ Compensation database who had diagnoses of disc degeneration, disc herniation or radiculopathy, a nerve condition that causes tingling and weakness of the limbs. Half of the patients had surgery to fuse two or more vertebrae in the hopes of resolving their low back pain. The other half had no surgery, even though they had comparable diagnoses.

After two years, only 26 percent of those who had surgery had returned to work, compared to 67 percent of patients who did not have surgery. Of the lumbar fusion subjects, 36 percent had complications and 27 percent required another operation. Permanent disability rates were 11 percent for patients undergoing surgery, compared to only 2 percent for patients who did not undergo surgery. In what might be the most troubling finding, researchers determined there was a 41 percent increase in the use of painkillers, with 76 percent of surgery patients continuing opioid use after surgery. Seventeen surgical patients died by the end of the study.

The study provides clear evidence that for many patients, fusion surgeries designed to alleviate pain from degenerating discs do not work, according to the study’s lead author, Dr. Trang Nguyen, a researcher at the University of Cincinnati College of Medicine. His study concluded: “Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a workers’ compensation setting is associated with a significant increase in disability, opiate use, prolonged work loss, and poor return-to-work status.”

Commenting on the procedure in general, Dr. Nguyen said, “The outcomes of this procedure for degenerative disc disease and disc herniation make it an unfortunate treatment choice.”

In 1994, the conducted the most thorough investigation into acute low back pain in adults and came to the following conclusion in its Patient Guide: “Even having a lot of back pain does not by itself mean you need surgery. Surgery has been found to be helpful in only 1 in 100 cases of low back pain problems. In some people, surgery can even cause more problems. This is especially true if your only symptom is back pain.”

In his 2009 article, “Overtreating Chronic Back Pain: Time to Back Off?” Dr. Deyo speaks of the shortcomings of medical spine treatments in the U.S.: “Jumps in imaging, opioid prescriptions, injections, and fusion surgery might be justified if there were substantial improvements in patient outcomes. Even in successful trials of these treatments, though, most patients continue to experience some pain and dysfunction. Prescribing yet more imaging, opioids, injections, and operations is not likely to improve outcomes for patients with chronic back pain. We must rethink chronic back pain at fundamental levels.”

Dr. Deyo is not alone in his call for reform in spine care. The editors of The Back Letter, a newsletter from the Department of Orthopedic Surgery at Georgetown Medical Center in Washington, D.C., agreed with his frustration:

“The world of spinal medicine, unfortunately, is producing patients with failed back surgery syndrome at an alarming rate … There is growing frustration over the lack of progress in the surgical treatment of degenerative disc disease. Despite a steady stream of technological innovations over the past 15 years – from pedical screws to fusion cages to artificial discs – there is little evidence that patient outcomes have improved … Many would like to see an entirely new research effort in this area, to see whether degenerative disc disease and/or discogenic pain are actually diagnosable and treatable conditions.”

Sudden Back Pain: Why does it happen and what can be done to prevent it?

As a chiropractor, I often get patients who come in with startling, out-of-the blue onset of intense back pain which is a surprisingly common experience for many back pain sufferers. If you’re lucky enough to not have experienced it yourself, you probably know someone who has. You’re going about your normal business and suddenly your back spasms up, seemingly for no apparent reason, and you just can’t move.

It’s a curious phenomenon, and one that holds a key to understanding why many types of back pain arise and what you can do about it. Of course, there are times when back pain has clear causes, originating from an accident, overuse or sports injury. But just as often, back pain strikes like lightning, for no apparent reason. And if it has happened to you once or twice, the more likely it is to happen again.

While it may seem to be something that strikes from out of the blue, it’s really just the straw that breaks the camel’s back. The movement or sneeze that triggers the back pain incident is preceded by a whole syndrome of muscular imbalances.

For many people, some muscles are chronically way too tight. It can be due to their daily habits or due to structural imbalances, or both. Correspondingly, some muscle groups will be too weak. If these muscular imbalances persist over time, it sets you up for the situation where one little thing is enough to trigger back pain. It doesn’t take much to cause the muscle spasm to start, because for months or years those muscles have been forced to do something that they are not really designed to do.

As the muscles get increasingly worn out, they will be more likely to go into spasm. But in cases like that, there is a generally a long-standing pattern of muscular imbalances behind it, and then one little incident is enough to trigger a muscle spasm.

The point is that back problems are years and often decades in development. Regular chiropractic check ups and Active Release Therapy improve the overall health of the back, so it’s just common sense prevention.

Baby Boomer Spines:

It’s no secret that baby boomers blaze a trail in medicine. Doctor’s are now preparing for an increased demand for back pain management as the active boomers begin to feel their age.

Dr. Holly Phillips spoke with Russ Mitchell on some information regarding back pain including common causes and why staying active is key.