Dr. Michael Shapiro discusses back pain, treatment options
That all-too-familiar bout with back pain
Everyone, at some point in their lives, has experienced the pain and frustration of back pain. Causes, it seems, vary as much as the individuals who complain of it, but there are also numerous ways to alleviate the agony.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, back pain affects 8 out of 10 Americans at some point during their lives. Most back pain goes away on its own, though it may take a while. Taking over-the-counter pain relievers and resting can help, but the institute cautions that staying in bed for more than 1 or 2 days can make it worse. If back pain is severe or doesn’t improve after three days, the institute advises, or if you have pain following an injury, you should get medical attention.
How Your Backbone Works
Your backbone is a stack of more than 30 bones called vertebrae which surround and protect your spinal cord. The vertebrae are held together by muscles, tendons and ligaments. Between the vertebrae are intervertebral discs, which act as shock absorbers by preventing the vertebrae from hitting one another when you walk, run or jump. The intervertebral discs also allow your spine to twist, bend and extend. When an injury or medical condition limits the freedom of movement in the discs, sometimes causing pressure on a nerve, problems arise.
Causes of Back Pain
The lower back, which carries most of your weight, is the site of most back pain. Some of the most common culprits are arthritis and degenerative disease of the spine. As your spine ages, ifs more likely to experience bone spurs and thinned or herniated discs. Work-related injuries from heavy lifting or injuries and strains from athletic activities are also common causes.
A sedentary lifestyle can also lead to back pain. Individuals who spend long hours in front of a computer, sitting in a non-ergonomically designed chair, for example, are particularly at risk for back problems.
The Good News
Back problems can frequently be avoided simply through lifestyle choices. Good posture and exercise and a generally healthy lifestyle are the keys. When back pain does strike, the good news is that in the vast majority of cases – 90 percent or better according to the experts -disc-related problems causing back pain can be alleviated without surgery. Most treatments, including some of the newer procedures, are covered by insurance.
Chiropractor Keith Solomon, DC, of Advanced Chiropractic in Melville, said his practice specializes in “decompression therapy, a new technology, to treat a host of conditions including bulging, herniated, ‘slipped’ and degenerated discs, sciatica, radiculopathy, spinal arthritis, spinal stenosis and facet syndrome.” New techniques and tools, he said, are used to open up the spine, decompress the discs, and take the pressure off the nerves.
Many of these respond to treatment using a non-invasive spinal decompression system called VAX-D, a leading alternative to surgery that is often used to treat professional athletes. VAX-D can eliminate disc compression and restore normal backbone function. Solomon emphasized the importance of exercise as a preventive measure and after therapy. “We have an aging population as well as a lot of people who have become sedentary, don’t move as much, which contributes to a lot of the problems. Motion opens up the spine.”
Dr. Michael B. Shapiro, of Orlin and Cohen Orthopedics, and Chief of Orthopedic Spine Surgery at South Nassau Communities Hospital, is one of the nation’s leaders in the areas of spinal instrumentation, revision spinal surgery and disc arthroplasty surgery. “Millions of people are afflicted with back pain,” Dr. Shapiro said, “but the vast majority get better with conservative courses of treatment including physical therapy, stretching, anti-inflammatory medicines, steroid injections, yoga, acupuncture, or chiropractic.”
Surgical Options
In the small percentage of cases where those methods fail, surgery, including some new procedures, are the next step. “There are lots of new things out there for surgical candidates,” said Dr. Shapiro. Disc replacement surgery has been improved by the emergence of new procedures, new designs, and less invasive surgery. “These procedures are less traumatic, offer faster recovery, faster return to work, and better results,” he said.
Dr. Shapiro also emphasized the importance of exercise. “With exercise and proper nutrition, there’s much less chance of these things happening, and if they do, you’re in a better position to get better, faster.” But, he said, “surgery should be the last resort.” Anyone considering a spine operation he said, needs to make sure they have tried all of the non-surgical options first.
Shapiro says he also does “revision surgery,” to undo procedures such as disc fusion that have not provided relief. “In cases where surgery has been tried and failed, the patient may not have been a good candidate in the first place,” he said.
