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Treatment of Lower Back Pain

December 1st, 2018
Treatment of Lower Back Pain

In this article, we shall briefly take a look at the different treatment options offered to patients suffering from lower back pain.

Conservative Medical Treatment

Conservative treatment options include over-the-counter painkillers and certain home remedies that can help manage pain in the short term.

Over-the-counter painkillers include drugs such as paracetamol and non-steroidal anti-inflammatory drugs. These must be taken on advice of the physician. Side effects are rare but must be kept in mind when taking these medications.

Certain home remedies that can help manage lower back pain include the use of hot and cold compresses on the painful area. This can assist with altering the blood flow to the neighboring muscles around the spine, relieving symptoms. Changing one's mattress and maintaining good posture when standing up and sitting down can contribute towards an improvement in symptoms. Exercise is strongly recommended for improving back pain. Physical therapy can accelerate improvement in some cases, and patients may notice a decrease in symptoms in just a matter of weeks.

Surgical Treatments

There are a variety of different surgical treatments that may be offered to patients to help relieve symptoms. Some of these treatments support patients in the short term, while many can alleviate symptoms experienced during long-term pain management.

  1. Facet Joint Injections
  2. This involves the injection of a steroid — with or without an anesthetic agent —into the facet joints of the vertebral bodies. Inflammation within the facet joint is relieved with the steroid (long term) and the anesthetic agent provides immediate pain relief.

  3. Nerve root injections
  4. Nerve root injections involve an anesthetic agent of a steroid, which is injected directly into the small nerve roots that emerge from the spinal cord. Many times, these nerve roots may be inflamed or injured, and the injection can improve their condition. This procedure is performed under fluoroscopy guidance and often provides excellent results.

  5. Intervertebral Disc Surgery
  6. Intervertebral disc surgery involves the removal or shaving of the part of intervertebral disc that is protruding out of its base and pressing upon nerve fibers.

    Sometimes, the intervertebral disc is removed and is replaced partly or wholly by an artificial disc. This is called disc replacement surgery. Another surgery includes the removal of the entire disc, with replacement by a bone graft with a metallic prosthesis. This type of surgery is called spinal fusion and is a commonly performed procedure. Spinal fusion is conducted through an anterior (front) or posterior (back) approach.

    The advantage of surgery is that it can provide long-term relief of symptoms. In a more general sense, surgery can be performed either through an open approach with a large incision and longer in-hospital stay, or through a laparoscopic approach using specialized equipment. This type of surgery involves just a small incision and a short hospital stay. The choice of surgery depends upon the type of lower back problem experienced, as well as the preference of the surgeon and the patient.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Lumbar Decompression Surgery

November 26th, 2018
Lumbar Decompression Surgery

Lumbar Decompression Surgery

What is Spinal Decompression Surgery?

Spinal decompression is a type of surgery to relieve symptoms caused by pressure on the spinal cord and/or the nerves branching off from it. Pressure (compression) on the nerves or spinal cord can be the result of several factors including:

  • Bulging or herniated discs
  • Bony growths
  • Loosened ligaments.

Symptoms of Spinal Nerve Compression in the Low Back Include:

  • Pain in the low back, as well as in the buttocks and down the leg
  • Numbness or tingling in the buttocks, leg and foot
  • Weakness

Severe cases of nerve compression in the low back (lumbar region) can cause paralysis and problems with bladder and/or bowel function.

How is Spinal Decompression Surgery Performed?

There are several surgical procedures that can be performed to remove the pressure (i.e., decompress) on a nerve or spinal cord. Surgeons often utilize more than one of these techniques. If the spine is unstable, spinal fusion may be required in addition to decompression.

Discectomy: A portion of a disc that has herniated is removed to relieve pressure on the nearby nerves.

Laminotomy/laminectomy: These procedures which increase the size of the spinal canal are very similar. A piece of bone (called the lamina) around the spinal canal is either partially or totally removed.

Foraminotomy/foraminectomy: These procedures are very similar; they increase the amount of space around nerves as they branch off the spinal cord. A piece of bone and other tissues are removed to provide this space.

Osteophyte removal: This procedure involves removing bony spurs (osteophytes).

Corpectomy: This is a procedure to remove a large portion of a vertebra.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Whiplash

November 21st, 2018
Whiplash or CAD Syndrome

What is Whiplash?

Whiplash is a term used to describe a painful neck injury that's often associated with car accidents, but it can occur from contact sports, falls, or other trauma. Whiplash is also referred to Cervical Acceleration/Deceleration, or CAD, Syndrome. Whiplash may result in conditions like herniated disc, cervical sprains, and others.

What causes Whiplash?

When a sudden force or trauma causes the neck to jerk out of its normal range of motion, whiplash occurs. This tends to happen in intense situations, such as car accidents that cause the head to jerk back and forth. However, this can also occur in rough sports or any trauma that roughly forces the neck to move out of its normal range. This is called hyperextension, and it may cause damage to the ligaments, muscles, and tendons in the neck. Whiplash can cause the neck's vertebral discs to bulge, tear, or even rupture in severe cases.

Symptoms and Diagnosis

Symptoms vary depending on the severity and type of injury. Common symptoms of whiplash may include dizziness, stiffness and pain in the neck, headache, and shoulder and back pain. Other symptoms may include issues with chewing or swallowing, as well as pins-and-needles or other abnormal sensations. Your physician will perform a review of your medical history and a physical exam. X-rays may be ordered, as well as MRIs or CT scans, depending on the type of injury suspected.

How is Whiplash treated?

Treatment depends on the severity of the injury, but most injuries due to trauma need immediate medical attention to avoid complications in the long run. Often, conservative treatments may help treat pain from whiplash. Your doctor may recommend physical therapy exercises, bracing the neck with a soft cervical collar, medication, and nerve blocks. In rare cases, surgery may be needed.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Meat & Veggie Paleo Chili Recipe

November 16th, 2018
Meat and Veggie Paleo Chili

Prep Time: 10 Minutes
Total Time: 50 Minutes
Makes: 6 to 8 Servings

1½ pounds ground beef
2 cloves garlic, chopped
2 tablespoons cooking oil
1½ cups onion, diced, about 1 large onion
½ cup chopped celery, about 1 stalk
1½ cups carrots, peeled and diced, about 4 medium carrots
2 tablespoons chili powder
1 teaspoon ground cumin
1 teaspoon oregano
1 teaspoon salt
¼ teaspoon cayenne pepper (optional)
4 cups zucchinis, diced, about 2-3 medium zucchinis
1 15-ounce can tomato puree or tomato sauce
1 15-ounce can diced tomatoes

Winter is the best time for chili, but too many beans can leave you feeling bloated. This easy and delicious Paleo alternative to traditional chili will be sure to satisfy every tummy in the family and warm you from the inside out. Not only does this Paleo chili skip the beans, but lots of hearty veggies are added to be sure it keeps a full flavor. This recipe makes a very thick chili, so if you prefer to thin out the sauce, be sure to add a cup or so of additional tomato sauce or water. Not Paleo? No problem. Sprinkle some cheese or add sour cream on top for some additional flavor!

Directions:

  1. Chop vegetables (onion, celery, carrots, and zucchinis) to the size of your liking. Put your food processor to work for a helping hand.
  2. Brown beef and garlic over medium heat in a large skillet or pot that can hold all ingredients. Thoroughly cook the beef and drain excess fat. Set beef aside.
  3. Add oil and cook chopped onions, carrots, and celery with seasonings over a medium-high heat until onions are translucent, about 5-7 minutes. Add the zucchini once the onions are golden and the rest of the veggies are partially cooked. Cook for an additional 2 minutes and stir well.
  4. Add the browned beef, tomato puree/sauce, and diced tomatoes and stir well. Bring to a boil, stirring frequently. Reduce heat to a simmer and let sit for 20 minutes.
  5. Check on the chili often and stir when needed to avoid sticking and scorching. Serve and enjoy!

All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Beyond Running: Best Lower Impact Cardio Exercise

November 11th, 2018

Beyond Running - Best Lower Impact Cardio Exercise Methods

Although running is considered one of the best cardio-vascular activities, it is not for everyone. Many people have trouble sticking to their workout schedule because of the endless, boring miles on the treadmill, or miss days due to poor weather.

Is running your only cardio choice? Nope! There are many other cardio exercises that can help you work up a sweat and benefit your heart. Here are some of the best cardio methods besides than running:

Jumping Jacks: Old School PE returns! Jumping jacks offer simple, total body exercise that has the added benefit of plyometrics – repeatedly contracting and stretching the hip and leg muscles makes them stronger. This video demonstrates proper jumping jack form:

Rope Skipping: Another childhood classic that’s good exercise for grownups. Rope skipping is a highly effective callisthenic activity for cardio exercise. You don't have to do fancy tricks, just set a steady pace with as little height as possible. Here’s a video to show you the basics:

Dancing: We're not talking about a romantic waltz, mind you! Dancing to upbeat music with energetic movements can give you a great cardio workout.

Stair Climbing: The stairs in your home or office can be a great tool in your alternative cardio arsenal. Maintain a brisk, but safe, pace as you walk up and down stairs, and keep a light grip on the rail. The incline of residential stairways is significant and a few trips up and downstairs will give you a great calorie burn, as well as a measure of lunge-type anaerobic exercise.

Aerobics: Jazzercise, Zumba, Tae Bo, and other classes that incorporate energetic motion and aerobic fitness, are great alternatives to running. Some classes also use light hand weights and body weight movements to increase heart rate and boost muscle-building.

Low-Impact Exercise Machines: Rowing machines, elliptical trainers, and gym-type step machines offer variable resistance to help you build stamina without the skeletal impact of running on road, track or treadmill. They’re expensive to buy for personal use, but community centers, work places and even some churches offer free or low-cost access to professional-grade exercise equipment.

If you find yourself growing bored with the same workout routine every session, consider switching to a different machine or technique periodically, to stay engaged and committed. Whatever alternative you may choose as your running replacement, be sure to learn proper form to avoid injury, and don't overdo new routines.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Long Car Trip? Here’s How to Avoid Back Pain

November 6th, 2018

Long Car Trip? Here’s How to Avoid Back Pain

Avoid Back Pain

One of the most common causes of back pain is prolonged sitting. If you are heading out on a long car trip, there is no way of getting around the fact that you will have to sit for prolonged periods of time. However, there are several easy measures you can take to ensure prolonged sitting does not result in pain. By preparing before your trip and by following the advice presented in this article, your next long car trip can be a pain-free one.

Preparing Before Your Trip

The following steps should be taken as soon as you know you are going on your trip:

  1. Determine the total distance of the trip. Use Google Maps or a similar resource to find out exactly how many miles you will be traveling and approximately how long it will take you.
  2. Plan breaks at comfortable places along your route. Breaks should be taken every 3-4-hours and should last at least 10-minutes. Once you know how many breaks you need to take, you can add the allotted break times to the total time for your trip.
  3. Buy pain relievers. An adequate amount of pain relievers should be purchased before you leave. Acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs such as Aleve, Motrin, and Advil are readily available in over-the-counter forms.

If you know about your trip far enough in advance, you can perform spine stretching and strengthening exercises and work on improving your sitting posture.

What to Do During Your Trip

The most important thing to do during your trip is to remain consciously aware of your posture while sitting. You should try as much as possible to sit up straight without rounding your shoulders, leaning forward, or lounging back. Additional measures you can take during your trip include the following:

  1. Rest at comfortable places. Taking a break at a rest stop or restaurant with comfortable seating in an air conditioned environment will help you relax and recharge. Taking a break at an outdoor rest area with wooden benches might have the opposite effect.
  2. Stretch. Stretching your neck and back while driving and at rest stops will help your muscles stay loose and pain-free.
  3. Stay hydrated. Drinking water, juice, or sports drinks throughout your trip will prevent muscle spasms and cramps caused by dehydration.

If you find yourself in a position where you begin to experience back pain, you should take the appropriate dosage of pain relievers as soon as possible so your pain does not worsen.

What to Do After Your Trip

After your trip is over, you should make sure you stand up straight with your head up and shoulders back. Stretching can be done to help treat or prevent stiffness.

When you decide to rest, you should do so on your back so pressure is not placed on your spine. If pain presents, you should take your pain relievers.

Conclusion

As you can now tell, preventing back pain caused by a long car trip is straightforward and easy. If you follow the instructions outlined in this post and still experience pain that will not go away or worsens, you may have a back condition or injury that needs to be seen by an orthopedic spine specialist. It is recommended that you make an appointment as soon as possible.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


That Tingling Feeling: Is it a Sign of Spinal Problems?

November 1st, 2018
tingling feeling

Have you ever experienced numbness or tingling in your arm or leg, your foot or your hand – something that feels like the pins and needles of a limb "going to sleep," but doesn't go away? Some people report shooting pain down their arm or leg, or even a sharp jolt of pain in the arm or leg when they sneeze or cough.

Unexplained numbness? Check With your Doctor

If you have unexplained numbness, tingling or pain in the arm or leg, you should consider the possibility of spinal problems. The spinal cord branches out from the back into the nerves that conduct sensation from the extremities to the brain. Sometimes, a nerve path is disturbed – compressed or pinched for example – as the result of a spinal condition. The interruption is interpreted by your brain as injury, and the result, called "referred pain," is felt in a location far from the true source of the problem in the spine.

Referred Pain Could Indicate Serious Spinal Problems

Tingling or pain in the arm or leg can indicate one or more serious spinal problems, including spinal stenosis, herniated disc, and degenerative disc disease. Let’s take a closer look:

Spinal Stenosis. The spinal cord which passes through the open core of the vertebral bones is the pathway for nerves communicating between the limbs, the torso and the brain. Stenosis (a medical for narrowing) can impinge on the spinal cord either inside one of the vertebrae or in the spaces between them. This sometimes happens without adverse symptoms, but for some people the consequence is leg pain ranging from mild discomfort to severe shooting pain – in the lower back, the condition is sometimes called sciatica, named for the large bundle of nerve roots in that region of the spine. Very severe cases can cause foot disorders or issues with bladder or bowel function. Treatment can range from nonsurgical remedies including analgesics like acetaminophen or NSAIDs like ibuprofen; injection of steroids to reduce inflammation or anesthetics to block pain, rest or a lumbar brace or corset. Chiropractic manipulation and acupuncture show some effectiveness in treating the effects of stenosis as well. Surgery may be an effective remedy in cases where the conditions causing spinal stenosis cannot be permanently altered by nonsurgical treatment. This often involves removing, trimming or adjusting existing bones or spinal disc. Once the impingement or obstruction is relieved, painful symptoms usually end.

Herniated Disc. Sometimes known as a slipped or ruptured disc, a herniated disc most often occurs in your lower back. The intravertebral discs form the flexible pads between the bones of the back, consisting of a gel-like inner layer (Nucleus pulposus) and a tough, flexible covering layer (Annulus fibrosus). The disc can herniate when the inner layer pushes against the outer cover due to injury or just wear and tear; this can cause pain in the back. The back pain may decline if the inner gel breaks through, but the herniated disc can interfere with the spinal nerves and cause referred pain in the leg or arm. Rest, physical therapy and anti-inflammatory medications are the main nonsurgical treatments; surgery is an option if these measures fail to control symptoms. The risk of post-operative complication is low compared to other surgeries, and as always you should discuss the benefits and hazards of surgery.

Degenerative Disc Disease. Most people’s spinal discs will tend to degenerate as they age, but when this deterioration starts at a younger age or progresses with abnormal speed, your doctor might recommendation intervention ranging from pain medication to bracing to surgery that fuses or braces up the collapsing bone that impinges on nerves or spinal cord.

If you’re experiencing pain in the arm or leg, don’t wait long to see your doctor. Get examined, discuss your concerns and get advice on what options you have for relief.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Direct Lateral Interbody Fusion (DLIF)

October 26th, 2018
Direct Lateral Interbody Fusion

What is Direct Lateral Interbody Fusion (DLIF)?

Direct Lateral Interbody Fusion, or DLIF, is a minimally invasive surgical procedure for treating leg or back pain caused by degenerative disc disease. Unlike traditional anterior or posterior approaches to back surgery, DLIF approaches the lumbar spine through the patient's side. Approaching through the side helps the surgeon to avoid major muscles of the back.

Who needs Direct Lateral Interbody Fusion (DLIF)?

Direct Lateral Interbody Fusion is recommended for patients of degenerative conditions, deformities, and injuries that can lead to spinal instability. If the instability of the spine exerts pressure on the spinal cord or spinal nerves, it can cause back pain, leg pain or muscle weakness. These symptoms can extend into the hips, buttocks, and legs.

DLIF is recommended only if these symptoms persist for a long period of time and have failed to be treated with conservative treatments such as rest, exercise, physical therapy, and medication.

What are the steps involved in Direct Lateral Interbody Fusion (DLIF)?

Following are the general steps involved in the DLIF surgery.

Incision

The patient is given general anesthesia. The surgeon then makes two small incisions in the side of the patient. These incisions are very small as compared to the traditional incisions made in the back surgery procedures.

Insertion of probe

The surgeon inserts a probe in one of the incisions. The probe stimulates and detects the nerves around the spine and helps the surgeon to avoid the nerves and to leave them undamaged. The surgeon uses the second incision to help guide the surgical instruments.

Insertion of dilation tubes

When the probe reaches at the proper position, the surgeon inserts a series of dilation tubes over the probe. This helps to create a larger opening.

Insertion of retraction device

The surgeon then inserts a retraction device over the dilation tubes. This device helps to move aside the muscle tissues and to provide access to the spine.

Removal of disc

The surgeon operates through the channel created by the retractor device and removes the damaged disc.

Implant

The surgeon then places an implant filled with bone graft in the empty disc space. The implant realigns the vertebral bones and lifts pressure from the pinched spinal nerves. The bone graft will grow and form a fusion to connect the vertebral bodies.

Closure

The retractor device is removed and the incisions are closed. The wounds are cleaned and medical bandage is applied.

What happens after the DLIF surgery?

This surgery may be performed as inpatient or outpatient surgery. Your doctor will advise you what option is best for you. The patient is often able to walk around the day of the surgery and able to return to normal activities after a few weeks. The physician will have a specific rehabilitation plan for the patient, which may include daily light exercise.

Note to patients

This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Compression Fractures of the Spine

October 21st, 2018
Compression Fractures

What are Compression Fractures?

A compression fracture is a type of fracture of the vertebral bones. The size of the vertebra is reduced or 'compressed', hence the name.

What Causes Compression Fractures?

Compression fractures are caused due to trauma to the spine. Thinning of the bones due to osteoporosis is a common risk factor. Bone tumors also place the spinal bones at the risk of compression fractures.

Compression fractures can be seen in any part of the spine, though they are common in the mid-lower back.

Symptoms

Patients with compression fractures experience pain in the back that usually starts slowly and gets worse on exertion. Patients may lose a few inches from their height as well. Fractured vertebra can cause forward bending of the spine - a condition called kyphosis. The symptoms can be precipitated by a fall onto the back. Patients with osteoporosis are particularly vulnerable to developing compression fractures even without experiencing any trauma. Compression fracture can irritate the nerves within the spinal cord, and this can result in alteration in sensation in the extremities.

Diagnosis

The best test to diagnose a compression fracture is an x-ray. This will demonstrate the fracture, change in the alignment of the spine and a reduction in the intervertebral space. The compressed vertebra is evidently smaller than the non-fractured vertebra.

In case the x-rays are inconclusive or if further investigations are needed, the patient may undergo a CT scan or MRI to visualise the structures a bit more clearly. A bone density scan can help assess the thickness of the bone and is particularly useful in evaluating osteoporosis.

In the event that a tumour is the suspected cause, further investigations may be needed to ascertain the type of tumour.

Treatment

Painkillers are the mainstay of treatment. Often patients do not experience any other symptoms besides pain, and therefore just painkillers will be sufficient. In order to strengthen the bones, calcium and vitamin D supplements may be prescribed. Bed rest is recommended if the pain is severe.

Patients may require physical therapy to help them restore their normal state of mobility following a fall or injury. The loss of confidence that accompanies a fall can be significant, and in the presence of compression fractures, it can take a few weeks to months before patients are back to their normal daily activities.

In the event of the above treatments not helping the patient, and the pain persisting for over 2 months, surgery may be offered. Procedures include vertebroplasty or kyphoplasty. Spinal fusion surgery may be performed.

Prognosis

Patients with a compression fracture usually experience a good recovery that takes around 6 to 8 weeks in total. It is essential for the patient to take any medication and supplements prescribed to help slow down the progression of osteoporosis and prevent future compression fractures. If left untreated, the patient can develop postural abnormalities and even compression of the nerve roots; hence timely treatment is important.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.


Moroccan-style Chick Pea and Vegetable Stew

October 16th, 2018
Moroccan-style Chick Pea and Vegetable Stew

This Middle East-inspired stew is colorful in the bowl, low in fat and high in flavor. It's great as a meatless main course, and also works as a side dish.

Ingredients:

  • 1 tablespoon Olive Oil
  • 1 medium Zucchini, cut into ½ inch cubes
  • 1 medium Yellow Squash, cut into ½ inch cubes
  • 1 medium Onion
  • 2 Carrots, chopped
  • 1 tablespoon Garlic, minced
  • 1 cup Chicken Broth
  • ¼ cup Raisins
  • 1 ¼ teaspoons ground Ginger
  • 1 ¼ teaspoons ground Cumin
  • ¾ teaspoon ground Coriander
  • ¼ teaspoon ground Cinnamon
  • 2 15 ½ oz. cans Chick Peas, drained
  • 1 14 ½ oz. can Stewed Tomatoes, undrained

Couscous

  • 1 1/8 cup Water
  • ¾ uncooked Couscous

Directions:

  1. Heat the oil in a large skillet over medium-high heat. Add zucchini, onion, carrot and garlic; sauté 5 minutes. Stir in the chicken broth and all ingredients through stewed tomatoes; bring to a boil. Cover, reduce heat, and simmer 8 minutes or until tender, stirring occasionally.
  2. While these ingredients simmer, prepare couscous. Boil water in a medium saucepan; gradually stir in couscous. Remove from heat, cover and let stand 5 minutes. Fluff with a fork.
  3. Serve stew over couscous.

All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2019 VoxMD.com, All Rights Reserved.