Frequently Asked Questions
Q: I have been diagnosed with sciatica, is this serious and what treatment is available?
A: Sciatica occurs when there is inflammation or compression of one of the nerves from your low back that travels down the leg. If it is caused by inflammation from activities like sitting too long, lifting or yardwork, it can be readily diagnosed and treated by your spine doctor with medications and shots if necessary, resulting in a full recovery. If it is caused by compression on the nerve from a herniated disc or a degenerative condition in the spine, it may require diagnosis with an MRI and if shots don’t provide relief, it may need a minimally invasive surgery to remove the disc or bone compressing the nerve. The surgery can be done in an out- patient surgery center and the recovery is rapid, within a few days of regaining normal activity.
Q: My doctor says I may have lumbar spinal stenosis, what does that mean and what should I do about it?
A: Spinal stenosis is usually diagnosed following specific symptoms like pain in your buttocks and legs with walking which is relieved by sitting or leaning over like with a shopping cart. It can also be confirmed on an MRI which will show that the space where the nerve leaves the spinal cord has been narrowed by disc herniations and/or degenerative changes in the vertebral joints. It can be relieved in the early stages by doing regular flexion exercises, spinal shots and in advanced cases requiring surgery such as minimally invasive procedures to increase the space where the nerve exits.
Q: I have constant back pain and I have been told I have degenerative disc disease, do I need to have my spine fused?
A: Degenerative disc disease is a common problem of aging or as a result of prior trauma. The discs in your spine lose their fluid and shrink, so they are no longer act as good shock absorbers between the vertebrae. Sometimes they can bulge or herniate or form boney outgrowths or osteophytes and cause pain. Pain from this can be well treated with physical therapy, spinal shots, altering your daily activities and habits to prevent aggravating the condition. If this does not work, surgery is an option.
Q: Why would my doctor need an MRI and an x-ray of my spine?
A: An X-ray shows details of the bones and their position in your spine, it will often show arthritic changes, abnormalities in alignment and loss of disc height. The MRI will show details of the soft tissues in your spine and provide information on disc bulges or herniation’s, the nerves and their pathways, the spinal cord and the ligaments within the spinal canal. Both are needed for adequate diagnoses of conditions in the spine.
Q: I have been disc bulges in my neck from a car accident, does this get better or will I need surgery in the future?
A: A disc bulges occurs after repetitive use, injury like a car accident or over loading an area such as heavy lifting. The ligament that surrounds the disc becomes weak and over stretched and allows the disc to bulge rather than holding it firmly in place. If you avoid straining this area, protect it and do not continue with activities that aggravate it, it can heal over a period of weeks to months.
Q: I get low back pain when I sit too long, am I causing damage to my back?
A: Prolonged sitting causes compressive loading to our spinal joints and can result in disc and spinal joint irritation or degeneration. We should try and not sit for long periods, get up and move every 20 minutes and stand up and stretch to relieve the stiffness. Regular exercise and movement will stop the pain and damage from occurring. The pain you are experiencing is warning you that you are sitting longer than your spine can tolerate- movement and stretching is a good first solution.
Q: What is lumbar spondylosis?
A: Lumbar spondylosis is another form of saying you have degenerative changes in your lumbar spine. This means, there could be disc bulges or herniations, loss of disc height and facet joint arthritic changes and boney osteophytes. Arthritic changes in a joint can often be well managed with exercises, good body mechanics, medication and shots.
Q: What is the best treatment for lumbosacral strain?
A: Lumbosacral strain is a strain of the large ligaments from the lumbar spine to the sacrum. It is caused by overuse of certain activities like heavy lifting, repetitive bending and twisting, leaning forward like mopping or sweeping or staying too long in one position. It maybe aggravated by weakness of the abdominal or core muscles which support our back. It is an inflammation/swelling or irritation of these ligaments and can be improved with correction of your body mechanics and altering activities, shots for the inflammation, use of a corset to rest the ligaments and strengthening of the core muscles.
Q: I have strained my cervical spine after doing excessive yardwork, what is the best treatment to manage this and do I need to get an MRI of my neck.
A: Our neck is supported by muscles and ligaments and if you have been doing lifting, sweeping, digging etc. these ligaments and muscles have been irritated and inflamed. The first choice of treatment is rest, ice and anti- inflammatory medications and the condition will resolve within a few days. Should you continue to have neck pain, then further evaluation, testing such as an MRI and diagnosis can be done by your spine doctor and possibly shots and stronger medication maybe recommended.
Q: When does the surgeon choose minimally invasive surgery and/or a spinal fusion?
A: If you have a small problem such as a disc herniation or spinal narrowing, stenosis from degenerative changes and the space between the vertebrae is not severely compromised, minimally invasive surgery is an excellent option. If there is an instability between joints or a complete loss of joint space, a fusion maybe a better choice in order to provide stability at that level and also create space between vertebrae and prevent compression of the nerves and spinal cord.