· Myth: Back surgery is the best medical option – While some injuries do require surgery, simple back pain can be treated with rest, physical therapy and anti-inflammatory medication. If the pain does not subside after using conservative methods of treatment, then surgery may be the next course of treatment. Ultimately, it is best to talk to an orthopedic spine surgeon to evaluate your pain or injury and determine the right course of treatment.

· Myth: Stay in bed until the pain goes away – If you have acute strain or injury, rest is important for a few days, but lying in bed for longer than that can cause muscles and joints to stiffen and weaken, which slows your recovery. If you must rest in bed, make sure to get up every hour and walk for a few minutes to keep back muscles strong. Using a heating pad or taking a hot shower can also loosen the muscles and reduce pain.

· Myth: Exercise is bad for your back – Conditioning your back muscles and stabilizing your spine can be done by strengthening your core and abdominal muscles. Yoga and flexibility exercises are also a good way to reverse muscle weakness and decrease stress on the spine.

If your back pain does not subside within a few weeks, you develop a fever or feel tingling or numbness, see an orthopedic spine surgeon immediately for a proper diagnosis. Don’t let back pain, or misconceptions about back pain, keep you from living a full life.

From baseball to soccer to football, everyday millions of children and young adults participate in sports activities. These activities teach children team work and improve their physical fitness, coordination and self-discipline. It also increases their chance of experiencing sports-related injuries such as concussions, sprains, fractures, muscle tears, and back and neck injuries. However, there are measures that can be taken to help prevent these types of injuries, such as:
• Undergoing medical exams prior to the sport’s season, which should include concussion screenings and physical evaluations;
• Using proper protective gear, such as shin guards for soccer and helmets for football and baseball;
• Staying hydrated and always warming up before practice or a game;
• Never playing through pain or an injury.

If an athlete does experience an injury it is important that it is not ignored or taken lightly.
Sports-related injuries in children are of great concern because their bones, muscles, tendons and ligaments are still growing. To avoid long-term damage, young athletes should seek immediate care for any minor or serious injury.

Following are several signs to help determine if immediate care is needed:
• Inability to play following a sudden injury;
• Decreased ability to play due to a chronic or long-term complication following an injury;
• Visible deformity of the athlete’s arms or legs;
• Severe pain from a sudden injury, which may prevent the use of an arm or leg.

Sometimes, sports-related injuries occur after office hours or on the weekends. If and when this happens I recommend that my patients visit the emergency room or an orthopedic walk-in clinic like the one we have at Methodist Sports Medicine / The Orthopedic Specialists. One of our fellowship-trained orthopedic surgeons is available to treat patients with sudden or recent sports or active lifestyle-related injuries. Patients can visit our Avon or Greenwood locations Monday through Friday from 8 a.m. to 10 a.m., or our Carmel location Monday through Saturday from 8 a.m. to 10 a.m. For more information, please visit www.methodistsports.com or call 317-817-1200.

Winter is upon us, and with it comes snow, ice and winter sports. Nowadays, adults and kids are turning to non-traditional games, such as downhill ski racing, snowboarding and ice climbing. From the airing of the X Games and the need for a bigger thrill, these extreme sports are drawing more and more fans and enthusiasts. While these sports can be fun, they also can lead to injuries if not done properly.

According to the American Academy of Orthopaedic Surgeons, snowboarding is the leading cause of winter sports injuries, sending nearly 150,000 people to emergency rooms and doctors’ offices. Coming in behind snowboarding is skiing and snowmobiling.

If you are one of the millions of people that will take to the ice and snow this season, here are some tips to protect your back and stay injury-free during the winter months:

• Warm up and cool down. Stretch for about 30 seconds or more and do some light exercise for three to five minutes to warm up your muscles. This allows for blood to flow to your back muscles and prepares your body for your activity. A cool down after the sport reduces cramping and tightening.

• Gear up properly. It is important to wear the correct footwear, protective gear and layers to keep warm. Not only is the proper gear important, but staying warm is essential to preventing frostbite and keeping muscles flexible.

• Don’t imitate stunts. Don’t try any stunts you see on TV. Those are practiced moves that can cause an untrained athlete to injure themselves if not done properly. Also, abide by all of the rules of the sport when participating.

• Never practice alone. Because extreme sports are just that, extreme, you should never practice alone. Make sure someone is with you at all times in case of an injury.

• Take frequent breaks. Just like with any exercise, take breaks regularly. Also, make sure to drink plenty of water to stay hydrated.

• Use good technique. Remember not to twist or jerk your body in a way that is uncomfortable. It’s also a good idea to take lessons by a trained professional to prevent possible back strain or injury.

Winter injuries should not be ignored. If you do experience pain, it is essential to obtain a consultation with an orthopedic specialist who can diagnose your injury and determine the proper course of treatment. Depending on the extent of your injury, your doctor may recommend rest, prescription pain and anti-inflammatory medicine, or possibly surgery.

Many people do not realize that backpacks that are too heavy or worn incorrectly could injure a person’s bones, muscles and joints.  In fact, according to the U.S. Consumer Product Safety Commission there were 12,309 backpack injuries in 2008, sending kids to doctor’s offices, hospitals and emergency departments. 

To minimize injury, consider following these guidelines:

• Choose the right backpack: The safest backpacks have two wide, padded shoulder straps, a padded back and a waist strap.  These features promote better circulation and comfort, and ensure that the weight in the backpack is evenly distributed.

• Always use both shoulder straps: If worn incorrectly, backpacks can strain muscles and increase the curvature of the spine.

• Pack light and right: A backpack should never weigh more than 10 to 20 percent of the child’s total body weight. It’s also important to pack heavier items closest to the center of the back where the weight is better supported.

• Unload frequently: Students should stop at their lockers or desks as often as possible to unload some of the weight from their backpacks. If they do find themselves carrying a heavy load, they should remember to bend using both knees when wearing or lifting a heavy backpack. 

Parents should also encourage their children to learn back-strengthening exercises that build up the muscles used to carry a backpack.  If a student begins to experience pain or discomfort caused by a heavy backpack, don’t ignore it. It could lead to long term lower back pain and other complications that may eventually require rehabilitation and even surgery.

These issues and concerns are leading many sufferers to ask “how can back pain be properly managed?”

• Rest: If your back hurts, rest. This doesn’t mean stay in bed for a week. Long-term rest can actually make back pain worse, as it often leads to stiffness and muscle weakness. After a short break, gently stretch your back muscles, and work on strengthening your stomach and leg muscles. Strengthening all muscle groups can actually help to reduce nagging back pain.

• Medications: If stretching and exercise doesn’t alleviate the pain, try adding a medication (e.g., Tylenol, etc.) to your treatment plan. Some over-the-counter medications relieve pain, reduce inflammation, and relax muscle spasms.

• See Your Doctor: If you’re experiencing back pain more frequently, and rest and over-the-counter medications don’t seem to be doing the trick, it’s time to see a doctor. A medical professional can rule out if disease or infection may be causing the pain, and determine the best course of treatment. Once your doctor has confirmed the source of your back pain, surgery may be recommended to reverse the damage.  However, surgery is typically considered the final resort and is only utilized once non-surgical treatment options have been deemed ineffective.

The overall goal is for you to resume normal or near normal physical activity as soon as possible.  If you are unable to accomplish this at home, it’s important to consult an orthopedic spine specialist who can help get you back on track.

One of the most common and painful injuries associated with outdoor sports occurs in the cervical spine, known as a hyperextension or hyperflexion injury. This type of injury occurs when the head moves backward and/or forward rapidly beyond the neck’s normal range of motion. The unnatural and forceful movement affects the muscles and ligaments in the neck, resulting in pain, stiffness and in more extreme cases, a cervical spine fracture.

 The following tips can help prevent some of the most common sports-related neck and spine injuries:

 Don’t go headfirst in football: When participating in full-contact sports like football, it is important to precondition and strengthen the neck muscles and make sure that all equipment, especially the helmet, is properly fitted. Players should also be discouraged from using the top of their football helmets as battering rams when blocking, hitting and tackling.
 

Dive into the deep end: Never dive into a shallow pool area or water that is less than 12 feet deep. Pool depths can be deceiving and you may hit the bottom before you realize it, causing a painful or life-altering injury. 
 

Secure helmets before bike rides: Bicyclists should always wear an approved American National Standards Institute or American Society for Testing and Materials helmet to help prevent neck and spine injuries.  Helmets should fit properly and the straps should be closed and tightened to ensure that the helmet does not come off during a fall.
 

Slide into home safely: Do not slide headfirst when stealing a base during a baseball game. Stealing a base can be exciting but sliding headfirst will only increase a player’s chance of colliding with another player or the base itself.
 

If you do experience a neck or spine injury, it is extremely important to seek immediate medical attention to prevent further injury or permanent damage. There are several nonsurgical options available to treat neck and spine injuries. However, depending on the location and extent of the injury, a physician may recommend surgery to correct the damage. An orthopedic spine specialist can provide you with the information needed to make an informed treatment decision.

When surgery is your only option, there are many questions to ask before taking the next step:

• Who should perform the surgery? For most patients, back surgery will be unfamiliar territory. You should consider a surgeon referred by a reliable source, such as a primary care doctor, a friend or relative, or doctor referral service from your local hospital. It is extremely important to select a spine surgeon who is board certified or board eligible, and who devotes at least 50 percent of his or her practice to the treatment of spinal conditions.

• What should occur during the first consultation? Meeting a spine surgeon can be intimidating and overwhelming. To help ease these feelings, research questions ahead of time and be prepared to discuss your symptoms and surgical expectations. It is important that you feel comfortable asking questions about your surgeon’s complication and success rates related to your surgery. Spinal surgeons should have this information on hand. If a surgeon is hesitant to answer questions or seems uncomfortable, consider selecting another spine surgeon with whom you feel more at ease.

• Are there risks? Many of the risks associated with back surgery are the same as with any form of surgery, and can include bleeding, infection, pain and the risk of a reaction to the anesthesia itself. However, the risk of these complications is extremely low and uncommon. Specific back surgeries carry additional risks, such as numbness, nerve damage, instability, fusion failure or a loss of bowel and bladder control. Back surgery is considered very safe; however you should always discuss all risks with your doctor prior to the operation.

• What can I expect after surgery? It is normal to have some pain after back surgery. Many patients experience achiness due to inflammation and/or muscle spasms across the back or down the legs. These are all normal after-effects of back surgery. As your body heals this discomfort should decrease. Maintaining a healthy attitude and a well-balanced diet and getting plenty of rest can help shorten recovery time, but keep in mind that recovery is a process. The amount of time it takes to return to normal activities is different for every patient and every surgery.

The information provided by your surgeon should help you determine if back surgery is right for you. If you need further clarification, don’t hesitate to ask more questions about your condition and treatment options, or even your surgeon’s qualifications.

The lumbar spine, or lower back, provides a foundation to carry the weight of the upper body and houses the nerves that control the lower body. As a person ages, degenerative changes in the spine can occur, which can lead to narrowing, or stenosis, of the spinal canal. As this narrowing occurs, the nerves become inflamed, causing pain or a sense of weakness in the buttocks and/or legs. Standing or walking usually increases these symptoms, which are generally relieved by sitting down or leaning forward.

Spinal stenosis typically occurs in middle-aged to older adults, and is difficult to diagnose because its symptoms can be caused by other conditions. Usually, people who develop stenosis have no history of back problems or any recent injury. Often, unusual leg symptoms are a clue to the presence of spinal stenosis.

The best way to avoid lumbar spinal stenosis is to stay as physically fit as possible. Regular exercise can improve endurance and keep the muscles that support the spine strong. It’s also important to reduce excess weight, which can place unnecessary stress on the lower back and spine. Additionally, patients should avoid cigarette smoking, as it can cause the spine to degenerate faster than normal.

To treat this condition, initially an orthopedic surgeon will prescribe non-surgical options, such as physical therapy, anti-inflammatory medications, epidural steroid injections or a lumbar brace or corset to provide some support and help the patient gain some mobility. Non-surgical therapies can provide relief, but they will not improve the narrowing of the spinal canal, so symptoms may reoccur. If and when non-surgical treatment options are ruled ineffective, and a patient is experiencing severe pain that limits the activities of daily living, surgery may be recommended.

There are two forms of surgery that can be performed to treat lumbar spinal stenosis. Decompression surgery removes the bone and soft tissues of the spine that are pinching the nerves. If a patient’s condition is more severe, spine fusion may be required. Fusion eliminates motion between vertebrae and prevents the slippage or curvature of the spine from worsening after surgery. The surgeon also may use screws and rods to hold the spine in place while the bones fuse together.

A medical consultation with a spine specialist can help determine how advanced your condition may be, and which non-surgical or surgical treatment options are ideal to treat your condition.

Prepare Your Body for Spinal Surgery

More than one million spinal surgeries are performed in America every year. Physical preparations prior to spinal surgery can have a major impact on its success and a person’s overall recovery. Following are a few things to consider:

Watch your eating habits: A key ingredient in keeping your immune system healthy is good nutrition. In the weeks prior to your surgery, stick to a well-balanced diet. Proper nutrition will increase the chance for healthy wound healing and reduce the risk of infection after the operation.

Lose excess weight: Experts believe that being overweight and undergoing spine surgery may contribute to a greater likelihood of complications, like blood clots, wound infections, heart problems, and deep vein thrombosis.  So, to reduce the likelihood of complications, it’s a good idea to shed those extra pounds before surgery.  Also, the more you weigh the greater the strain on your back, which can slow the healing process and increase the pain after surgery.  

Exercise: A suitable cardiovascular workout can help strengthen muscles, allowing you to return to a healthy, active lifestyle more quickly after surgery. Most people find walking, swimming, light weight-training or aerobics to be beneficial. Talk to your physician about how to start an exercise program that is right for your condition before and after spine surgery.

Put down the pack: Smokers have a significantly higher chance of experiencing surgical complications with anesthesia and post-operative pneumonia than non-smokers. Nicotine is also associated with lower success rates for fusion surgery because it can interfere with bone healing. For the best results, you should quit smoking three months before your surgery. This will allow time for your pulmonary function to recover and your body to begin ridding itself of toxins caused by smoking.

If spinal surgery is in your future, by adhering to a few simple guidelines before hand, you’ll be sure to be back on your feet in no time.