Backache and Neck Pain?

Modern Methods can help you.

Many people suffer from back and neck pain.  Some have ongoing pain that gets in the way of their everyday activities. This condition affects not only the physical health of these individuals, but their social and economic well-being too. The pain can disrupt work, routine and other daily activities that they engage in. In fact, back pain and neck pain are among the most common reasons for doctor visits, and are major causes of disability, lost work days, and high healthcare costs.

1. Why Do So Many People Suffer From Back and Neck Pain?

According to Dr Prem Pillay, Consultant Neurosurgeon , there appears to be a silent epidemic of spine problems and this is related to our modern  lifestyle. A  poor posture and long hours sitting with computers at work and home  are part of this problem. Sports activities that load our spine like road running and high impact aerobics can also cause damage.  Pain in the back and neck area can be acute, which comes on suddenly and intensely, or chronic, which can last for weeks, months, or even years.

2. What Causes Back and Neck Pain?

Dr Prem Pillay states that back and neck pain may be a symptom of several different causes, including:

• muscle strain
• degeneration of the discs in the spine causing a slipped disc
• Spinal stenosis, facet degeneration and osteoporosis

.       Spinal Tumors including cancer spread

.        Spine Infections

3. How Can Back And Neck Pain Be Diagnosed?

Before your doctor can diagnose your condition and design a treatment plan for you, a complete history and physical examination are necessary.

Imaging tests such as X-rays and MRI (Magnetic Resonance Imaging) scans are helpful for diagnosing most episodes of neck and back pain. In most cases, they are only used if the doctor suspects a serious problem, such as a slipped disc or herniated disc, a spine fracture, or cancer, or if surgery is being considered or planned, advises Dr Prem Pillay. Some patients require additional tests like the DEXA scan to assess for osteoporosis and PET-CT scans if cancer spread to the spine is suspected as a cause of back pain.

4. What Are The Available Treatment Options?

Treatment is determined by the nature and cause of the problem and its severity. For mild slipped disc problems, they can be treated by pain medications and physiotherapy, together with lifestyle adjustments. If the pain is recurrent, prolonged or increasing in severity, a specialist consultation is necessary and a spine procedure may be recommended.

Dr Prem Pillay shares that the modern spine procedures include spine injection treatments that do not require open surgery. These  treatments include spine injections mainly for pain relief such as epidural steroids , nerve blocks and facet joint blocks.  Newer procedures that more directly treat the affected parts of the spine include discoplasty, annuloplasty, nucleoplasty, biacuplasty, neuroplasty , vertebroplasty, kyphoplasty and others that can be done under local anesthesia as day procedures. However, not all patients can have these done as there are criteria to be followed for a successful outcome. These procedures may give a medium term  relief from pain  , and may not always adequately treat the root of the problem for conditions such as disc herniations.

5. When Is Surgery Required?

Surgery may be indicated and give a long term solution when degenerative changes in the spine are severe or progressive that the function of the spinal cord or nerve roots is impaired or threatened,  there is severe and persistent pain that goes down an arm or a leg associated with weakness of the limbs , or when conservative treatment (anti-inflammatory medication, limited activity, physiotherapy) and spine injection treatments fail.

Dr Prem Pillay explains that patients should be reassured that spine surgery in experienced hands and with the right tools can be  safe and effective.  Certainly with new technologies including microsurgery and endoscopy, the openings needed are smaller than before and finer instruments are used to remove the damaged parts of the disc. Nerve monitoring during spine surgery can also be helpful in reducing risks. There are now  alternatives to spinal fusion  such as artificial disc replacement and dynamic spinal implants that allow motion preservation of the spine. All of these methods and precision have allowed spine surgery to become more successful  in returning people quickly to normal life.

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In the past , if you had degenerative disc disease such as a slipped disc, herniated disc, disc protrusion, disc extrusion, disc sequestration; the options were either conservative management or spinal surgery.

Discoplasty offers an in between option often without any surgery. It can be done as a day treatment , through a needle, under local anesthesia. An energy pulse is given to the disc center. This can reduce the internal disc pressure ( which is pushing on the spinal nerves and causing back pain and leg / arm pain ) and allow disc repair and healing.  Discoplasty therefore treats the root of the problem and not just the symptoms as in pain injections.

Lasers or plasma energy can be used to deliver the energy pulses.

Most people can return home the same day and are back to work the next day. Return to recreational activities and sports is usuallyvery quick as well.

More info on back and neck problems can also be found at http://neurospine.blogspot.com

These solutions include several of the following:

1.Percutaneous Plasma Energy Discoplasty
2.Percutaneous Endoscopic Laser Disectomy-PELD
3.MicroDisectomy
4.Endoscopic Disectomy
5.Microsurgical Discetomy with Dynamic Implants
6.MicroEndoscopic Discectomy-MED
7.Microsurgical Spinal Decompression
8MicroEndoscopic Spine Microsurgery- MESM
9.Percutaneous Disc Regeneration Technology
10.Endoscopic Disc Replacement

Many of these options allow the patient to arrive at a day surgery center, have the procedure under iv sedation and local anesthesia (no general anesthesia) and leave within a few hours of a fairly short procedure. Most patients walk out of the center themselves and can return to work in a few days.

Unlike taking pain medications or pain injections; these procedures do address the root of the problem. They allow reduction in nerve pressure and therefore can prevent ongoing or future nerve damage. Spinal nerves especially the spinal cord, cannot be effectively replaced at this point in time. Stem cell treatment is still experimental and not consistently successful.

These procedures are also evolving and becoming more successful with experience, technology and the passage of time. Many of us who are Minimally Invasive Spine Surgeons believe that more spine doctors need to know and be trained to do these procedures. An informed patient can also help to accelerate these changes worldwide by insisting on the latest and least invasive spine treatments.