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Louisville Orthopaedic Clinic
4130 Dutchmans Lane
Louisville, KY 40207
Northgate Medical Center
3605 Northgate Court
New Albany, IN 47150
Take Charge of Your Aching Back
Venu Vemuri, D.O.
Louisville Orthopaedic Clinic
I am often amused by the sighs of relief from my patients after I tell them they don’t need an operation. The reality is the vast majority of patients I see in clinic do not need spine surgery. In fact, up to 90% of back pain resolves uneventfully in ones’ lifetime. Rare is the diagnosis that requires “urgent” or “emergent” rush to the operating room such as for existing or impending paralysis.
Can Deterioration Be Prevented?
Most conditions arise from an arthritic or degenerative spine. I often remind patients, that at the turn of the 20th century the average lifespan of humans was 45 years of age. Thanks to modern medicine and sanitation that number has jumped to roughly 80 years. Unfortunately, our bodies have not evolved to match that progress and we are left with deteriorating parts. Depressing, isn’t it? In the words of many of my patients; “It sucks to get old!” So what can we do? For the lucky ones who are still young, can this be prevented? Well yes and no. You CAN live healthy by not smoking (FYI: smoking accelerates spinal disc degeneration and smokers have twice the rate of back/neck pain than nonsmokers), eating well, maintaining a healthy weight, and EXERCISING regularly! These measures won’t halt the eventual deterioration of your spine (you can blame a lot of that on your parents, i.e.: it’s hereditary), but you’ll be better off.
How Do I Manage Painful Symptoms?
Since there is no cure for arthritis, the best medicine is managing the symptoms. Besides having a healthy lifestyle, regular exercise is proven to ease the symptoms of an arthritic spine. How does this work? Well, strengthening of your body’s core or midsection relieves stress on painful discs and joints in the spine. Stretching tight muscles can lead to more fluid motion of joints further reducing stress on a painful spine. Finally, cardiovascular exercise can pump much needed blood to painful muscles as well as increase pain- reducing chemicals called endorphins. So what are you waiting for? Dust off that gym card and get moving!
I’ve Tried Everything, Now What?
So what if you try exercise, heat/ice, physical therapy, medications, etc. and you still have pain? Some conditions I frequently see like spinal stenosis, herniated discs, and spondylolisthesis may require more invasive treatment. These conditions arise from wearing-out of the spine eventually leading to pinched-nerves. For anyone who has experienced a pinched-nerve, they can tell you it’s no picnic and can be extremely painful. Associated symptoms include radiating pain down an arm or leg, numbness/tingling, and sometimes weakness. Another common symptom of spinal stenosis in particular is difficulty standing and walking and the habit of leaning on the shopping cart at the grocery store to facilitate walking. Believe it or not, we call this “shopping cart sign”. Standing upright or even laying flat squeezes the nerves and blocks the nerve signals to the legs. Leaning forward, sitting down, or bending the knees all relieve this squeezing allowing the signals to flow freely and lessen the pain.
Typically I prefer to offer spinal steroid injections before surgery. The results vary widely but the anti-inflammatory effect of the steroid can give much needed relief especially if the nerves are only mildly narrowed. Usually a series of two or three can do the trick. If they last for months it is safe to get injections up to three times a year maximum.
Minimally Invasive Options
If the injections only provide weeks of relief then I will offer surgical options. With new technology and techniques, spine surgery has come a long way focusing now on less invasive ways to accomplish the same goal. I personally am very passionate about minimally invasive spine surgery. Through smaller incisions and muscle sparing techniques, minimally invasive spine surgery can provide; faster recovery, less blood loss, less pain, less muscle damage, and decreased infections. Select procedures can even be done outpatient with patients going home the same day. It gives me great satisfaction to treat complex spine problems with minimal disruption to the body.
I always involve my patients in their medical decisions. The vast majority of spine surgeries are elective meaning the patient, not the doctor, chooses to have surgery. I present the pros and cons of surgery and work with the patient to decide if surgery is indicated. After all, it’s your body and YOU are in charge.