Ways to Protect Your Spine as You Age

in

Article featured on Brigham Health Hub

The human spine consists of discs and joints that, like a hinge on a door, can wear out with time. While you may hear worrying terms such as “degeneration” or “arthritis” to describe these changes, it’s a natural part of the aging process.

This wear and tear don’t necessarily produce symptoms. It’s only when changes cause structures in the neck or back to press on spinal nerves that a patient may experience pain with movement, tingling, numbness, weakness, or shooting pain into a hand.

At this point, a patient may visit their primary care doctor, and leave with a prescription for an anti-inflammatory and/or a referral to physical therapy. If symptoms persist they might visit a spine surgeon.

Matching symptoms with findings from imaging

Jay Zampini, MD is a spine surgeon in the Department of Orthopaedic Surgery at Brigham and Women’s Hospital. He sees hundreds of patients a year suffering from a broad range of spinal conditions, from whiplash to a disc herniation.

“In my initial evaluation with a patient,” says Dr. Zampini, “I perform a physical exam and review X-rays or MRIs. I try to match symptoms with abnormalities on imaging.”

For example, if a patient has sensory problems or pain that radiates into the first two fingers in their hands, Dr. Zampini will discern that there’s likely damage to the cervical (neck) vertebra, probably C6.

He balances such findings with the understanding that imaging can present abnormalities that aren’t always responsible for symptoms.

Treatment starts with non-surgical options

Dr. Zampini was trained by Michael W. Groff, MD, a neurosurgeon and the Director of Spinal Neurosurgery at the Brigham. The two now work side-by-side to evaluate, diagnose and treat patients with conditions that affect the neck and back.

While Dr. Groff and Dr. Zampini are both spine surgeons, they don’t operate until a patient has exhausted all non-surgical options. In fact, 90 percent of patients experiencing back and neck pain won’t need spine surgery.

“We treat problems with the spine very conservatively. We start with anti-inflammatory medications and physical therapy, then pain management, if necessary. I might also encourage patients to continue care with a physiatrist,” says Dr. Groff.

The vast majority of patients recover after physical therapy. If a patient returns to their surgeon with persistent symptoms, the next step can be taken.

When spine surgery is needed

“If we exhaust all non-surgical options and the patient still experiences symptoms, such as pain with weakness, gait problems, or difficulty with bowel or bladder function, then we start to consider surgery,” says Dr. Groff.

Surgery is recommended if a patient has been suffering with symptoms for6 weeks or more. Likewise, severe cases of disc herniation that may risk paralysis, and serious conditions, are corrected surgically.

“If you do require surgery, the Brigham has an integrated approach to spine care and all the clinical resources of a world-class academic medical center,” says Dr. Groff.

At Brigham Health, a multidisciplinary team of surgeons, physiatrists, physical therapists and pain specialists collaborate to get patients back to their lives as quickly as possible.

Spine care is part of the Brigham’s larger ecosystem, so patients with co-morbidities, such as hypertension or diabetes, have access to resources that can address any complications that may crop up as their spinal condition is being treated.

Keep your spine healthy by knowing your limits

In most conversations with patients, Dr. Zampini usually illustrates how our spines change throughout our lives by telling a personal story about a devastating injury he suffered that changed how he now thinks about his body.

Dr. Zampini was 38-years-old when he ran a half-marathon in less than 90 minutes. It was blistering pace, a personal best, but the strenuous effort fractured his pelvis. “I was completely overdoing it, running as if I was still 25-years-old,” he says.

It was a wake-up call, and he changed his mindset during the eight months of recovery. He began listening to his body more.

“Some of my patients can relate to my story, because they’re trying to do things their bodies just can’t handle for their age,” says Dr. Zampini.

He advises his patients to understand and respect their limits. What kinds of activities and levels of intensity can you realistically handle given your age and level of conditioning?

To avoid injuries, Dr. Zampini advises patients to strengthen their core muscles, which include the lower back, hips and abdomen. These muscles work together to keep your body balanced. He also advises people to use proper technique when performing high-intensity movements and to modify movements or use lighter weights to lower intensity.

For those who work in an office, it’s also important to customize your work space to avoid muscle imbalances and repetitive injuries.

Exploring the best way forward with a spine expert

After Dr. Zampini recovered from his pelvic injury, he switched from running to lower-impact activities, including the elliptical and stationary bike. He also stretches and does yoga exercises every morning before he sees patients in his clinic.

“I still jog occasionally, but I don’t race anymore. I’ve accepted what I can and can’t do, and I’m happy about that,” says Dr. Zampini.

Both Dr. Zampini and Dr. Groff encourage anyone who has had to give up an important activity to seek consultation from a spine expert to explore the best way forward.

“In many cases, certain activities can be reclaimed in a responsible way,” says Dr. Groff. “It’s gratifying to see patients get back to the activities they love.”

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Techniques and Technology Improving Outcomes for Complex Scoliosis Surgeries

in , , ,

In Scoliosis Surgery, Lengthy and Complex (Albuquerque Journal), Dr. Anjali Subbaswamy (a Pediatric Intensive Care Physician at UNM) answers questions regarding a patient whose pediatrician has suggested she may need surgery and is wondering what that entails.

She notes a recent observation of markedly improved conditions post-surgery, prompting her to ask her colleague  Dr. Antony Kallur (a Pediatric Spine and Orthopedics specialist formerly with UMN and currently with New Mexico Orthopaedics) what might be contributing to the improvements:

Q: My 14-year-old daughter has scoliosis and her pediatrician thinks she might need to have surgery. What does that entail?

A: The surgical repair for scoliosis is Posterior Spinal Fusion, and it is a surgery performed often in my hospital. It is a long surgery, often taking between 6 to 8 hours. The children usually, but not always, come to the Pediatric Intensive Care Unit (PICU) afterwards for postoperative care. They might stay in the PICU for 1 to 4 days, depending on how they recover. After that, they go to our inpatient Carrie Tingley Rehabilitation Unit, where they receive physical and occupational therapy. These therapies facilitate their ability to resume their activities of daily living, and also enhance their recovery. The therapists will give you exercises to continue at home. The entire hospital stay is typically 5 to 7 days.

There are 3 different kinds of pediatric scoliosis, all of which may require surgical treatment. They are idiopathic scoliosis, neuromuscular scoliosis and congenital scoliosis. Idiopathic scoliosis is by far the most common type. This affects otherwise healthy children, who have a sideways curve in their spine, which measures greater than 10 degrees. Your pediatrician may have done the Adams Forward Bend test to assess this, followed by some X-rays.

The American Academy of Orthopedic Surgeons (AAOS) provides the following information: If the spinal curve is between 25 degrees and 45 degrees and your child is still growing, your doctor may recommend bracing. Although bracing will not straighten an existing curve, it may prevent it from getting worse to the point of requiring surgery. Your doctor may recommend surgery if your child’s curve is greater than 45-50 degrees or if bracing did not stop the curve from reaching this point. Severe curves that are not treated could eventually worsen to the point where they affect lung and heart function. That is the main medical reason for intervening.

Now, here’s some good news. I have personally noticed that the patients I get from the operating room after this procedure are in much better condition than in years past. They are more stable in terms of their breathing and blood pressure, they start eating and drinking sooner after surgery, they start sitting up and getting out of bed sooner and their pain is better controlled. It is frankly amazing to me that some of these children don’t have to come to the PICU after surgery. This surgery takes a long time and involves blood loss and many hours of anesthesia. All of those factors are stressful to the body, and these children used to come out of surgery somewhat unstable. They would require active management of their fluid balance, blood pressure, pain and breathing. We would check labs and replace electrolytes and clotting factors. Nowadays, we barely do anything except watch them closely. They typically come out of the operating room breathing on their own, with stable blood pressure and good pain control. These changes are striking improvements, and prompted me to ask my colleague Dr. Antony Kallur, “What has changed?” 

Here’s Dr. Kallur’s answer:

Well, things definitely have changed for the better in a lot of ways.

First of all we understand the importance of three dimensional correction and restoration of spinal alignment. Anesthetic techniques have changed very much and are safer with newer medications and ability to keep children unconscious but maintaining baseline nerve and brain function so that we can monitor the child’s spinal cord.

Neuro-monitoring; which is now used all the time for any scoliosis surgery has made the surgery very safe reducing the incidence of neurological injury.

The surgical techniques and our understanding of how to correct the spine and the alignment that needs to be restored has made the children able to return to all activities after healing from surgery without any restriction. The implants used are advanced to help us correct the spine and maintain alignment to healing and can be placed safely. Titanium implants used now are also biocompatible and incidence of infection is negligible in healthy children. Our incidence at Carrie Tingley hospital is ‘zero’ in healthy children.

These days, the child does not need to stay in bed or use a brace after surgery. The newer instrumentation techniques mean that need to harvest child’s own bone (from the pelvic bone) as graft for achieving fusion/healing is not needed.

The recovery from scoliosis surgery has become so much easier to the child and family compared to how it was 10 to 15 years ago. So, we achieve better correction and alignment with safer surgery with a quicker recovery and return to activities. I hope things go very smoothly for your daughter!

Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Antony Kallur is a Pediatric and Adult Orthopedic Surgeon and Pediatric Spine Specialist at New Mexico Orthopaedics. 

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300 or utilize our self-scheduling tools here.

 

5 Benefits Of Aquatic Therapy For Spine Pain

in

Article featured on Spine Health

The pool is a great place to take your workouts or physical therapy exercises. Here’s a look at five reasons why your back benefits from aquatic therapy.

Benefits of Water Therapy For Your Back

Your back can benefit from a water therapy session, but it’s important to note that aqua therapy may not be right for everyone. If you are dealing with a fever, infection, or an open wound (including a surgical incision that has yet to fully recover), water and the chemicals in the pool can make the problem much worse. If you have any of these conditions, speak with your doctor before moving forward with water-based therapy.

Here’s a look at why your back can benefit from water therapy:

  1. Decreased load bearing. Aqua therapy can decrease the stress placed on your spine because of the buoyancy provided by the water. If you are dealing with a disc issue that makes movement painful or if you are trying to re-strengthen your spine weeks after a surgery, aqua therapy can take some of gravity’s stress off your spine, which allows you to focus on your therapy exercises.
  2. Increased mobility. Along a similar vein, because of the buoyancy of water, we are often able to twist and turn more freely in water, which allows us to do range-of-motion exercises that would not be possible on land. Increased mobility is a benefit of water-based therapy.
  3. Natural resistance. If you do trunk twists on land, you’re not going to encounter any resistance and thus won’t be working your spinal muscles very hard. Try doing them in water instead. Water is roughly 600 times more resistant than air, so simple land workouts will be more effective when performed in the water.
  4. Decreased pain. Many people who suffer from back pain remark that it’s less painful to do a water workout than a normal land routine. This makes sense, because the water helps to increase blood supply to sore muscles and joints. The feel of the water is also comforting, which helps take your mind off your pain.
  5. No falling. Spinal surgery or other painful spinal conditions can have a negative impact on our balance. A painful nerve sensation or a momentary loss of balance on land due to a spinal condition can send us toppling to the earth, which can lead to fractures or other injuries. However, balance isn’t an issue when you’re up to your waist in water. You eliminate your risk of falling by conducting your workout in water, and it will also help to strengthen the muscles in your feet to improve your balance when you’re on land.

If you are dealing with spine pain and you are looking for a refreshing way to complete your physical therapy exercises, talk to your doctor about developing a water-based exercise program.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Tips to Keeping Your Spine Healthy

in

Article featured on Brigham Health Hub

While the COVID-19 pandemic has changed our lives dramatically, back and neck problems are still as common as ever. In fact, some people are experiencing pain and other discomforts for the first time due to changes in their work locations and equipment as they moved from the office to home. The good news is that most spine conditions improve with time, physical exercise and getting back to your normal activities.

During the pandemic, Michael W. Groff, MD, a neurosurgeon and the director of the Neurosurgical Spine Service at Brigham and Women’s Hospital, had a virtual visit with a patient who was having neck pain along with tingling and weakness in an arm. The patient had undergone a previous surgery with Dr. Groff and feared he might need another.

While an MRI showed more wear and tear in the man’s neck, Dr. Groff reassured his patient that the condition would likely improve without surgery. The best course of action included physical therapy and performing exercises at home.

“I’m not one hundred percent certain that this patient won’t need surgery again,” says Dr. Groff. “But I reassured him that the path to recovery was to get moving and return to his normal routine. And neither of these things would further hurt his neck.”

Dr. Groff is co-chair for the editorial board of Journal of Neurosurgery: Spine. In this role, he and others have been distributing timely information about providing safe care for spine patients during the pandemic.

Keep your back and neck strong with an exercise routine

To keep your back and neck healthy, Dr. Groff urges his patients to perform any physical activity that helps maintain fitness, strengthens the core muscles and includes stretching. If you have back issues, the best way to stay healthy is to stretch often and keep your core strong.

Many people have found virtual exercise classes or routines that include Pilates, yoga or cardio workouts. To stay in shape, you can also use elastic bands, hand weights and/or perform isometric exercises, like planks or squats at home.

“It’s especially important to avoid being sedentary for long periods of time,” says Dr. Groff. “Being inactive can cause muscles that support the spine to weaken. This can sometimes lead to back or neck pain or exacerbate an existing spine condition.”

Getting regular exercise can have other benefits, too. It can give your day structure and help break up the monotony of staying at home for an extended time. Physical exercise can also help you maintain a positive outlook while navigating this challenging period.

When to seek care for back or neck problems

If you have an acute injury, like a pulled back or neck muscle, your pain will likely only last a few days. However, if your symptoms last 2 to 3 weeks and you have weakness or tingling in an arm or leg, contact your doctor.

For pain relief, Dr. Groff recommends ice for the first 48 hours and then alternating between heat and ice for several days after. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), can also help reduce pain and lower inflammation.

For flare-ups of back or neck pain, most spine care providers recommend only staying in bed for about 3 days. In the past, doctors used to recommend a few weeks of bedrest for flare-ups until a pivotal 2016 study showed that 3 days of bed rest is all patients need before they should return to normal activity.

“Staying in bed any longer than 3 days may lead to muscle weakening that can actually worsen a pain episode,” says Dr. Groff. “If you’re having pain, I usually recommend that patients rest and recover over a long weekend and then resume their normal activities.”

Back or neck pain usually doesn’t cause physical damage

If you have back or neck pain, how you interpret it can often impact how disabling it can become. Many patients ask Dr. Groff whether their pain is “all in their heads.” It is, he says, because all pain is experienced in our minds.

“If you’re in pain, most patients find it helpful to know that their pain is most likely not causing physical damage to their spines,” says Dr. Groff. “If you know you aren’t hurting yourself, you can feel better about exercising and returning to your routines.”

Dr. Groff hopes to help patients understand their pain from this new perspective. Doing so often removes the fear of physical activity, because getting back to normal life is a common pathway out of pain for many patients.

“The experience I’ve gained during the COVID-19 pandemic gives me the confidence to say that the Brigham is providing care that’s compassionate, technically excellent and safe for you and your family,” says Dr. Groff.

Dr. Groff can see patients both in person and through virtual visits, which allow him to stay in contact with patients who prefer to connect from home.

“I can still meet with patients and discuss their symptoms during virtual visits,” says Dr. Groff. “I can review imaging and develop a care plan that’s tailored to their unique circumstances. I can also follow up with patients to see how they’re progressing.”

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Degenerative Disc Disease and Sciatica Facts

in ,
Article featured on MedicineNet
Sciatica can result from lumbar disc herniation (“ruptured disc”) or spinal osteoarthritis when nerves in the low back are irritated by the abnormal anatomy in the low back.

What is the design of the spine?

The vertebrae are the bony building blocks of the spine. Between each of the largest part of the vertebrae are the discs. Ligaments are situated around the spine and discs. The spine has seven vertebrae in the neck (cervical vertebrae of the cervical spine), 12 vertebrae in the mid-back (thoracic vertebrae of the thoracic spine), and five vertebrae in the low back (lumbar vertebrae of the lumbar spine). In addition, in the mid-buttock beneath the fifth lumbar vertebra are five sacral vertebrae — usually fused as the sacrum bone followed by the tailbone (coccyx).

What is the purpose of the spine and its discs?

The bony spine is designed so that vertebrae “stacked” together can provide a movable support structure. The spine also protects the spinal cord (nervous tissue that extends down the spinal column from the brain) from injury. Each vertebra has a bony arch behind the spinal cord that shields the cord’s nerve tissue. The vertebrae also have a strong bony “body” in front of the spinal cord to provide a platform suitable for weight-bearing.
The spinal discs are pads that serve as cushions between each vertebral body that serve to minimize the impact of movement on the spinal column. Because the discs are situated between vertebrae, they are sometimes referred to as intervertebral discs. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus) surrounded by a firmer ring of tissue (annulus fibrosus). With injury or degeneration, this softer component can sometimes rupture (herniate) through the surrounding outer ring (annulus fibrosus) and irritate adjacent nervous tissue. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae and surround each of the discs. When ligaments are injured as the disc degenerates, localized pain in the area affected can result.

Degenerative Disc Disease Symptom

Low Back Pain

Pain in the low back can be a result of conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.

What is degenerative disc disease? What causes degenerative disc disease?

As we age, the water and protein content of the cartilage of the body changes. This change results in weaker, more fragile, and thin cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). The gradual deterioration of the disc between the vertebrae is referred to as degenerative disc disease, sometimes abbreviated DDD. Wear of the facet cartilage and the bony changes of the adjacent joint is referred to as degenerative facet joint disease or osteoarthritis of the spine. Trauma injury to the spine can also lead to degenerative disc disease.
Degeneration of the disc space and its contents is medically referred to as spondylosis. Spondylosis can be noted on X-ray tests or MRI scanning of the spine as a narrowing of the normal “disc space” between the adjacent vertebrae.

What are degenerative disc disease symptoms?

Degeneration of the disc tissue makes the disc more susceptible to herniation. Degenerative spondylosis is another name for degeneration of disc tissue. Degeneration of the disc can cause local pain in the affected area. Any level of the spine can be affected by disc degeneration. When disc degeneration affects the spine of the neck, it is referred to as cervical disc disease. When the mid-back is affected, the condition is referred to as thoracic disc disease. Disc degeneration that affects the lumbar spine can cause low back pain (referred to as lumbago) or irritation of a spinal nerve to cause pain radiating down the leg (sciatica). Lumbago causes pain localized to the low back and is common in older people. Degenerative arthritis (osteoarthritis) of the facet joints that can be detected with plain X-ray testing is also a cause of localized lumbar pain. The pain from degenerative disc or joint disease of the spine is usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.

What are the symptoms of radiculopathy and sciatica?

Radiculopathy refers to nerve irritation caused by damage to the disc between the vertebrae. This occurs because of degeneration (“wear and tear”) of the outer ring of the disc or because of traumatic injury, or both. Weakness of the outer ring leads to disc bulging and disc herniation. As a result, the central softer portion of the disc can rupture through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column.
It is important to note that many people have degenerative spines without having any symptoms. When nerves are irritated in the neck from degenerative disc disease, the condition is referred to as cervical radiculopathy. This can lead to painful burning or tingling sensations in the arms. When nerves are irritated in the low back from degenerative disc disease, the condition is called lumbar radiculopathy, and it often causes the commonly recognized “sciatica” pain that shoots down a lower extremity. This condition can be preceded by a localized low-back aching. Sciatica pain can follow a “popping” sensation at onset and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, lumbar radiculopathy can be accompanied by incontinence of the bladder and/or bowels.

How do health care professionals diagnose degenerative disc disease, radiculopathy, and sciatica?

Degenerative disc disease, radiculopathy, and sciatica are suspected when the symptoms described above are noted. The doctor can sometimes detect signs of irritated nerves during the examination. For example, increased radiating pain when the lower extremity is lifted supports the diagnosis of lumbar radiculopathy. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect the nerve irritation. Health care professionals can visualize degenerative spondylosis using plain film X-ray imaging of the spine, CAT, or MRI scanning. The actual disc herniation can be detected with radiology testing, such as CAT or MRI scanning.

What is the treatment for degenerative disc disease, radiculopathy, and sciatica?

The treatment of degenerative disc disease, radiculopathy, and sciatica ranges from nonsurgical (medical) management to surgery. Medical management of radiculopathy includes patient education of the condition, medications to relieve pain (NSAIDs, analgesics) and muscles spasm (muscle relaxants), cortisone injection around the spinal cord (epidural injection), physical therapy (heat, exercises, massage, ultrasound, electrical stimulation), chiropractic manipulation and rest (not strict bed rest, but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (producing a small hole in the bone of the spine surrounding the spinal cord), laminectomy (removal of the bony wall adjacent to the nerve tissues), by needle technique through the skin (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.

What is bony encroachment and spinal stenosis?

Any condition that results in movement or growth of the bony vertebrae of the spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foramen narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body), spondylolisthesis (slipping of one vertebra relative to another), and spinal stenosis (narrowing of the spinal canal causing by compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). For example, lumbar spinal nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities.
Spinal stenosis (narrowing of the spinal canal) can occur at any level of the spine, but it’s most common in the lumbar spine of the low back. Symptoms depend on the level affected. For example, lumbar spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking poor circulation of the lower extremities).
Treatment of these conditions varies (depending on the severity and condition of the patient) from rest to epidural cortisone injection and surgical decompression by removing the bone that is compressing the nervous tissue.

What is the outlook (prognosis) of degenerative disc disease, radiculopathy, and sciatica?

The outlook of degenerative disc disease, radiculopathy, and sciatica depends on the severity of the condition, its precise cause, and the interventions used to treat the patient. When patients respond to conservative treatments, the result can be complete healing. Surgical repairs can require postoperative rehabilitation, including physical therapy.

Is it possible to prevent degenerative disc disease, radiculopathy, and sciatica?

Avoiding injury can prevent degenerative spondylosis and resulting nerve irritation. When the disease already exists, aggravation of existing symptoms can be avoided by limiting stressing or overusing the involved spine.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Telltale Signs You Have a Slipped or Bulging Disc

in

Article features on Spine-Health
When a disc in your lower spine bulges or tears, you may feel pain in your lower back and/or your leg. Here are 3 unique signs of a herniated or protruding disc to help you identify the underlying cause of your lower back problem:

1. Pain while sitting

An activity that exerts tremendous pressure on your lower spinal discs is sitting. If you have a herniated or bulging disc, this increase in pressure within your disc may cause the bulge to become more pronounced, which may aggravate your lower back pain when you sit.

2. Radiating pain into your leg (sciatica)

The discs in your lower back typically herniate or bulge in the posterior (back) and/or lateral (side) region, which is in close proximity to your spinal nerve roots. Herniated discs may affect these nerve roots through one or both of the following 2 methods:

  • Direct compression. When the disc’s bulge or leaking inner contents directly press on a spinal nerve root as it exits the spinal canal.
  • Chemical irritation. When a herniated disc leaks out acidic chemical irritants from the disc material, which may cause inflammation and irritation in the area around the nerve root.

The function of the affected nerve root is then altered, and you may feel a burning pain along with numbness, weakness, and/or tingling along the front and/or back of your thigh, leg, and/or foot. These symptoms are commonly referred to as sciatica. The symptoms and signs of sciatica typically affect one leg at a time.

3. Pain aggravated by specific activities

Your lower back pain and/or sciatica may worsen when you perform certain activities, such as:

  • Bending forward/down
  • Lifting a heavy object
  • Pushing or pulling a heavy object
  • Coughing
  • Sneezing

Lumbar herniated disc pain usually comes on fast. In most cases, there is no single, clear reason for the pain, such as a specific injury or traumatic event. Yet, the pain feels sudden.
This condition can be very painful, but for most people, the symptoms don’t last too long. Nearly 90% of people who experience painful lumbar disc herniation report within 6 weeks that they no longer feel the pain, even if they received no medical treatment for it.

Warning signs and when to see a doctor

Visit your doctor if you exhibit these 3 telltale signs of a herniated disc. Your doctor may recommend a combination of nonsurgical treatments, such as pain-relieving medications and a guided physical therapy program, as well as referral to an interventional pain specialist for image-guided lumbar injections—to help decrease inflammation and relieve the pain.
If you experience any difficulty in controlling your bowel and/or bladder movements, numbness in your inner thigh and genital area, and/or problems in starting urination, consult your doctor immediately. These symptoms and signs may indicate cauda equina syndrome, a serious medical emergency, which is possible with certain severe lower back disc herniations.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Spinal Stenosis: Symptoms and Solutions

in

Article featured on Arkansas Surgical Hospital

What is Spinal Stenosis?

Spinal stenosis is a deterioration of vertebrae that causes narrowing of the openings of the spinal column.  Over time, this puts pressure on the nerves inside the spinal column.  In most cases, individuals develop spinal stenosis in either the neck (called cervical stenosis) or the lower back (called lumbar stenosis).

What Causes Spinal Stenosis?

The most common cause of spinal stenosis is osteoarthritis that causes bone spurs.  These spurs can impinge on the spinal cord or pinch one or more nerves emanating from the spinal column.  Other causes of spinal stenosis include pressure on the spinal cord or nerves from herniated discs, tumors, thickened or inflamed ligaments, or trauma that dislocates or breaks vertebrae.

Types of Spinal Stenosis & Their Symptoms

Some people develop mild cases of spinal stenosis without experiencing any symptoms.  However, if the deterioration continues over time, a variety of symptoms can develop.  Symptoms are most common in individuals over 60 years of age and tend to become more severe with age due to wear and tear on the spinal vertebrae. Symptoms typically vary based on the location of the stenosis in the spine.

Lumbar Spinal Stenosis

Spinal stenosis is more common in the lower back than in the neck.  This type of spinal stenosis is called lumbar stenosis.  The most common symptom of lumbar stenosis is neurogenic claudication, which is leg pain that comes and goes due to pinched nerves in the spinal cord.  It can cause weakness or cramps in the legs that can be severe.  It is more troublesome when standing or walking for long periods, and it may become less severe or go away when you sit or bend forward.
Numbness or a pins-and-needles sensation in one or both legs is another symptom.  The sensation is similar to when your foot falls asleep, but is more frequent or may last longer.  Weakness in the feet or legs can also indicate lumbar stenosis.  Gait issues such as foot drop may arise from weakness in the calves or quadriceps.  Foot drop is the inability to raise the front of the foot properly due to weakness.  Instead, the foot drops forward, often dragging on the ground or causing the person to trip.
When the pain is in one leg and accompanied by weakness, it may be referred to as sciatica, depending on which nerve is compressed.  Some individuals may feel pain in the buttocks and lower back as well.

Cervical Spinal Stenosis

The narrowing of the spinal column that causes pressure on the spinal cord in the neck is called cervical stenosis.  People with cervical stenosis can develop problems with their gait and keeping their balance, which affects their mobility.  The gait problems arise from the compression of the spinal cord rather than a pinched nerve.  This condition progresses over time, with the individual falling more frequently as the compression worsens.
Pain in the shoulder, arm, or neck may also be a sign of cervical stenosis, particularly if the pain is shock-like or is accompanied by a burning sensation.  Some people experience numbness or a pins-and-needles tingling sensation in one or both hands.  This is sometimes accompanied by weakness and loss of fine motor skills.  Over time, it becomes increasingly harder to fasten buttons, use a pen, or perform simple tasks that require small movements.
In exceedingly rare cases, individuals with severe spinal stenosis may experience incontinence, severe weakness in the legs, or loss of feeling in the genitals and inner thighs.  If this happens, contact emergency medical help immediately.  For most people, spinal stenosis is diagnosed and treated before it progresses to this point.

Diagnosing Spinal Stenosis

Your doctor will initially diagnose cervical or lumbar stenosis based on your symptoms, medical history, risk factors (such as age and injury), and a complete physical exam.  To confirm the diagnosis, they will use imaging procedures to determine the cause of your symptoms.  These may include x-rays of the spinal column, MRIs, and CT scans.  These techniques can reveal bone spurs, herniated discs, tumors, and areas where there is pressure on the spinal cord or nerves.

Conservative Treatments for Spinal Stenosis

There are several treatment options for mild to moderate spinal stenosis.  Your doctor can help determine the best treatment (or combination of treatments) for you based on the severity of your condition and your pain level.
Conservative treatments for mild to moderate spinal stenosis may include:

  • Pain relievers such as naproxen, ibuprofen, or acetaminophen for short-term relief
  • Antidepressants to minimize chronic pain and any resulting minor depression
  • Prescription opioids such as hydrocodone (used sparingly for short periods of time)
  • Physical therapy to improve muscle tone and strength, maintain spinal stability, and improve balance
  • Steroid injections to reduce the inflammation of irritated nerves

While these methods don’t correct spinal stenosis and may not work for everyone, they are typically done to reduce swelling, pain, and other symptoms.  Surgery is the last resort after other options for alleviating the symptoms of spinal stenosis have proven ineffective.

Surgical Solutions for Spinal Stenosis

When the symptoms of spinal stenosis become moderate or severe, surgery may be the only option.  This is particularly important when neurological issues, pain, or mobility problems have developed.  The goal of spinal stenosis surgery is to relieve pressure on the nerves or spinal cord so they can heal and return to proper functioning.

Laminectomy

The most common surgical treatment for either cervical or lumbar stenosis is a laminectomy.  During this procedure, two vertebral laminae—which form the “roof” of the spinal canal—and the bony area connecting them are removed, relieving pressure on the spinal cord.  Bone grafts or instrumentation are added to stabilize the site and protect the spinal cord.  Depending on the severity of the stenosis, fusion of the surrounding vertebrae may be performed for added stability.

Transforaminotomy

Transforaminotomy is generally for less severe cases of lumbar stenosis.  This option is not as involved as a laminectomy and is reserved for situations when the stenosis is restricted to a small area of the lumbar spine.  Transforaminotomy involves the widening of the bony openings between affected vertebrae, including the removal of any bone spurs that have developed.  Your surgeon may also remove damaged soft tissue or herniated discs.

Discectomy

If spinal stenosis is caused by a degenerated or herniated disc pressing on a nerve or the spinal cord, discectomy surgery may be done to remove all or part of the affected disc.  Partial discectomies are typically performed for lumbar stenosis, while complete discectomies are more common for cervical stenosis.  Your surgeon may fuse the surrounding vertebrae if needed.
Any of these surgical procedures may include minimally invasive options, depending on the severity of the spinal stenosis.  After surgery, appropriate care must be taken to allow the area to heal.  In some cases, patients will need physical therapy to ensure proper mobility following surgery.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Spine Structure and Function

in
Article featured on the Cleveland Clinic
Key parts of your spine include vertebrae (bones), disks, nerves and the spinal cord. The spine supports your body and helps you walk, twist and move. The disks that cushion vertebrae may compress with age or injury, leading to a herniated disk. Exercises can strengthen the core muscles that support the spine and prevent back injuries and back pain.
spine, illustration, cervical, lumbar, thoracic
The spine has three normal curves: cervical, thoracic and lumbar. There are seven cervical vertebrae in the neck, 12 thoracic vertebrae in the torso and five lumbar vertebrae in the lower back.

What is the spine?

Your spine, or backbone, is your body’s central support structure. It connects different parts of your musculoskeletal system. Your spine helps you sit, stand, walk, twist and bend. Back injuries, spinal cord conditions and other problems can damage the spine and cause back pain.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.

What are the parts of the spine?

A healthy spine has three natural curves that make an S-shape. These curves absorb shocks to your body and protect your spine from injury. Many different parts make up your spine:

  • Vertebrae: The spine has 33 stacked vertebrae (small bones) that form the spinal canal. The spinal canal is a tunnel that houses the spinal cord and nerves, protecting them from injury. Most vertebrae move to allow for a range of motion. The lowest vertebrae (sacrum and coccyx) are fused together and don’t move.
  • Facet joints: These spinal joints have cartilage (a slippery connective tissue) that allows vertebrae to slide against each other. Facet joints let you twist and turn, and they provide flexibility and stability. These joints can develop arthritis and cause back pain or neck pain.
  • Intervertebral disks: These flat, round cushions sit between the vertebrae and act as the spine’s shock absorbers. Each disk has a soft, gel-like center (the nucleus pulposus) surrounded by a flexible outer ring (the annulus). Intervertebral disks are under constant pressure. A herniated disk can tear, allowing some of the nucleus’ gel substance to leak out. Herniated disks (also called bulging, slipped or ruptured disks) can be painful.
  • Spinal cord and nerves: The spinal cord is a column of nerves that travels through the spinal canal. The cord extends from the skull to the lower back. Thirty-one pairs of nerves branch out through vertebral openings (the neural foramen). These nerves carry messages between the brain and muscles.
  • Soft tissues: Ligaments connect the vertebrae to hold the spine in position. Muscles support the back and help you move. Tendons connect muscles to bone and aid movement.

What are the spine segments?

The 33 vertebrae make up five distinct spine segments. Starting at the neck and going down toward your buttocks (rear end), these segments include:

  • Cervical (neck): The top part of the spine has seven vertebrae (C1 to C7). These neck vertebrae allow you to turn, tilt and nod your head. The cervical spine makes an inward C-shape called a lordotic curve.
  • Thoracic (middle back): The chest or thoracic part of the spine has 12 vertebrae (T1 to T12). Your ribs attach to the thoracic spine. This section of the spine bends out slightly to make a backward C-shape called the kyphotic curve.
  • Lumbar (lower back): Five vertebrae (L1 to L5) make up the lower part of the spine. Your lumbar spine supports the upper parts of the spine. It connects to the pelvis and bears most of your body’s weight, as well as the stress of lifting and carrying items. Many back problems occur in the lumbar spine. The lumbar spine bends inward to create a C-shaped lordotic curve.
  • Sacrum: This triangle-shaped bone connects to the hips. The five sacral vertebrae (S1 to S5) fuse as a baby develops in the womb, which means they don’t move. The sacrum and hip bones form a ring called the pelvic girdle.
  • Coccyx (tailbone): Four fused vertebrae make up this small piece of bone found at the bottom of the spine. Pelvic floor muscles and ligaments attach to the coccyx.

What conditions and disorders affect the spine?

Up to 80% of Americans experience back pain at some point. Vertebrae and disks can wear down with age, causing pain. Other conditions that affect spine health include:

  • Arthritic conditions, such as ankylosing spondylitis (AS).
  • Back strains and sprains.
  • Birth defects such as spina bifida.
  • Bone spurs (jagged edges on vertebrae that put pressure on the spinal cord and nerves).
  • Curvatures of the spine (scoliosis and kyphosis).
  • Neuromuscular diseases, such as amyotrophic lateral sclerosis (ALS).
  • Nerve injuries, including spinal stenosis, sciatica and pinched nerves.
  • Osteoporosis (weak bones).
  • Spinal cord injuries, including spinal fractures, herniated disks and paralysis.
  • Spine tumors and cancer.
  • Spine infections like meningitis and osteomyelitis.

How can I keep my spine healthy?

Strong back muscles can protect your spine and prevent back problems. Try to do back-strengthening and stretching exercises at least twice a week. Exercises like planks strengthen the core (abdominal, side and back muscles) to give your spine more support. Other protective measures include:

  • Bend your knees and keep your back straight when lifting items.
  • Lose weight, if needed (excess weight strains your back).
  • Maintain good posture.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • Back pain with fever.
  • Bowel or bladder control issues.
  • Leg weakness or pain that moves from your back down your legs.
  • Pain that worsens, causes nausea or sleeplessness or interferes with daily activities.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

4 Reasons You May Have Back Pain on Only One Side

in ,

Article featured on Penn Medicine
The pain may come on suddenly, as a sharp stitch on the left side of your back. Or it may throb to life on your right side, growing slowly worse each day. No matter its exact location, though, one thing is sure: Back pain isn’t fun—but it’s a familiar foe.
Some 80% of the population in the U.S. will have a back problem in their lifetime, and Americans spend upwards of $50 billion a year treating it, according to the American Chiropractic Association.
That pain can radiate from the bones, joints, ligaments, muscles, or a combination of sources. Lifestyle plays its part in back pain, too. Everything from sports injuries and poor posture to obesity and psychological stress can contribute to back pain.
When the pain is isolated to one side, though, you may wonder what exactly is going on. The pain could represent something minor from which your body will heal itself, or it could indicate a more serious condition.
One-sided back pain is a fairly common issue,” says Bradley Tucker, MD, a Penn Medicine Physician and Assistant Professor of Clinical Physical Medicine and Rehabilitation.
Read on to learn symptoms to watch for and what back pain on one side may mean. Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back and neck pain.

Tissue Injuries

Injuries to the spinal structures can happen in the muscles, discs, or joints, and make up the most common cause of back pain on just one side. They often occur after minor injuries or from an impact in sports or a car accident.
Tissue injuries typically cause pain central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. And of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.
Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically when you sit, everything should be at a 90 degree angle: knees, ankles, hips, and elbows,” he explains.

Muscle Strain Symptoms Include:

  • Limited range in motion
  • Tenderness or swelling
  • Muscle spasms
  • Pain the improves with rest, ice or NSAIDs
  • Pain that worsens after sitting or getting out of bed

Bone Issues

Arthritis, bone spurs, or spinal stenosis (a narrowing of the spinal column) also all may cause pain on one side of the back. The pain may radiate down the leg or cause weakness. For instance, Dr. Tucker says, “If someone has right hip pain from arthritis, they may walk in a way meant to prevent falling and minimize hip irritation. But then they might have left-side back pain as a result.
He adds that this compensation might not be something your body does consciously. “It’s just the body protecting itself from worsening pain, which causes muscles and other joints to be overused or over-fatigued,” he says.
Your treatment options depend on how badly the issue interrupts your daily life: walking, sitting, and other activities you enjoy. Your physician will discuss your optimal treatment options based on the severity of your symptoms.
Treatments may include pain medication and hot/cold packs. They may also range from physical therapy to surgery. Keep in mind that while frustrating, finding the right treatment that works for your specific back pain will likely take time, trial, and error.

Internal Organ Problems

Though you may not think of them at first, pain on the right side or left side of your back may actually come from the organs in your mid-back, abdominal, or pelvic area. That pain may signify infection, inflammation, or irritation, and the potential affected organs include:

  • Kidneys
  • Pancreas
  • Colon
  • Uterus

There are a lot of one-sided issues you could have from pelvic or abdominal structures, but it’s not the typical back pain people think of,” says Dr. Tucker. “For instance, kidney stone pain tends to radiate from the flank down to the groin.
Your kidneys live toward your lower back and can cause pain if infected. However, if you’re experiencing kidney stones or a kidney infection, you’ll likely have other symptoms, too, including pain when urinating, nausea, or fever.
Chronic inflammation of the large intestine, called ulcerative colitis, can also cause back pain—along with abdominal cramping, digestive issues, weight loss, and fatigue, as well. And in women, pelvic pain from endometriosis or fibroids can radiate into the lower right back. This pain often comes with other issues, too, including abnormal menstruation, frequent urination, and pain during intercourse.

Emergency Symptoms

Nobody wants to rush to the Emergency Room over back pain, but it’s important to take right-side or left-side back pain seriously. Go to the emergency room if your back pain is severe or if you believe it could be an emergency, such as a serious health problem or injury.
You’ll also want to recognize if it’s happening in conjunction with other symptoms, such as spinal tenderness, swelling, or bowel or bladder problems.
One such issue is a serious nerve condition called cauda equina syndrome, which involves nerve compression at the end of the spinal cord. “Usually, symptoms include numbness around the groin, significant leg pain, loss of bowel/bladder control, and paralysis,” explains Dr. Tucker.
But emergency symptoms that cause back pain don’t necessarily have to do specifically with the back. An abdominal aortic aneurysm causes the abdominal aorta to balloon and, in some cases, rupture. If the aneurysm ruptures, there is often associated sudden and severe abdominal or chest pain radiating to one side of the back. It’s important to familiarize yourself with emergency symptoms and seek medical attention immediately if you suspect you may be having an issue.
In general, remember: It’s better to be overly cautious when dealing with back pain on your right or left side, especially if the pain interrupts your daily life or comes on suddenly and doesn’t go away with rest or medication.
Talk with your doctor or go to an emergency room to solve exactly what’s going on behind your back.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Why is my sciatica not going away?

in , ,

Article featured on MedicalNewsToday and medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written by Zawn Villines on October 23, 2020

Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.

The pain can feel like an intense cramp or burning electrical sensations.
Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.
Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.
This article reviews what sciatica is, what causes it, and how to treat it.

Why is my sciatica not going away?

Sciatica happens when something presses on or traps the sciatic nerve.
The most common cause is a herniated disk in the lower spine.
Another risk factor is spinal stenosis, a condition that causes the spinal column to narrow.
Herniated disk
Doctors do not know why some cases of sciatica become chronic. Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.
Injury
People with herniated disks often remember a specific injury that triggered the pain. An injury does not mean that the pain will be chronic. However, people who have a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.
Inflammation
Inflammatory conditions can trap spinal nerves, causing sciatic pain. People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition gets worse. Treating the underlying condition may help treat the sciatica.
Infection
An infection in or around the spine can cause an abscess, which is a swollen and infected mass. This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms. A person with an abscess may develop a fever, have pain in other areas of the body, or find that sciatica begins after they have another infection.
Spinal mass or cancer
Any type of mass in or near the spine may trap spinal nerves, causing sciatic pain. Some masses are cancerous. In other cases, an epidural hematoma, which is a swollen blood spot near the spine, can cause the pain. It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when sciatica does not go away.
Wear and tear
As a person ages, the normal wear and tear on their spine can cause the spinal column to narrow, resulting in spinal stenosis. For some people, spinal stenosis causes chronic or worsening pain.
Lifestyle issues
Several lifestyle factors may increase the risk of sciatic pain or extend the healing time. People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

As sciatica often follows an injury, people may also find that the symptoms do not improve if they continue the activity that caused the original injury.
Tuberculosis
Sacroiliac joint tuberculosis, which doctors call tuberculous sacroiliitis, is a rare form of tuberculosis (TB), a lung infection. It happens when the infection creates an abscess that spreads to the sacroiliac joint in the pelvis and lower spine. A person may also have symptoms of TB, such as breathing problems or coughing. TB is a very rare cause of sciatica, but if symptoms persist, and a person has a history of exposure to TB, testing is important.
Spinal misalignment
When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae. This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Will my sciatica come back?

Sciatica can and does come back, especially when a person has a chronic medical condition.
People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

Exercises for sciatica

Exercise can help ease the sciatic pain. The following exercises might help a person with sciatica:

  • Aerobic exercise promotes fitness and can help a person reach and maintain a moderate body weight. Try low impact exercises, such as swimming or walking.
  • Stretch the hip flexors by standing straight in front of a chair. Bend the knee to a 90-degree angle and put the foot on the chair. Lean forward to stretch for 30 seconds.
  • Kneel with the buttocks resting on the heels, then put the chest to the ground with the arms elevated straight above the head and flat on the ground. Hold for 30 seconds.
  • Lie on the back and bring the knees to the chest. Hold for 30 seconds. Some people find additional relief by rocking from side to side in this position.
  • Lie on the back, with the knees bent and the feet flat on the floor. Lift alternating legs up, as if marching, for 30–60 seconds.

Other symptoms of sciatica

The most common symptoms of sciatica include:

  • electrical sensations along the side of one leg
  • pain that radiates from the lower back to the hip and down the leg
  • intense leg cramps
  • pain when walking or moving
  • numbness in the legs, hips, or lower back
  • pain when sneezing or coughing

When to see a doctor

Sciatica usually goes away on its own, with or without treatment.
A doctor can diagnose the cause of sciatica and may prescribe treatment to speed healing.
However, sciatica is not a medical emergency, and it is fine to wait to see whether the symptoms resolve on their own before visiting a doctor.
It is advisable to see a doctor if:

  • sciatic pain interferes with daily functioning
  • sciatica lasts longer than 3 months
  • sciatica goes away and then comes back
  • the pain is unbearable or gets steadily worse

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.