Medical Care & Diagnosis

Lower Back Pain and Core Strength

With over 31 million Americans suffering from lower back pain, this persistent ailment is one of the most common health problems plaguing adults in the United States. While some severe cases are the result of a deeper issue, temporary back pain is quite normal and can be reduced or eliminated through proper exercise and postural techniques. One way I recommend to reduce minor low back pain is through strengthening your core. The core encompasses all of the muscles from your hamstrings up to your neck, from your abdominals to your back muscles. Since all of these muscles work together to support your spine, keeping the core engaged and strong can eliminate minor back , improve posture, and reduce the risk of greater injury down the road. Yoga and pilates, two very popular forms of exercise, focus on engaging and strengthening core muscles. Yoga works the core muscles methodically through balance, flexibility, and relaxation. The core components of pilates are control, concentration, and centering the body. These are all achieved through engaging core muscles and, over time, building strength that can help reduce minor pain. Swimming is also a great way to engage your deep core muscles and hit different muscle

March 5, 2014

Pregnancy and Back Pain

We’re still in the throes of a frozen winter – which just so happens to be a very popular time to conceive. If you’re pregnant or considering it, there are a few things to be aware of when it comes to your back and spinal health. Women who have experienced chronic back pain or other spine issues and are hoping to become pregnant should visit a spine first. Chronic spinal conditions can worsen during pregnancy due to increased mechanical stress and hormonal changes. This sometimes requires prolonged bed rest toward the end of gestation, or occasionally surgery during the pregnancy. Even if you’ve never experienced major back pain, according to a 2004 study, more than two thirds of pregnant women reported suffering from lower back pain at some point after the first trimester. And it’s no wonder: with weight gain and a surge of hormones relaxing the ligaments in the pelvis, pregnant women often experience strain on their lower back muscles. There are a number of ways to reduce pain by preparing for back strain during pregnancy. 1. Practice perfect posture. As your center of gravity changes, it can be difficult to keep good posture in mind, but slouching is

February 11, 2014

Can’t Sleep? Perhaps it’s Your Back

Many patients come to me concerned about waking up with back pain caused by a “bad mattress” or uncomfortable sleeping position. This is often indicative of an underlying disk problem or arthritic condition. Even those without a spinal diagnosis or chronic pain can experience an achy back or neck after a night of sleep. What’s worse is that a lack of sleep can actually cause more sensitivity to pain and make mild back pain feel more severe. In general, we recommend a firm mattress with a pillow-top cushion layer for comfort. Back pain from sleeping is caused when strain is put on the spine in one position for a prolonged period of time – most often felt in the lower back. When this occurs, getting out of bed in the morning can be very painful, especially for the first 30 minutes until things loosen up. How can you avoid this pain? Simple adjustments to your sleeping positions can help make a difference. Side Sleepers The most common sleeping position for adults is on your side with your hips aligned and legs slightly bent. However, as we sleep, the unsupported top leg tends to fall and rotate the lower spine.

January 21, 2014

Five Healthy New Year Tips

As the New Year begins and my patients are getting back into their routines, I’ve heard a number of healthy living resolutions for 2014. From cutting out junk food to making it to the gym every morning, my patients are focused on living their most healthy 2014. Resolutions can be difficult to stick to, but I wanted to show you five easy ways to change your habits for a happier and healthier new year. Sit tall.Whether you’re sitting at your desk, on a plane, or in the car, proper posture can help reduce strain on your back and minimize unnecessary pain. How do you check for proper posture? With your buttocks at the back of the chair and weight evenly distributed between both hips, sit tall and relax your shoulders. If needed, get a “lumbar support” type pillow for your chair. Set a timer to check in on your posture every thirty minutes, as slouching and poor posture can sneak up on you. Take ten. Many friends and patients have resolved to exercise more this year. As a doctor, I know well the benefits that exercise can have , especially how strengthening your core can improve spine health. But I

January 17, 2014

Do Flat Feet Cause Back Pain?

In a recent study, researchers found that women who have flat feet, a common condition, are 50 percent more likely to have pain in their lower back as opposed to those with normal or high arches. This study is the first of its kind to make a significant connection between low back pain and flat feet. Published in the journal Rheumatology, the study examined both men and women, measuring each subject’s arch in the standing position and how pressure was distributed on the foot while walking. To confirm and expand the findings, future studies will likely follow participants with different types of arches for a significant period of time, and will attempt to determine what effect interventions such as orthotics may have on the development of back pain. So why are women more affected by walking with flat feet than men? Marian Hannan, senior author of the study, and her team were not able to determine exact causes but suggested a few possible reasons. For example, pelvic bones in women are wider than and not as flexible as those in men, and women tend to rotate their hips and move their upper bodies more as they walk.

November 19, 2013

Understanding Adult-Onset Scoliosis

Contrary to popular knowledge, scoliosis does not exclusively affect adolescents. Many people experience scoliosis for the first time as older adults, and in a recent New York Times Well Blog post, long-time health journalist Jane Brody shared her own experience with this condition. Also known as degenerative scoliosis, this condition occurs most frequently in people over 65. In a study by orthopedists at Maimonides Medical Center in Brooklyn, 68 percent of healthy volunteers over age 60 had spinal deformities that met the definition of scoliosis. Degenerative scoliosis is caused by a gradual deterioration of the disks and facet joints. This is the same process that can lead to osteoarthritis and stenosis of the spine, but causes the spine to curve to one side. In Brody’s experience, she and her son were out on a hike when he noticed that her hips were uneven. Getting shorter and visible signs of a postural imbalance are key indicators that something may be wrong. Pain from adult scoliosis usually begins in the lower back due to the degeneration and curvature. In order to properly diagnose the condition, a Spine Specialist will perform a physical exam, do a detailed neurological exam ,

November 12, 2013

James Levine’s Recovery and Return to the Stage

On a recent episode of Charlie Rose, James Levine, Musical Director of the Metropolitan Opera, spoke about his return to conducting after a two-year absence. Following multiple health issues, most recently a fall that damaged a vertebra which left him with no feeling in his legs, he now conducts from a motorized wheelchair. It was back in March that he made his debut – and received a standing ovation due to his remarkable recovery. Levine, 70, has worked with the Met since 1971, and during that time he has unfortunately experienced multiple health issues, including surgery in 2009 and again in 2010 to repair a herniated disk in his back. Following his recent fall, he went through intensive therapy that helped him to develop feeling and eventually to walk again. According to the Huffington Post, his doctors are ‘hopeful for a complete recovery.’ What Mr. Levine has accomplished in his recovery is remarkable. While I’m not his doctor, I can confirm that paralysis is often experienced due to an injury in the spinal cord, often from a crushed vertebra or disc. The spinal cord normally carries nerve impulses, but in people who are paralyzed, the nerve cells do not function

October 29, 2013

New Study Shows Back Braces Effective in Scoliosis Treatment

In a recent study published by The New England Journal of Medicine, researchers found that despite some controversy, bracing adolescents with scoliosis can work to prevent the need for surgery. This study is especially noteworthy since physicians, including myself, have recommended bracing for decades – but to date, there has been controversy about effectiveness. Scoliosis is defined as a curvature in the normally straight spine. This condition occurs primarily in adolescents; approximately three percent of Americans at age 16 have scoliosis, usually girls. Scoliosis is diagnosed by physical exam and x-ray to measure the degree of the curve. For curves between 25-40 degrees, doctors typically recommend braces. For more severe curves, spinal fusion surgery is recommended to prevent larger problems down the road. In the NEJM study, researchers studied data of 242 patients at 25 locations in the US and Canada aged 10 to 15 with a spinal curvature of 20 to 40 degrees. The trial was stopped early due to the clear benefit of bracing: the rate of treatment success was 72 percent versus 48 percent in the control group of children who simply remained under observation. The study scientifically affirms that brace treatment works for adolescents with scoliosis

October 22, 2013

Research Round-Up: Back pain intensity may predict future pain and disability

Back pain is one of the most common health complaints: it’s believed that 70 percent of people will experience it in their lifetime. New research found that many of these patients will in turn suffer long-term chronic pain in the low back area. While this may seem obvious, having proven scientific findings at the ready will enable doctors to take immediate action for patients experiencing pain to prevent more problems down the road. In a recent study published by the American Pain Society’s Journal of Pain, it’s become clear that high pain intensity at onset, as well as a belief that back pain will last for a long time, can forecast future pain or disability within a five-year span. This study is the first to demonstrate this association over a long period of time and “confirms that pain relief is an important target, not only in the initial management of the symptoms, but for the potential contribution to long-term improvement.” It’s important for doctors to address both pain management and the patient’s beliefs early in the treatment process. The American Academy of Pain Management is candid in saying that there is no single medication or procedure to cure everything and

October 15, 2013

How to Prevent Osteoporosis

How to Prevent Osteoporosis: Osteoporosis is a common condition, especially in Caucasian women over age 50, in which bones become fragile and can break. What happens is the bone loses density, meaning calcium and mineral levels are lower than normal, weakening the bone. This disease is quite common in elderly people. While there are no symptoms as it develops, osteoporosis can have significant effects on the spine if the vertebra start to break. The most common fractures as a result of osteoporosis are of the wrist, shoulder, hip and spine; people with osteoporosis most often break bones in the upper (thoracic) spine. One of the most serious injuries is a vertebral collapse, also known as a compression fracture, which is extremely painful. These types of fractures can also change the shape of the vertebra, leading to a hunched posture (“kyphosis”). You can protect your spine by moving properly during the day, according to the National Osteoporosis Foundation. With severe osteoporosis, people should avoid the following: Bending forward at the waist Reaching over to open a window Twisting and bending at the torso to an extreme Carrying heavy packages Bending forward when coughing and sneezing Reach for objects on a high

September 24, 2013

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