Medical Care & Diagnosis

Back to School: Possible Back Pain Due to Heavy Backpacks

It’s that time of the year again! The start of September marks both the end of the summer season and the beginning of the school year for young adults and children. The first thing on the back-to-school supply list: the backpack! According to the American Occupational Therapy Association, over 79 million students in the US use a backpack daily. And each new grade means more books and heavier bags. Backpack safety is an important issue all parents should take into account as their children embark on another school year. Photo Credit: WellCommons.com, http://wellcommons.com/groups/hy-vee/2011/aug/3/back-to-school-backpack-safety-check/ The back is made up of some of the strongest muscles in the body, but carrying more weight than it can handle may lead to chronic back pain . However, backpack misuse can be prevented! Below are some tips for parents and caregivers to keep their children safe from back pain: Backpacks should weigh no more than 15 to 20 percent of the child’s bodyweight (Source: American Academy of Orthopaedic Surgeons) The backpack should never hang more than 4 inches below the waistline; the bottom of the pack should rest in the lower back curve Try and purchase a backpack with compartments and distribute items so the

September 17, 2013

Dr. McCance Introduction

This is the first introductory video in an upcoming series that discusses spine health and the implications of various injuries and treatments, including surgery. Here, I discuss my background, residency and current position within the field of surgery. Thank you for watching, and to see the full series and stay updated on the latest health tips, please follow my practice on Facebook: www.facebook.com/McCanceMD

August 28, 2013

Is Sleeping in Hammocks Bad for Your Back?

During the summer it can be quite a joy to simply sit back and relax in a hammock. You can read a book, enjoy the scenery, or even take a nap. As it turns out, sleeping in a hammock can actually help you fall asleep faster and give you “better” rest, eliminating tossing and turning. Back pain often leads to discomfort, which can disrupt your sleep cycle and even prevent you from getting to sleep at all. It is important to keep in mind that a strong, supportive hammock that is properly hung is the best option for easy relaxation. Flimsy or smaller versions can lead to lower back pain, so it’s best to avoid those at all costs. Hammocks were first invented for sleeping in Central and South America, and later introduced to Europeans by Christopher Columbus, who brought several back from his voyages to the New World. As early as 1600, the British Royal Navy adopted them for use on ships, as the movement provided superior comfort for their sailors and prevented them from being thrown to the deck if waves tossed the ship. Hammocks can actually help us fall asleep faster and encourage a deeper, more fulfilling

July 11, 2013

Herniated Disc of the Lumbar Spine (Part II)

Last week, I posted about herniated discs in the cervical spine (or neck), but herniated discs can also occur in the lumbar spine (low back). Often times, patients suffering from a herniated disc in the lumbar spine are in the 30 – 40 year old age range. Many of the patients that I treat have injured their back from sporting or lifting incidents, but sometimes the injury occurs just from routine activities like bending over to pick up an object on the floor. According to the American Academy of Orthopaedic Surgeons, low back pain affects four out of five people; therefore a herniated disc in the lumbar spine can go unnoticed. It is especially important for patients to visit their doctor or a specialist if their low back pain persists longer than 2 weeks or starts to radiate down the leg. Although pain is the first and most noticeable symptom of a herniated disc in the lumbar spine, the severity of the pain depends on which disc is injured and the extent of the herniation. In some cases, the pain may spread over the buttocks, down the back of the thigh and into the calf. The pain may be in one leg

May 14, 2013

Herniated Disc of the Cervical Spine (Part I)

Have you ever heard someone complaining of pain from a “slipped disc?” If so, they are referring to a herniated disc. Discs can bulge when they lose water content, making the disc flatter with less cushioning. When a disc becomes too weak and begins to bulge, it puts pressure on the surrounding nerves. This pressure can cause nerve pain, numbness, tingling and weakness. Herniated discs can occur in the cervical spine (neck) or in the lumbar spine (lower back). Today, I will share my experience with patients who have a herniated disc in the cervical spine. This condition can occur without any obvious cause or injury. Some of the risk factors include: trauma, an accident or sudden twisting, a repeated or sudden strain on the back (as from lifting a heavy weight) or certain jobs that require heavy lifting. Some people are at a higher risk for this condition, but how do you know when you have actually hurt yourself? Symptoms of a herniated disc in the cervical spine include: Sudden neck or shoulder pain that travels down your arms Numbness, tingling, or weakness in one or both arms In some cases, weakness in legs, loss of balance, partial or

May 7, 2013

Lower Back Pain: Strains

Have you recently moved, cleaned or performed a series of lifting and are experiencing lower back pain, as a result? Dr. Louis Bisogni featured me on his television show Healthy Frontiers, and here I discuss strains of the lower back and why these can be extremely painful. Watch below, and leave me any questions or comments:

May 3, 2013

Neck (Cervical Spine) Fracture

I have treated numerous patients suffering from neck fractures, and each injury is different from the next. A neck fracture can happen for many different reasons. Common causes include falls, collisions, diving into shallow water, sudden twists to the neck or severe blows to the head and neck area. The first thing I do with an injured patient is assess the severity of the injury. Is it associated with dislocation or instability? Which cervical bones are broken? Is there a spinal cord or nerve injury? This information helps me determine the best option for treatment. Common treatment options include immobilization, bracing and surgery. Immobilization is safest immediate option at the accident scene, when there is a possibility of a broken neck, as it minimizes or prevents further spinal cord injury. Bracing is recommended as ongoing treatment for minor or stable fractures, when allowing the neck to become more stable. A neck brace or collar is often worn until the neck completely heals, usually lasting between 8 – 12 weeks. Certain exercises are often used for a fractured neck that will strengthen and stretch the muscles supporting the cervical vertebrae. This is essential for proper recovery, and is often done with

April 30, 2013

Jarvis Jones – Spinal Stenosis

I see patients in my practice with conditions ranging from neck and lower back pain to spinal fractures. From one patient to the next, the injury is never the same. This is most certainly the case with spinal stenosis, a condition that I often see and treat. Let’s start with what spinal stenosis is. It is a narrowing of the spinal canal that can occur anywhere along the length of the spine. The symptoms depend on what part of the spinal cord or nerve roots that are affected. Although spinal stenosis is more common in older patients due to the natural aging process, some people are born with a narrow spinal canal that lead to symptoms at a younger age. There are also patients who suffer from spinal stenosis because of other factors, such as trauma, which is common in athletes after sports-related injuries. With the NFL Draft quickly approaching, there’s a lot of conversation surrounding individual players. Conversations run the gamut of athletic strengths and weaknesses to individual character and football IQ. Injuries are a hot topic, as the media always wants to find a player’s weakness. Spinal injuries are always highlighted, as they are categorized as huge disadvantages.

April 16, 2013

Scoliosis: When is Surgery Required?

Patients frequently come into my practice with the notion that surgery is the best cure to their scoliosis pain. How do you know that’s the best course of action? Well, that’s my job. Surgical decision making for scoliosis is multi-factorial, and we assess many different parameters in coming to the right decision for each patient. The Scoliosis Research Society estimates that approximately 1 in 40, or 7 million people are affected by scoliosis in the United States alone, making it an extremely prevalent condition. Unfortunately it most often develops in children, particularly female adolescents between the ages of 10 and 15. To properly cure scoliosis, the treatment must match the source of the problem. Here are some of the main factors I consider when discussing if surgery is right for a patient with scoliosis: Degree: How large is the curve measurement? Spinal Maturity: Is the spine still growing? Location: Do you have a thoracic (upper spine) curve, a thoracolumbar (middle spine) curve or lumbar (lower spine) curve? Progression: Is the curve likely to worsen? Is the curve painful? What is your age and medical condition? Has there been prior surgery? Do you have osteoporosis? My recommendation for surgery is based

April 2, 2013

The July Effect: Patient Spinal Care Service Unaffected in July

A controversial topic has been dominating headlines recently, and is an important issue that I’d like to discuss. It’s the phenomenon known as the “July Effect” – the notion that being admitted to a teaching hospital in July, the month in which medical students begin residency, will increase the risk of poor patient care and medical errors. With this uptick in concern, numerous articles have been published about the topic and rightfully disprove the claim, including research from The Journal of Neurosurgery: Spine and The Mayo Clinic. In my opinion, the July Effect is absolutely false. The Journal of Neurosurgery: Spine found that among the sicker, high-risk patients who had more illnesses and higher rates of mortality, there was no difference in any outcome of patients admitted in July compared to those admitted in another month. Jennifer S. McDonald, a researcher in the radiology department at the Mayo Clinic, made the poignant argument that “if there really was a July effect, we would expect it to manifest in these patients.” I agree. Let’s look at spinal surgery specifically – a practice that is immensely delicate and technically demanding. At Mt. Sinai Hospital, on my service, the residents are closely supervised

March 25, 2013

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