Back Injury

A Look at Spinal Manipulation Therapy and Back Pain

If you’ve ever been to a chiropractor or had a professional “crack your back,” you may have been a recipient of spinal manipulation therapy (SMT). Spinal manipulation, also called spinal manipulative therapy or manual therapy, is used in both Western and traditional East Asian medicine; in North America, it’s typically performed by chiropractors, osteopathic physicians, and physical and occupational therapists. Over 100 types of adjustment techniques are known throughout the world, but typically chiropractors will focus on eight to 10 varying approaches within their practice. Spinal manipulation therapy uses force, while spinal mobilization therapy is gentler. Some conditions such as osteoporosis, the patient’s size, or simply patient comfort may require spinal mobilization therapy. Chiropractic treatment can be extremely effective for acute neck or back pain due to muscle spasm, strain or sprain, and inflammation. If you’ve never experienced it before, it can be surprising just how much force can go into the manipulation of different joints of the spine. The most frequently used technique in SMT is the high-velocity low-amplitude thrust, which often results in an audible “pop.” A more sophisticated technique relies on using a flexion distraction technique that is somewhat gentler and safer. The goal of these techniques

April 8, 2015

10 Years Later: James’ Patient Experience

Meet James, a former patient of mine. James’ story began when he was lifting paving stones and felt a sudden shooting pain in his back, eventually traveling to his legs and toes. Knowing something was wrong, he immediately consulted a physician, but doctor after doctor couldn’t figure it out. He had undergone prior surgery for a herniated disk about 15 years ago. After receiving five different opinions with no clear answer, James was left with more uncertainty: “Five different guys didn’t seem clear on where my problem was. They thought it was scar tissue from a previous surgery I had 15 years ago or a herniated disc. Three of the doctors consulted each other and thought some kind of implant would be best for me.” James continued to look for someone who could provide a better answer. He didn’t want rods put in his back. When a friend recommended my services, James did his research and made his appointment the next day. What I did differently from the previous doctors was to get a high quality MRI and special Xray views. Once I got the results back, I assured him that the pain was not due to scar tissue left

March 3, 2015

Winter’s Effect on Back Pain

It’s no secret that this winter has been unbearably cold. With record lows this February in many cities along the Eastern Seaboard, including here in New York, you might be wondering: what exactly is this bitter cold doing to our backs? Winter in itself can make your joint pain worse – and in some cases it can be debilitating. In fact, some people with rheumatoid arthritis and psoriatic arthritis suffer from cold allodynia, which means they can predict approaching colder weather by how much pain they are in. In colder temperatures, the tissues in your body shrink, causing them to pull on nerve endings, which for many can result in joint pain. Also, cold weather can lead to muscle tightness, exacerbating lower back spasm. Additionally, many cold weather activities can cause back aches and pain – from the repetitive bending and twisting associated with shoveling snow to the chance of slipping on a sheet of ice, winter-related slips and falls are highly common. With Winter Storm Pandora on its way out and the potential for more still on the horizon before spring finally hits, protect yourself from extra pain with these helpful tips: Bundle up, including layers, hats, scarves, and

February 24, 2015

Back on the Dance Floor: Kathryn’s Patient Experience

Kathryn is a former patient of mine who has left a lasting impression. Her back pain began when she hurt her L3/L4 disc after a spinning class, and she believes she aggravated the injury during a subsequent game of golf. Initially, Kathryn told me she didn’t think too much of it because she’s athletic and used to pushing herself outside her comfort zone. Kathryn thought this was something she could deal with – so she sought a massage treatment, iced her lower back area, and rested. Afterwards, she continued to play golf and attend spinning class. Unfortunately, what Kathryn didn’t do was listen to her body and get help when she needed it. I see this in a lot of patients; a good rule of thumb is if the pain persists, starts to travel down your arm or leg, and/or keeps you up at night, it’s time to see a physician. Unfortunately, the pain took a turn for the worse when Kathryn further exacerbated her injury lifting a mattress while vacuuming. Kathryn contacted my office and met with me to discuss different options that would work for her injury. Because she had severe nerve compression in her lower back due

February 3, 2015

3-D Printing in Spinal Surgery

In spinal surgery, advancements in technology and medicine have given doctors new ways to combat conditions affecting the human body. Minimally invasive procedures use small incision for less complex procedures; in robotics, surgeons use robotic arms to carry out a minimally invasive procedures with potentially more accuracy. So what about 3-D printing? Technically, it’s been around since the 1980s, but hasn’t been used in medicine until recent years. Commonly used to support or replace body parts that don’t enter the bloodstream, 3-D printing has the ability to fabricate prosthetic limbs, layer by layer, from the ground up. What is 3-D printing? What is 3-D printing? In medicine, 3-D printing, also referred as additive manufacturing, is the process of using plastic or metal gel to shape a replacement body part based on a patient’s MRI or CT scan. 3-D printing is allowing prosthetics to be produced and personalized in complex shapes including hands and fingers. No longer will these devices cost thousands of dollars, removing much of the financial burden patients and their families may face. “If a parent wanted to purchase a 3-D printer of their own and produce hands for their own child, the cost of the printer and

January 27, 2015

Is Robotic Surgery Right For You?

What is Robotic Surgery? Robotic surgery is a term used for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery has the potential to help overcome the limitations of minimally-invasive surgery, and to enhance the capabilities of surgeons performing some types of open surgery. To date, robotic surgery has had its biggest impact in Urological (Prostate) surgery, and general surgery. The applications in Spine surgery have been very limited to date, but we continue to monitor and research this technology. With robotically assisted surgery, the surgeon uses a remote manipulator to control the robotic arms that carry out the movements of the surgery. The advantage of this is to allow for very fine and controlled movements in a tight and inaccessible space, and for potentially improved visualization with the miniature camera systems that accompany the robotic arms, examples of such systems include the DaVinci Robot platform. Robotic surgery has been criticized for its expense, by one estimate costing $1,500 to $2000 more per patient. [1] However, this advanced technology allows surgeons to perform general exams as well as complex gynecological, cardiothoracic, and urological procedures with a minimally invasive approach. Potential benefits of robotic surgery In general,

January 20, 2015

The Pros and Cons of Laser Spinal Surgery

Sustaining a spine injury can be devastating – and can lead to significant pain, dysfunction, and loss of mobility. In recent years, laser spinal surgery has appeared on the scene, touted as a quicker and easier option than typical spinal surgery and performed for a variety of spinal conditions—with mixed results. Many patients with a spine injury try to educate themselves with internet research when trying to decide whether to have surgery, and what type to have. While laser spinal surgery can be less invasive, and effective in some cases with a certain diagnosis, there are many conditions that it is not effective in treating. Laser spine surgery is heavily marketed on the internet and TV as “better and safer” than traditional surgical techniques, and claims to give a “quicker recovery.” These claims are unproven and can be mis-leading. Patients often assume that “laser” means more technically advanced. Before you choose laser spinal surgery, it may be best to do your homework on the facility preforming the surgery. You should also get more than one opinion from an experienced spine specialist. Please contact my practice if you have any questions or are considering laser spinal surgery. What is laser spinal surgery? Laser spine surgery refers to

January 13, 2015

Top Products for Easing Back Pain

It’s that time again: the season of giving! It can be tough to give gifts that are both thoughtful and useful – no one wants to give something that’s going to get tossed the next day – but if you know the recipient well enough, a product that can help ease their back pain might just hit the spot. While the cause of back pain is different for everyone, we’ve spotlighted some of the top products that patients have said help them to prevent or calm existing back pain in their daily lives. And while you’re browsing, think about how these could help your own back pain, too.

December 3, 2014

Back Pain Tops List of Workplace Injuries

Even in today’s world where so many of us spend our days at a desk, back injuries are still the most common workplace injuries, according to a survey from U.S. Healthworks. Of course, outdoor workers and those who must regularly lift heavy objects are the first to be hurt, but those who don’t lift anything heavier than a file folder in our 9-to-5 are at risk as well. If you work does happen to be physically demanding, it doesn’t mean you have to live with chronic back pain; there are things you can do to prevent injuries: Make sure you’re lifting carefully. Take extra care when lifting items that are either below knee level or above shoulder height, as that reach can put added strain on your back. Do your best to avoid lifting things placed on the floor to reduce strain ot the lumbar spine. Remember to bend your knees as you lift and take a break to stretch at least once an hour. Avoid twisting as you lift heavy objects. However, if you must turn, move your feet so you don’t wrench the muscles of the back. If you have to climb stairs, ladder or other structure with

September 16, 2014

All-Terrain Vehicle-Related Spinal Injuries on the Rise in Children and Adolescents

Emergency room visits, specifically spinal cord injuries, are becoming increasingly prevalent amongst children and adolescents. Unfortunately, this increase is occurring from those who use all-terrain vehicles, otherwise known as ATVs. For those of you who are unfamiliar, ATVs are 3 or 4-wheeled motorized vehicles that weigh up to 800 pounds and are popularly used for recreation. Although ATVs are not common on the streets of Manhattan, I am very familiar with the damage they create. There are thousands of ATV-related injuries amongst children and adolescents each year and reports of children as young as eight being treated for an ATV-related injury in an emergency room. The U.S. Consumer Product Safety Commission estimates that there are approximately 2.2 million ATV riders under the age of 16. Countless medical organizations and physicians including myself have recommended that ATVs not be operated by anyone under the age of 16, but legally there is no way to prohibit usage. ATVs have a tendency to flip, making it especially easy for children to sustain spinal fractures from the impact. A study published in the Journal of Pediatric Orthopedics reinforces their danger, “The injury rate for children from ATV accidents has increased 240% since 1997” and

April 9, 2013

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