Back pain

Eat Your Way to Pain Relief

Reaching for the broccoli is typically not the first thing you do when experiencing back pain. The average American diet has no more than 10 percent of calories coming from fruits and vegetables. But if you’re experiencing back pain, particularly pain caused by inflammation, you may want to rethink your diet. Reducing inflammation is easier—and tastier—than you may think. The most common causes of back pain are mechanical; however, inflammation frequently accompanies mechanical problems – for example, in the setting of a strained ligament, disc degeneration, or a herniated disc. Therefore, supplementing the treatment of back pain with the right nutrients can be helpful. Inflammatory back pain is classically associated with myofascial pain, rheumatoid arthritis, or ankylosing spondylitis and is typically worse at rest and relieved by activity. A common complaint with this condition is early morning stiffness. Foods high in saturated fats, trans fats, simple sugars, and white flour can trigger inflammation throughout our bodies, causing joint swelling and back pain. So, instead of reaching for processed food, fast food, or food high in saturated fats, try choices that will actually make you more comfortable. Begin by fighting inflammation and cellular damage with vegetables—the greener the better. Try kale,

April 28, 2015

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

Acupuncture and Back Pain

Does acupuncture work for pain relief? It’s a question that’s been debated by the medical community for some time, but of late, more and more physicians have come down on the side of supporting it, or at least maintaining that it does no harm. In 1998, the National Institutes of Health (NIH) stated that there was enough evidence to show that acupuncture has beneficial, pain-relieving qualities for adults suffering from postoperative dental pain, the nausea of chemotherapy, lower back pain, headache, myofascial pain, osteoarthritis, and carpal tunnel syndrome. There have been several important studies that report acupuncture is effective in reducing chronic pain. Most recently, a study in the Journal of Clinical Pain suggests that people being treated for lower back pain with acupuncture are less likely to gain benefit from treatment if they have low expectations for its effectiveness – an interesting twist to the earlier findings on pain relief. Emotion and attitude seem to have quite an impact on acupuncture’s efficacy. Dr. Felicity Bishop, author of the study, wrote: People who started out with very low expectations of acupuncture – who thought it probably would not help them – were more likely to report less benefit as treatment

April 1, 2015

9+1: Derrek’s Patient Experience

Derrek is a patient of mine who has left a lasting impression – he recently ran his first half marathon after having a 2 level spinal fusion (see his xray to the left). He is a great example of patients who become more physically active after a spinal fusion than they were before, which is a common experience in our practice. Derrek’s back pain began eleven years before his surgery, when one day he woke up with terrible pain in his back. Over the course of the eleven years, after all else failed, his condition deteriorated to the point where he considered surgery. Failing to get the answers he was looking for after speaking to a doctor specializing in psychosomatic symptoms, Derrek came to my office. Here’s what he had to say about his experience: “Dr. McCance really did a great job explaining everything to me and my wife. He told us that surgery is what needs to happen now, or something much worse will happen later. “What I’m most impressed by is that Dr. McCance even explained the differences between psychosomatic therapy and surgery to my wife. He answered all of our questions and gave us two solid options.” Derrek’s options were

March 17, 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

How Weight Loss Can Affect Back Pain

Sure, it’s easier to gain weight than it is to lose it – but at what cost? Studies show that a healthy diet and exercise can help combat obesity and metabolic disease, and prevent future back problems. Weight loss can improve back pain for both men and women of all demographics. I have many patients who have successfully improved their chronic back pain with weight loss and regular exercise. Physical activity increases the exchange of nutrients between spinal discs and other spine structures. When an individual doesn’t participate in enough physical activity, the spinal discs are deprived of the nutrients needed to stay healthy and strong. Increased body weight causes extra stress on the lumbar vertebrae, facets joints, and disks, which can lead to increased rates of injury and pain. People who have difficulty losing weight and keeping it off are at higher risk of developing osteoarthritis, a chronic condition that causes sore or stiff joints due to the breakdown of cartilage that cushions those joints, especially when their BMI is too high. Major Benefits of Weight Loss More energy to participate in everyday activities Potential for improved body/self confidence Lower propensity for stiffness and weakness of joints Minimized recurrence of lower

February 10, 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

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