The spine is one of the hardest-working components of your body, yet not many people pay attention to their spine’s health. Dr. Howard Robinson at Ingalls Health System in Harvey, Ill. Offers some insight into how patients can keep their spines at the forefront of their health care. Dr. Robinson is a physiatrist who is board certified in physical medicine, rehabilitation and pain management.
Q: What is the most common spine ailment and what is its usual cause?
A: In younger patients it tends to be more muscular mediated, and a little less commonly, disc related. Muscular problems in the low back can be exceedingly painful. Herniated discs can be a problem when they push on or cause inflammation on the nearby nerve.
Older patients can have disc or muscular problems, but it’s more likely to be related to the osteoarthritic changes in aging. The pain tends to be in the low back radiating into the lower extremities that is worse with walking and much better with sitting.
Q: What is the most common treatment(s) for spine injuries?
A: Most back pain resolves on its own, but if it doesn’t, we typically start with the least invasive options. We usually have patients try physical therapy first. Most of the time a very good physical therapist will be able to help the patient rather quickly and painlessly. In addition, we will often use medications to help with the pain.
Injection treatments have been very helpful for many of my patients. Surgery continues to be a good option for pain, especially for patients with coexisting weakness. Acupuncture, massage, and nutrition consultations can be very helpful. Weight loss can help significantly with low back pain: The lighter the load on the spine, the better it will feel. Smoking cessation can also be very helpful.
Q: What about chiropractic?
A: Unlike a lot of physicians, I feel that chiropractic treatments can be helpful. From my experience it seems that chiropractors can be very helpful for joint and muscle problems and less helpful for nerve-related problems.
Q: What can people do who are in jobs that stress the spine, such as heavy lifting or sitting for long periods of time?
A: Short of getting a new job, use good biomechanics with the lifting – lifting with the legs rather than with the back. In jobs that require lengthy periods of sitting, change positions as often as possible, getting up and walking around the office or going for a walk at lunchtime.
Q: If a person thinks he or she may have injured the spine, how long should someone wait before seeing a doctor if the pain doesn’t subside?
A: Most of the time, low back pain occurs gradually over time. I would suggest seeing a physician sooner rather than later if the pain does not resolve after about a week or two. If there’s weakness associated with the low back pain, their physician should be seen as soon as possible.
Q: Should heat, or cold, be used on an injury/surgical site?
A: I suggest using cold for an acute injury. If the low back pain started within two to three weeks I would suggest using only cold, alternating with 20 minutes of cold on the painful site, then 20 minutes off, and so on, for hours if necessary. You don’t want to risk frostbite by leaving the ice on too long. Packaged frozen vegetables work well; they can be molded to fit and can be refrozen.
Heat tends to work better on chronic conditions; it helps loosen up muscles. We do caution patients not to leave heat on to long as it can actually burn the skin.
Q: Can exercise strengthen the spine?
A: Absolutely; it can strengthen the muscles that support the spine. Often my patients are instructed to avoid doing weight lifting exercises above their shoulders because it produces a significantly compressive force on the spine.
Ingalls Health System Spine Center
One Ingalls Drive