Oh My Aching Back!
June 2022 Issue — Pink Prescriptions
Oh My Aching Back!
When it comes to back pain, words such as non-functioning, desperation, unbearable and horrifying are heard by back experts every day. Fact is, back pain can be some of the most severe pain a human may ever encounter. The good news—and there is good news—is much of it resolves in time by the body’s natural healing combined with the help of professionals like surgeons, physical therapists, acupuncturists, exercise physiologists and massage therapists. When it comes to back pain, all modalities are welcome if it leads to relief. If you, or a loved one, has experienced back pain, then you are well aware of the toll it takes on overall well-being and function. Bottom-line: Our backs are truly the back bone of our health. That’s why we asked local experts to radiate their knowledge to help us have healthier backs.
by Tammy Anderson A+ Acupuncture
Back pain is making my life almost non-functional.
I can’t imagine this pain never subsiding.
Is acupuncture an option that can help?
There is more to healthcare than prescription medications, elimination diets or scalpels. Chronic back pain is the top reason people seek out acupuncture services. Scientific evidence continues to grow in support of acupuncture as an effective treatment for back pain. Acupuncture can enable people to live life pain-free without having to rely on pharmaceuticals. The insertion of ultra thin needles into the skin causes the body to release neurotransmitters such as endorphins, serotonin, dopamine, acetylcholine and more.This influences the central nervous system, muscles and connective tissue which alleviates discomfort and pain.
“But I don’t like needles” you say? No one likes needles. One of the biggest misconceptions about acupuncture is that it hurts. Patients may experience some sensations during treatment, as some points are more sensitive than others. However, most patients find they feel nothing at all. Acupuncture doesn’t need to hurt to be effective. When done correctly, acupuncture will alleviate pain and discomfort, not cause it.
Tammy Anderson, DOM, AP, L.Ac. is a renowned authority when it comes to complex conditions, chronic pain, and specifically those cases deemed “hopeless” or “untreatable”. Her focus is treating neuropathy, failed back surgeries, fibromyalgia, migraines, chronic pain, and other complex conditions. Dr. Anderson has been recognized for excellence in advanced integrated pain management techniques, seamlessly blending the time-tested science of acupuncture with innovative modern medical technologies. In utilizing this approach, she gives her patients a real chance at living their lives to the fullest. She has been helping the senior community for more than 14 years and experiences much joy in seeing people live without debilitating, chronic pain.
by Mary Descaro, PT, DPT, OMT-C, Beaufort Memorial Hospital
I often have shooting pains in my back and legs.
Is it Sciatica? What are the signs/symptoms
and treatments for Sciatica?
Although sciatica is a commonly used term, it often causes confusion because it is a symptom rather than a diagnosis. In most cases, sciatica is used to describe pain that radiates downward from the buttock along the course of the lumbosacral nerves. An alternate term for sciatica that you might hear from your doctor is lumbar radiculopathy. Your physician or physical therapist will be able to help you differentiate if the pain is truly sciatica, or if it’s being referred down your leg from another structure such as ligament, joint, or the spinal discs.
Sciatica occurs when material from a herniated disc in the lower spine creates pressure and inflammation around the nerve roots. Symptoms often include: leg pain, numbness, weakness, diminished reflexes and increased pain with coughing, sneezing, or taking a deep breath. In the first six to eight weeks, the best advice is to stay physically active. If able to stay active, most cases will spontaneously resolve within two months. If pain persists beyond eight weeks, your doctor may recommend physical therapy, anti-inflammatory medications, or injections. Spinal manual therapy and surgery (discectomy) have been shown to provide short term relief for some chronic cases.
However, if you have traumatic onset, loss of feeling in genital or bowel area, or disturbances in your bowel or bladder function, this may be a sign of something more urgent and you should contact your doctor right away.
Mary Descaro, PT, DPT, OMT-C is the Clinical Lead Physical Therapist for Beaufort Memorial Outpatient Rehabilitation in Beaufort and Okatie. She holds a Doctor of Physical Therapy degree from the Medical University of South Carolina.
by K. Craig Boatright, MD, Orthopaedic Spine Surgeon
Spine Institute of the Carolinas
There is a lot of terminology around disc injuries. Can you clarify the differences between bulging and herniated discs?
The terms are non-specific and somewhat inaccurate. This is why it is so confusing for people. A bulging disc happens to almost everyone as they age, as the discs no longer contain the same water content as when we are 18. As a disc becomes less plump and dehydrated, it is not as good of a shock absorber. This is considered a bulging disc, but it is not a tear in the disc. However, this condition may contribute to stenosis (narrowing of the nerve canal) and cause pain. An operation is not required for a bulging disc.
A herniated disc is when a disc is torn, also considered ruptured, which allows some of the material inside the disc to escape. This is the cause of pressure on a nerve and severe pain. Occasionally, when a disc herniates, immediate surgery is needed, specifically if there is profound weakness or problems going to the bathroom. Otherwise, 90% of patients who experience a herniated disc do not require surgery. Though extremely painful, a herniated disc can be treated with alternative interventions, such as physical therapy, steroid medications and injections. This condition will get better in most patients, it just takes time. Most people wait 6-12 weeks to try to heal without surgery.
What is the most common complaint spine professionals hear from their patients?
Definitely low back pain or “throwing your back out.” I am referring to non-radiating, non-nerve pain, such as mechanical pain in the back, frozen or “locked up” back or a back sprain. This condition is excruciatingly painful; patients come in wanting an immediate back transplant! Usually, with a day or two of bedrest, along with taking Motrin, Advil or Aleve for inflammation and Tylenol for pain, it will start to improve. Some people experience this condition multiple times, but it is not an indicator of something terrible going bad in your back, even though it feels like it. More than 50% of people by age 65 will have one low back episode. The good news is it resolves itself.
I woke up with a large knot in a muscle in my back. Should I seek medical attention?
A knot is the result of a muscle spasm. This is your body’s natural way to protect something that may be going on along your spinal column. Whether it is a tumor, a disc herniation, or whatever things may occur, they all cause the muscles that run along the spine to spasm up. If you break your leg, the doctor puts a cast or splint on it to keep it from moving to facilitate proper healing. Your body’s natural way to “splint” your back when something goes wrong is to have those powerful muscles become rock hard to stop the motion and allow whatever is going wrong to heal. The spasms don’t last forever. People will say when this first happens it is awful, however, it does not necessarily mean anything ominous. It’s very painful, but it goes away with time. It may come and go, or last anywhere from an hour to several days.
Dr. Boatright is a native of Georgia. He studied biology as a Woodruff Scholar at Emory University before being awarded a Rhodes Scholarship to continue his studies at Oxford University. Upon return to the US, he attended Harvard University Medical School. He completed his orthopedic residency at the University of Washington and a spine fellowship at Emory University. He has practiced in the Lowcountry since 2008.
by Betsy Sears, PT, DPT, Beaufort Memorial Hospital
What can I do to protect my back from injury?
While it is unrealistic to never have aches and soreness, there are steps one can take to prevent back injury and manage pain. Many injuries can be prevented by simply taking your time and being mindful of body mechanics while performing everyday activities, such as when vacuuming, raking leaves, picking up kids/grandkids, etc. For instance, most people know they should lift with their legs but don’t know it is because the back muscles are much smaller than the leg muscles, which are designed to do the job. Another way to protect your back is to strengthen and stretch to address muscle imbalance. Often times our posture is affected by muscles that are tight and muscles that lack the endurance to help us maintain positions for longer periods of time. Someone who sits often for work may have tightness in their front hip muscles. These muscles actually attach to the spine, causing extra strain on your back when you are standing and walking if they are tight. Typically what we work on in physical therapy is addressing these imbalances and reviewing body mechanics, allowing our patients to have the tools to prevent injury and self-manage symptoms in the future.
Betsy Sears, PT, DPT is a Physical Therapist at Beaufort Memorial’s Outpatient Rehabilitation Comprehensive clinic located at the hospital’s LifeFit Wellness Center. She holds a Doctorate in Physical Therapy from the University of Lynchburg.