According to the National Spine Health Foundation, about 100 million Americans suffer from chronic neck or back pain each year. It’s the number one reason for physical pain and leads to hundreds of millions of dollars in lost workdays each year.
KERA’s Sam Baker talks with Dr. Michael Catino, an orthopedic spine surgeon with Texas Health Denton, about why back and neck pain is so widespread.
Dr. Catino: The spine is part of the body where if you start to lead a lifestyle where you’re not exercising, where you are not cognizant of your posture, these are all things that can really contribute to a generalized deconditioned state where you just will struggle more with the chronic neck and back pain that comes from it.
Baker: So, some of this is a naturally occurring thing, and some are things maybe we could have avoided?
Dr. Catino: Sometimes, in the end, the patients who come to me with various radiographic studies of their spine, you’re always going to see disk bulges and bone spurs and other abnormalities. These are the normal aging findings that you’re going to see in the spine. We all are going to have that to some degree as we get older.
But here’s the deal. A lot of folks have these kinds of radiographic abnormalities with no pain whatsoever. So, the question really becomes: Why is it that some patients with these degenerative spinal conditions really do quite well and some don’t?
A lot of it simply comes down to how well they take care of themselves: Watching their weight, make sure they’re maintaining good core muscle strength, good spinal flexibility, aware of their posture, aware of the ergonomics when they’re working, from standing working desks to using different lumbar pillows, for example.
Baker: Do people ignore that kind of pain when it comes about in the beginning? Or perhaps rely more on over-the-counter medication?
Dr. Catino: Yes. I think that’s fairly common. Back pain is ubiquitous, right? A lot of folks are going to have episodes of pain that at times can be quite significant, but the first line of treatment is always a period of rest, using anti-inflammatories such as Advil, Aleve, ibuprofen, potentially Tylenol and let it run its course.
Baker: When should you see a doctor?
Dr. Catino: Falls from ladders, trauma events, infectious pictures, where there’s associated fevers or chills or weight changes to suggest more significant underlying cause. Patients who have pinched nerve pain acts debilitating. Some patients with a disk herniation or severe pinched nerves pain that goes all the way down the arms or the legs, when the pain becomes debilitated clearly, that’s another good time for the patient to seek out medical care.
Baker: Does surgery have to be an option or are there other alternative methods for dealing with that pain?
Dr. Catino: More often than not, patients will do very well with non-operative treatment, often physical therapy and or chiropractic therapy, medical management with pain medication, steroids.
There are some other medications such as gabapentin or Lyrica that are very effective in managing pinched nerve pain.
Spinal injections are usually a nice in-between between that medical management and surgical management.
But in the end, you know, patients who ultimately end up having an operation for pinched nerve pain are those patients whose pain is just so substantial that they can’t tolerate anymore or the options that we just discussed just haven’t been effective in getting their pain under control.
Baker: So what steps should we routinely take to maintain or protect the spinal health?
Dr. Catino: It really just comes down to trying to optimize your overall physical health. The earlier it starts, the better. Just make sure that you have a regular home exercise program, whether you want to do yoga or Pilates or weight training, that again, emphasizes that core strength. If you do those things and you stick with it on a regular basis, simply the best thing you can do to maintain good spinal health.
RESOURCES:
Steps to maintain/protect spine health
30 Tips for Spine Health Prevention & Wellness
UC San Diego Researchers Discover Why Chronic Low Back Pain Feels “Personal”
Update on Non-surgical Treatments for Lumbar Pain
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