Uncategorized Archives | Center for Comprehensive Spine Care

Understanding Lower Back Pain

rladmin — Fri, 31 Mar 2023 00:59:47 +0000

It’s one of the most common complaints among Americans. It doesn’t discriminate based on race. It doesn’t favor a certain gender. Lower back pain will afflict 80 percent of all adults at some point in their lives. The end result ranges from mild irritation to crippling pain. Anyone faced with chronic back pain should see an experienced spine specialist to discuss their symptoms and treatment options. Everyone can start their spine health education by learning some basic facts and figures related to this widespread ailment.

A Leading Cause of Distress

Over any three-month period, more than 25 percent of adults will suffer low back pain. Their grievance is far from trivial. Pain disrupts the lives of many people. Back pain is the number one reason people miss work. It’s also the leading cause of job-related disabilities. According to some experts, the problem is only getting worse. Once considered the sixth most burdensome condition in the United States, lower back pain has risen to third place in recent years.

Types of Back Pain

Pain can be acute (short-term) or chronic (long-term). Sometimes the aches disappear within a day. Other people suffer for months, if not years or decades. Roughly 20 percent of people who suffer an acute case of back pain will go on to develop a chronic condition that lasts for up to a year. The type and severity of pain also vary. Some people feel a dull ache that accompanies them through their daily activities. Others experience a sharp, stabbing pain that prevents them from functioning.

What Causes Low Back Pain?

Pain is a symptom of something else. Typically, it results from an underlying condition. Most back disorders are mechanical, meaning they affect the spine, discs, muscles, and/or nerves. Examples include:

Ruptured disks
Degenerated disks
Skeletal problems or irregularities (e.g., scoliosis)
Muscle spasms or strains
Nerve compression (e.g., sciatica)
Acute trauma
Long-term lack of exercise

Och Spine at NewYork-Presbyterian at the Weill Cornell Medicine Center for Comprehensive Spine Care is dedicated to providing world-class medical care to people who suffer from back pain. We remain at the forefront of both research and treatment of spinal conditions. Look through our website to learn more about lower back pain treatment options.

Sources

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Dr. Roger Härtl: Innovations In Microscopic Spine Surgery

rladmin — Fri, 21 Sep 2018 20:59:47 +0000

Becker’s Spine Review

Dr. Roger Härtl: Innovations In Microscopic Spine Surgery

By Laura Dyrda

February 6

· Dr. Roger Härtl discusses recent innovations in minimally invasive spine surgery.

· Dr. Roger Härtl, Director of Spinal Surgery and Neurotrauma and Co-Director of the Weill Cornell Spine Center and professor of neurological surgery

· http://www.beckersspine.com/mis/item/35222-dr-roger-haertl-innovations-in-microscopic-spine-surgery.html

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Back Pain Treatment: When to Consider Spine Injections

rladmin — Fri, 21 Sep 2018 20:59:47 +0000

No matter who you are, you’ll most likely experience lower back pain at some point in your adult life. Most of the time, the pain goes away within a few weeks, but what happens if it lingers and disrupts your daily routine? When should you see a spine specialist to receive lower back pain treatment in the form of steroid injections?

Lower Back Injections: The Basics

Spinal injections are increasingly popular. By reducing inflammation, the injected medications offer relief from the constant pain that accompanies many people through the course of a day. ¹

The procedure is relatively simple and non-invasive. It involves two separate stages. The first stage involves epidural steroid injections (ESI). A doctor injects cortisone and epidurals directly into the spine near the location of the irritated nerve.

The second stage involves regenerative stem cell and platelet injections, a process which helps the tissue to repair itself using the body’s own plasma platelets. In other words, this part of the treatment is designed to help the body heal itself.

Although relatively conservative when compared to spine surgery, spine injections nevertheless have their upsides and downsides. Like many treatments, it comes with rare but real side effects—anything from weight gain to hypertension. ² Injections are not right for everyone, and they are neither the first nor the last course of action recommended by spine doctors.

Conservative Back Pain Treatment: The First Line of Defense

In most cases, physical therapy is the first recourse. Combined with regular exercise, it is the most conservative strategy for relieving pain and addressing underlying issues. That being said, someone suffering from crippling pain may first need to receive injections before taking part in a physical therapy session.

In general, the first line of defense against back pain should include some combination of the following:

Physical therapy
Exercise
Posture modification
Stretching
Ergonomics
Chiropractic care
Acupuncture
Massage

Steroid Injections: The Next Level of Lower Back Pain Treatment

If conservative treatments fall short, steroid injections may be next on the list of remedies, particularly since they are preferable to more invasive treatments. Before turning to the spine surgeon, it’s usually worthwhile to speak with a doctor about ESI.

On the other hand, EMI may not be enough. Injections can alleviate pain in the short term, but they do not necessarily resolve the underlying problem. For that, surgery may be required. In the end, the only way to determine whether injections are appropriate is to speak with a qualified spine specialist.

If you want to learn more about cutting-edge treatments for back pain, or if you want to make an appointment with a doctor to discuss whether ESI is right for you, contact the spine specialists at Weill Cornell Medicine: Comprehensive Spine.

Sources

Consumer Reports. “Epidural steroid injections for back pain: Worth a shot, or should you skip it?” < http://www.consumerreports.org/cro/2011/03/steroid-injections-for-lower-back-pain/index.htm>

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Research Uncovers Bacteria Linking Crohn’s Disease to Arthritis

rladmin — Fri, 21 Sep 2018 20:59:47 +0000

Specialty Pharma Journal

Research Uncovers Bacteria Linking Crohn’s Disease to Arthritis

By Nicole Watkins
February 7

* Dr. Randy Longman’s new study, published in Science Translational Medicine, explains the connection between symptoms of abdominal pain and diarrhea and joint pain, in patients with Crohn’s disease. This discovery could help physicians identify which patients with Crohn’s disease are more likely to develop spondyloarthritis, enabling them to prescribe more effective therapies for both conditions.

* Dr. Randy Longman, director of the Jill Roberts Institute Longman Lab and assistant professor of medicine

* http://www.spjnews.com/ 02/research-uncovers-bacteria- linking-crohns-disease-to- arthritis/

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Weill Cornell’s Spine Care Center Leverages Multidisciplinary Approach: 6 Highlights

rladmin — Fri, 21 Sep 2018 20:59:47 +0000

Becker’s Spine Review

Weill Cornell’s Spine Care Center Leverages Multidisciplinary Approach: 6 Highlights

By Megan Wood

February 9

* The new Center for Comprehensive Spine Care at Weill Cornell Medicine offers patients with spine-related conditions and injuries centralized, multidisciplinary care in one building.

* Dr. Roger Härtl, Director of Spinal Surgery and Neurotrauma and Co-Director of the Weill Cornell Spine Center and professor of neurological surgery

* Dr. Neel Mehta, Medical Director of Pain Medicine, assistant professor of anesthesiology

* Dr. Bridget T. Carey, assistant professor of clinical neurology

* Dr. Jaspal Ricky Singh, assistant professor of rehabilitation medicine

* http://www.beckersspine.com/spine/item/35280-weill-cornell-s-spine-care-center-leverages-multidisciplinary-approach-6-highlights.html

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Lumbar Herniated Disc: What You Should Know

rladmin — Fri, 21 Sep 2018 20:59:44 +0000

Spinal discs play a crucial role in the lower back, serving as shock absorbers between the vertebrae, supporting the upper body, and allowing a wide range of movement in all directions.

If a disc herniates and leaks some of its inner material, though, the disc can quickly go from easing daily life to aggravating a nerve, triggering back pain and possibly pain and nerve symptoms down the leg.

See What’s a Herniated Disc, Pinched Nerve, Bulging Disc…?

Lumbar herniated disc most often affects people afed 35 to 50.
Watch: Lumbar Herniated Disc Video

Disc herniation symptoms usually start for no apparent reason. Or they may occur when a person lifts something heavy and/or twists the lower back, motions that put added stress on the discs.

Lumbar herniated discs are a widespread medical problem, most often affecting people age 35 to 50.

This article covers how a lumbar herniated disc develops, how it is diagnosed, and the available surgical and non-surgical treatment options.

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Radiculopathy

rladmin — Fri, 21 Sep 2018 20:59:44 +0000

Point/Counterpoint

Guest Discussants: Sayed E Wahezi, MD, Andrew Lederman, MD, Eric H Elowitz, MD Feature Editor: Jaspal Ricky Singh, MD

Conservative Treatment Versus Surgery for Lumbosacral Radiculopathy with Muscle Weakness and Loss of Reflexes

What is radiculopathy?

A compressed or irritated nerve in the spine can cause pain, numbness, tingling, or weakness along the path of the nerve. This condition is called radiculopathy. It can occur in any part of the spine, but it is most common in the low back (lumbosacral radiculopathy, sometimes called sciatica) and neck (cervical radiculopathy). Patients involved in heavy labor or contact sports are more prone to develop radiculopathy than those with a more sedentary lifestyle.

What causes radiculopathy?

Spinal disks are located between each vertebra of the spine, acting as shock absorbers when the body moves. A disk is made up of a tough fibrous outer surface with a soft, gel-like inner substance. A forceful movement can injure the lumbar spinal disks, or repetitive straining can gradually damage them over time.

With a mild injury, the disk can be stretched or pinched. With a more severe injury, the outer surface can be weakened, allowing the substance inside to push towards the outside. This is known as a bulging or herniated disk. Disk herniation reduces the amount of space in the spinal canal and compresses the exiting nerve. This is called “mechanical radiculopathy.”

With further damage, the outer surface can tear, and the disk fluid inside might leak out. This is known as a complete herniation or extrusion. The disk material may then irritate nearby nerves as they exit the spinal cord. This is called “chemical radiculopathy.”

How is radiculopathy diagnosed?

A physician will begin by asking the patient his or her medical history and performing a physical examination. During the medical history, the doctor asks questions about the type and location of symptoms, how long they have been present, and what makes them better and worse.

By knowing the exact location of the patient’s symptoms, the doctor tries to determine the nerve that is responsible for the pain. Neurological tests are performed to determine loss of sensation and motor function. Abnormal reflexes and muscle weakness may indicate a source of the radiculopathy.

Imaging may also be useful for diagnosis. Plain X-rays can often see the presence of trauma or osteoarthritis and early signs of tumor or infection. A magnetic resonance imaging (MRI) or computed axial tomography (CAT) scan looks at the soft tissues (nerves, muscles, etc.) around the spine to determine possible compression of the nerves. In some cases, the doctor may order an electromyogram (EMG) which can show if there is damage to the nerve.

How is radiculopathy treated?

Most radiculopathy symptoms go away with conservative treatment such as anti-inflammatory medications, physical therapy, chiropractic treatment, and avoiding activity that strains the neck or back. Symptoms often improve within 6 weeks to 3 months. If radiculopathy symptoms do not improve with conservative treatments, patients may benefit from an epidural steroid injection (ESI), which reduces the inflammation and irritation of the nerve. Read more about ESIs.

If the symptoms continue despite all the above treatment options, surgery may be an option. The goal of the surgery is to remove the compression from the affected nerve. Depending on the cause of the radiculopathy, this can be done by a diskectomy or microdiskectomy.

A diskectomy removes the part of the disk that has herniated out and is compressing a nerve. In microdiskectomy (or microdecompression) spine surgery, a small portion of the disk and disk material impinging the nerve root is removed to provide more room for the nerve to heal.

In the June 2015 issue of Pain Management and Rehabilitation Journal, three physicians shared differing opinions about treatment for lumbosacral radiculopathy with muscular weakness and loss of reflexes. A patient’s case is presented here, followed by a debate as to the best treatment plan. Drs Sayed Wahezi and Andrew Lederman will argue that a conservative treatment plan will help the patient regain full function. Dr Eric H Elowitz suggests that surgery will provide the best outcome.

Sayed E Wahezi, MD, and Andrew Lederman, MD, respond

Logan’s treatment plan is up for debate because current literature supports both nonsurgical and surgical intervention.

Logan has persistent weakness, and his pain is going away. We recommend an ESI because Logan likely has chemical radiculitis. The painful symptoms already have subsided, and motor recovery will likely follow. If a compressed nerve were the cause, the pain would likely persist.

Logan’s case is an example of a complete herniated disk. The herniated disk is the cause of Logan’s muscle weakness. Understanding the composition of the extruded disk material is critical to understanding our case.

Herniated disk material is primarily the gel-like substance that cushions the vertebrae. Due to its chemical composition, this material promotes inflammation. When it comes into contact with the nerve root, nerve pain occurs. We will demonstrate that Logan’s symptoms indicate chemical radiculitis as the cause of his radiculopathy.

As in Logan’s case, radiculopathy with muscle weakness is likely caused by nerve damage. Chemical radiculopathy causes nerve damage due to the direct contact of the thick disk material with the nerves, causing inflammation and decreasing normal neural transmission [1,2]. The nerve heals as the disk herniation recedes from the nerve and the chemical irritants go away. Chemical radiculopathy usually responds well to conservative treatment, while mechanical radiculopathy may not.

A complete disk herniation, as in Logan’s case, often improves without

surgery because of the absorption of the disk material back into the body. In clinical practice, most disk herniations with muscle weakness are caused by inflamed nerves rather than compression. This is substantiated by most patients whose symptoms improve with conservative treatment alone.

Epidural steroid injections (ESIs), physical therapy, and oral anti-inflammatory medicine are important in treating chemical radiculopathy because they all help reduce inflammation [13]. ESIs decrease the chemical irritation to neighboring nerve roots.

Some investigators have even demonstrated the effectiveness of ESIs without steroids, which supports the theory that diluting or “washing away” inflammation-inducing material adjacent to a nerve also could reduce symptoms [6]. Physical therapy may improve spinal blood flow as well as cerebrospinal flow, adding to the washout concept [7]. Finally, oral anti-inflammatory medicine improves the local inflammation [8].

The decision to perform surgery is a clinical one; we must consider the type of herniation, partial or complete herniation, as well as the patient’s pain state. I believe that current evidence and research suggests that physicians should use conservative therapy in cases of mild weakness before considering surgery.

In Logan’s case, he has chemical radiculitis with mild muscle weakness.

His MRI, which depicts a disk extrusion, and his pain that went away on its own, both support this diagnosis. An ESI may reduce local inflammation, ultimately leading to resolution of his chemical radiculopathy.

We must also consider the cost of the services we offer our patients. A head-to-head cost analysis favors conservative, non-surgical treatments, including ESI, physical therapy, and potentially oral medications, for this patient.

Disk extrusions often improve on their own. A trial of ESI has a better chance of improving short-term outcomes than worsening long-term outcomes [5,9]. Furthermore, Logan’s other factors support conservative therapy; his young age, new symptoms, mild muscle weakness, and the limited number of muscles involved all favor a good prognosis without surgery [3,4].

If we were treating this patient, we would closely monitor Logan’s weakness and schedule Logan for an ESI. At this point, we are comfortable watching Logan’s neurologic function, and if there is no return of strength or even progression of weakness in the ensuing 4-6 weeks, we would then consider surgery.

References

Eric H Elowitz, MD, responds

The management of Logan’s condition can be quite controversial. Although his muscle weakness can sometimes appear trivial to the examiner, it can have an adverse impact on function and self-image in active patients. Herniated lumbar disks, one of the most common problems seen by physicians, can produce back pain and other symptoms, including lower extremity pain, numbness, and weakness.

The treatment recommendations for a patient with a herniated disk are based on the initial physical examination, as well as MRI images. Therapeutic options include physical therapy, EPIs, oral steroidal and nonsteroidal anti-inflammatory medications, and surgery [1,2]. Although herniated lumbar disks are common, there is no standard for the timing and order of these therapeutic options [3,4].

Logan is a young, active man with radiculopathy. He is unable to perform a single-leg heel raise, and his MRI scan indicates an extruded disk herniation with S1 nerve root compression. Patients with muscle weakness are clearly more of a treatment concern than those who present with pain alone. In fact, Logan no longer has pain.

Although most patients with herniated disks should initially be treated nonsurgically [5], early surgical intervention can be beneficial for select patients [6]. I believe that, in Logan’s case, a minimally invasive microdiskectomy would be the best treatment.

The Spine Patient Outcomes Research Trial (SPORT) assessed the efficacy of surgery in patients with herniated lumbar disks [5]. Eligible patients were assigned to either the surgery or nonsurgical treatment groups; however, patients could crossover between groups. Patients in both the nonsurgical as well as in the surgery groups achieved substantial improvement over 2 years. A follow-up study of patients at 4 years found that those who underwent surgery achieved greater improvement than patients who did not undergo surgery [7].

Logan has muscle weakness caused by extruded disk herniation. Few studies specifically address the timing of surgery in such patients. Studies by Aono et al [8] and Postacchini et al [9] evaluated the recovery of motor function after a microdiskectomy. Overall, there was a full recovery in muscle strength in 84% of patients with mild muscle weakness and 61% with severe muscle weakness. Regarding the timing of surgery, all patients with a severe deficit undergoing surgery within 1 month of the onset of weakness had a complete recovery in contrast to those undergoing surgery after 70 days, where most had an incomplete recovery of

muscle strength. This finding would argue for early surgery in patients with a severe deficit.

A review of patients with muscle weakness who underwent surgery showed a significant improvement in strength [10]. Maximal recovery occurred within 6 weeks in most the patients.

In evaluating patients with radiculopathy and muscle weakness, I take several factors into consideration. Clearly, the degree of weakness as well its functional impact on Logan must be weighed. One can assume that Logan is a high-level functioning young man who would find even a mild residual muscular weakness and loss of reflexes to be unsatisfactory. In such a patient, I would be much more inclined to recommend surgery earlier rather than later to decompress the nerve root.

Another factor is the MRI findings. I would lean more toward early surgery in patients with a disk herniation or an extruded fragment that is causing significant nerve root compression. In patients with smaller herniations or less-obvious nerve root compression, I would feel more comfortable in nonsurgical measures initially.

Another factor arguing for surgery in Logan’s case is the safe and minimally invasive nature of modern-day microdiskectomies [11,12]. This surgery is provided on an outpatient basis, and most patients can return to work within a week. The recurrence rates are low, generally in the 3-5% range, and the

complication rate is extremely acceptable.

Treating a herniated lumbar disk must be customized to the patient and have a clear goal in mind. For Logan, the goal would be an improvement in his motor strength to prevent permanent disability. As such, I recommend an early microdiskectomy rather than nonsurgical treatment to maximize his chance of a complete recovery.

With this approach, the nerve root would have an opportunity to heal and subsequent treatment, such as a physical therapy, may have a better chance of success in regaining his strength. Ultimately, the decision would have to be one shared between the physicians involved and Logan with a clear understanding of the treatment goals.

References

Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: Navigating evaluation and treatment choices. Am Fam Physician 2008;78:835-842.
Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine 1989;14:431-437.
Legrand E, Bouvard B, Audran M, Fournier D, Valat JP. Spine Sec tion of the French Society for Rheumatology. Sciatica from disk herniation: Medical treatment or surgery? Joint Bone Spine 2007; 74:530-535.
Sharma H, Lee SWJ, Cole AA. The management of weakness caused by lumbar and lumbosacral nerve root compression. J Bone Joint Surg Br 2012;94-B:1442-1447.
Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonopera tive treatment for lumbar disk herniation: The Spine Patient Outcomes Research Trial (SPORT): A randomized trial. JAMA 2006; 296:2441-2450.
Peul WC, van den Hout WB, Brand R, Thomeer RT, Koes BW; Leiden-The Hague Spine Intervention Prognostic Study Group. Prolonged conservative care versus early surgery in patient with sciatica caused by lumbar disc herniation: Two year results of a randomized controlled trial. BMJ 2008;336:1355-1358.
Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar disc herniation: Four-year results for the spine patient outcomes research trial (SPORT). Spine (Phila Pa 1976) 2008;33:2789-2800.
Aono H, Iwasaki M, Ohwada T, et al. Surgical outcome of drop foot caused by degenerative lumbar diseases. Spine (Phila Pa 1976) 2007;32:262-266.
Postacchini F, Giannicola G, Cinotti G. Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br 2002;84-B:1040-1045.
Ghahreman A, Ferch RD, Rao P, Chandran N, Shadbolt B. Recovery of ankle dorsiflexion weakness following lumbar decompressive surgery. J Clin Neurosci 2009;8:1024-1027.
Dasenbrock HH, Juraschek SP, Schultz LR, et al. The efficacy of minimally invasive discectomy compared with open discectomy: A meta-analysis of prospective randomized controlled trials. J Neu rosurg Spine 2012;452-462.
Parikh K, Tomasino A, Knopman J, Boockvar J, Ha¨rtl R. Operative results and learning curve: Microscope-assisted tubular microsurgery for 1- and 2- level discectomies and laminectomies. Neuro surg Focus 2008;25:E14.

Keywords

Chemical radiculopathy: With a complete disk herniation, the outer surface can tear, and the disk fluid inside leaks out; this disk fluid irritates the nearby nerves as they exit the spinal cord.

Compressed nerve: Sometimes called a pinched nerve, this condition is caused when if a spinal disk weakens or tears and puts pressure on a spinal nerve.

Mechanical radiculopathy: When disk herniation reduces the amount of space in the spinal canal and compresses the exiting nerve.

Motor function: The ability of the nerves to convey sensory and motor impulses to the body.

Radiculitis: Terminology used to describe the neurological symptoms felt as a nerve is pinched, compressed, irritated, or inflamed.

Radiculopathy: A set of conditions in which one or more nerves do not work properly, resulting in pain, weakness, numbness, or difficulty controlling specific muscles.

Spinal nerve: A nerve that carries motor, sensory, and autonomic signals between the spinal cord and the body. There are 31 pairs of spinal nerves, one on each side of the vertebral column.

Vertebrae: The bones that make up the spinal column. In between each vertebra lies a disk.

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Dr. Härtl Wins AOSpine’s Regional Educator of the Year Award

rladmin — Fri, 21 Sep 2018 20:59:44 +0000

Michael Grevitt, Chair of the AOSpine Education Commission and Course Director of Davos Courses 2016, presents the Regional Educator of the Year Award to Dr. Roger Härtl in Davos, Switzerland.

Dr. Roger Härtl, professor of neurological surgery and director of the new Weill Cornell Medicine Center for Comprehensive Spine Care, has been named the AOSpine Regional Educator of the Year. The award was presented yesterday at the annual meeting of AOSpine in Davos, Switzerland. Dr. Härtl was honored by the global spine society for his international leadership role in educating neurosurgeons in minimally invasive spinal surgery (MIS) techniques.

The Regional Educator of the Year Award recognizes a highly respected member of the AOSpine Community who has demonstrated sustained and significant contribution to educational excellence. Dr. Härtl has chaired several AOSpine MIS courses over the past three years and has developed much of the innovative educational material used in those courses. The 2016 course, for example, introduced a new surgical simulator to teach surgeons less invasive spinal surgery.

Dr. Härtl also played an integral role in the creation of the AOSpine Minimally Invasive Spinal Surgery Online Modules, which debuted at the 2015 course in Phoenix, Arizona. To develop those modules, Dr. Hartl worked with the AO Education Institute and AOSpine Education International to create procedural videos, illustrated step-by-step guides, and a webinar in addition to selecting pre-course reading and two cases for online discussion.

Dr. Härtl is a sought-after speaker and faculty member at MIS conferences and courses worldwide, and co-hosts (with Dr. Luiz Pimenta) his own MIS and navigation CME course in New York City each December. ( Get more information on that course here.)

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The Upright Truth: How a Healthy Spine Supports Overall Wellness

rladmin — Wed, 30 May 2018 20:59:49 +0000

The importance of the human spine to overall health begins with a flexible support structure and extends to every nerve in the body. Weill Cornell Medicine Center for Comprehensive Spine offers services from experienced specialists to keep your spine – and the rest of you – in healthy balance.

Whether you sit focused at a computer screen all day, or if your work is physical, taking care of your spinal health ensures all of your systems are well supported and protected. There are many helpful steps you can take to keep your spine limber and strong.

Why Is the Back Important to Health ?

Keeping the body upright and balanced, supporting our heavy heads, and protecting the central nervous system are the primary functions of the spinal column. It provides the flexibility to twist and bend as well as anchors the structures of the arms and legs to the body center.

When the spine is strained, injured, or misaligned, the other systems that anchor to it must adjust. Shoulders, hips, knees, and feet all might show the strain of spine health problems. If the spinal cord or the network of nerves connected to it are pinched or constricted, nerve pain that radiates down the leg, arm, or up the neck might occur.

Take Care of Your Spine and It Will Take Care of You

These daily habits will keep your spine healthy:

Stand Solidly

Practice standing with your feet slightly apart. Roll your shoulders back and keep your chin level. Relax your shoulders and jaw.

Sit Straighter

Sit back in your chair until the base of your spine touches. With your feet flat, pull your chest up and shoulders back, straightening your spine.

Sleep Sideways

Try not to lay on your stomach for long periods of time. On your side is an ideal sleeping posture. Pillows should be just thick enough to align your head to your spine.

Exercise Easily

Warming up your muscles before exercise and building up muscle strength gradually will protect your spine and joints from injury later. Yoga and massage can improve balance and relieve muscle spasms.

Lift Low

With the load in front of you, bend to a squatting position, pick up the object, then lift yourself up with your legs. Don’t twist or bend over. Put it down the same way.

Shop Shoes

Good shoes support your healthy spine and help you keep your footing. Make sure they are non-skid and are snug enough in the heel to prevent rolling the foot to either side. They should have good arch support and allow your toes to spread out naturally.

Another Vital Support System

The spine specialists at Weill Cornell Medicine Center for Comprehensive Spine Care offer the best options to bring your spine back to peak health and keep it there. Starting with non-invasive treatments like holistic spine treatment and a variety of physical therapy solutions, as well as performing minimally invasive surgery when necessary, our balanced interdisciplinary team brings the most innovative approaches to treatment.

The esteemed physicians at Weill Cornell Medicine include experts in primary care as well as a diverse range of specialties, from cardiology to endocrinology and diabetes to reproductive medicine to vascular surgery. Our doctors are faculty members of Weill Cornell Medical College, among the top-ranked clinical and medical research centers in the country; they are also attending physicians at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, one of the most comprehensive care facilities in the world. Please use our contact us page to schedule an appointment with a provider (new and existing patients), access your medical records, contact your physician, or with billing, technical, or general questions.

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Common Sports Injuries that Require Treatment

rladmin — Fri, 16 Mar 2018 20:59:49 +0000

Athletes push their bodies to the limit every day. Weekend warriors carry out a less rigorous training schedule, but they too face the risk of injury every time they lace up their running shoes or hit the court. Here are some of the most common types of sport injuries and the treatments available at the Weill Cornell Medicine Center for Comprehensive Spine Care.

Slipped Disc

The spinal column is made up of many bones, called vertebrae. Between these bones sits a cushion, called a disc. When the soft tissue inside of this disc bulges through a tear in the rougher exterior, it’s called a slipped or herniated disc. Slipped discs can result from repetitive motion or traumatic injury suffered during a game of contact sports (e.g. football).

Bulging Disc Treatment

Rest
Pain medications
Steroids
Back physical therapy
Minimally invasive surgery ¹

Spondylolysis & Spondylolisthesis

Spondylolysis occurs when the connections between the vertebrae of the lower back weaken to the point of causing fractures. These stress fractures can further weaken the bones, leading to a condition called spondylolisthesis, in which a vertebra slips out of place. Both conditions can cause back pain.

Back Pain Treatment

Rest
Non-steroidal medications
Steroid injections
Surgery ²

Neck Pain & Injury
Many athletes suffer neck strains (muscle injuries) and sprains (ligament injuries). A blow to the neck or head can cause such soft tissue injuries. Repeated movements can also put pressure on the neck, causing wear and tear that weakens the muscles and ligaments. In severe cases, neck fractures and dislocations can occur.

Treatment

Rest
Pain medications
Spinal injections
Physical therapy
Surgery ³

Tendon Ruptures

Tendons are fibrous bands of tissue that connect your muscles to your bones. An injury that cuts through the entire tendon is called a rupture. An athlete can rupture the Achilles tendon (which connects the calf to the heel), or the quadriceps tendon (which connects the thigh to the lower leg), or the patella tendon (around the kneecap). Those who jump or run are particularly prone to such ruptures.

Tendon Rupture Treatment

Minimally invasive surgery to reattach the tendon; and/or
Splinting ⁴

Knee Injuries

The knee is the largest joint in the body. It’s also complex. Knee injuries are common among athletes, and they come in many varieties—bone fractures, meniscal tears, dislocations, and sprains.

Knee Injury Treatment

Ligament reconstruction
Knee replacement
Arthroscopic surgery to repair cartilage ⁵

About Weill Cornell Medicine Center for Comprehensive Spine Care

The Center for Comprehensive Spine Care at Weill Cornell Medicine is a state-of-the-art clinical facility with 15 doctors across four spinal specialties, including neurology, pain management, rehabilitation medicine, and neurological surgery.

The expert specialists at the Center for Comprehensive Spine Care take a collaborative approach to care and treat a range of spinal conditions and injuries, from scoliosis to spinal compression fractures to schwannomas (benign tumors). To schedule an appointment with one of our providers, please call 888-922-2257 or use our contact form to send us a message.

Sources

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