Ask the Expert: Dr. Jennifer Solomon, physiatrist, answers your questions on non-surgical spine treatment
Q1: What kind of injury could be solved with non-surgical spine treatment?
The majority of spinal injuries can be resolved non-surgically. It is estimated that more than 80 percent of the general population will suffer from low back pain in their lifetime. This low back pain can be caused by a multitude of injuries and conditions including muscular strains, disc herniations, degenerative disc disease, spinal stenosis and osteoarthritis. Although less common, sacroiliac joint dysfunction, spinal tumors, fibromyalgia and piriformis syndrome can also cause low back pain.
Q2. What are some common spine treatments that can keep me out of the operating room?
There are several different treatment options that can keep you out of the operating room, depending on the underlying condition. Physicians typically begin treatment conservatively and advance to more invasive procedures if conservative measures fail. Typically, these treatments include: rest, ice, oral medications (including anti-inflammatories), physical therapy, chiropractic care and alternative medicine.
- Physical therapy – Often the first step in managing back and neck problems. It serves to improve flexibility and mobility while increasing strength. Typical physical therapy treatments include exercise, massage, electrical stimulation, heat therapy, hydrotherapy (aquatic therapy) and more.
- Pain management – Many types of acute or chronic back pain can be alleviated with such treatments as injections, drugs and medications, spinal bracing and others.
- Chiropractic care – Will likely include the adjustment of the spine in order to treat back and neck pain. Chiropractors employ such techniques as applied pressure, massage, and manual manipulation (adjustment) of the vertebrae and joints.
- Alternative medicine – Is a broad term used to describe non-traditional therapies including acupuncture, acupressure, yoga, biofeedback and more. Although supporting research is limited, some people do report experiencing relief from alternative medicine.
Additionally, adopting a healthy lifestyle through healthy eating and exercise habits and adjusting posture and body mechanics will help to keep you out of the operating room.
Q3. What is the treatment time versus surgical recovery time, i.e. which would get be back in the game faster?
The majority of spinal issues are treated conservatively and most resolve within six weeks after non-surgical intervention. Surgical recovery time depends on the type of surgery, the extent of damage, and the individual undergoing the procedure. Typically, this will be longer than the aforementioned six-week time period.
Q4. I’ve heard of the use of steroids for spine treatment. Are there any lasting effects or dangers with this treatment?
There are two types of steroids utilized in spine treatment: oral (systemic) steroids or steroid injections. Oral steroids are employed to decrease inflammation and are prescribed for only a few days at a time, with temporary side effects. These may include an increase in appetite, difficulty sleeping (insomnia), changes in mood and behavior, flushing (redness) of the face, and short-term weight gain due to increased water retention. These side effects usually resolve after a few days once the patient stops taking the medication.
Lumbar epidural steroid injections are also utilized in spine treatment. As with all invasive medical procedures, there are potential risks associated with these injections. Although risks are rare, it is important to discuss them with each professional who will be conducting the procedure.
Dr. Jennifer L. Solomon is a board-certified physiatrist in Physical Medicine and Rehabilitation. Her practice is devoted to using non-operative and minimally invasive treatments of spine and sports injuries. Dr. Solomon serves as a team physician for the United States Tennis Association and has worked at such sporting events as the ING New York City Marathon, other races, and tennis and volleyball tournaments.