Chronic Pain: Dealing With Back and Neck Pain (cont.)

Moderator: Member question: Can you recommend any a particular exercise regime to help prevent and/or lessen chronic back pain?

Heary: Yes. One of the newer treatment methods we have had a lot of success with is use of a large fitness ball. These are large rubber balls filled with air that are between 22 to 26 inches across. I routinely have patients of mine do both abdominal exercises (sit ups) and back exercises (extension) while laying on the fitness ball. This provides an excellent method for stabilizing abdominal, back, and side of the trunk muscles. By strengthening all the trunk muscles, chronic back pain can be lessened.

janice519_webmd: Where to go now -- I have a significant tear on the back right and a small on the right side (L5 S1). 5/2000 had and the IDET without positive results and performed again 3/ and again without positive results. Pain is in low back (very sensitive to the touch), down both buttocks, then down the outside of the right leg to the knee periodically to the ankle and on the left on the outside to the knee, bypass the calf and the bottom of my foot on the arch. My doctor and I are frustrated because of the multiple symptoms. Which disc do you think are affecting these?

Heary: This brings up an interesting point. Patient is referring to an IDET procedure (intradiscal electrothermy). This is where the disc is heated with a coil to reduce back pain. I have written an editorial on this topic in the Journal of Spinal Disorders. I see far too many people with this exact same story. I am skeptical of the long-term results with the IDET procedure, and my suggestion to anyone who had this performed and who is not happy with the results, that they be evaluated by a spine surgeon who does open surgery to determine whether or not a fusion would be useful.

Moderator: We are almost out of time. Before we say goodbye, do you have any closing comments for us?

Heary: Yes, I do. I think it is important for all to realize that all neurosurgeons are spine specialists. They have an extensive amount of training with a minimum of 6 years of residency training after completion of medical school. This is the most rigorous residency program of any specialty. As a result, neurosurgeons are highly trained specialists when it comes to spine disorders. To address each area separately, problems in the neck are usually due to a disc that may cause neck pain or into the arms, and possibly the hands. If the spinal cord is affected, the result will be difficulty walking, with balance, hand numbness, and sometimes additional problems with the legs. When the spinal cord is compressed, surgery will be the best treatment. If the spinal cord is not compressed, then attempts at conservative treatment should be tried. As far as the lower back is concerned, as a general rule, it's better to avoid surgery whenever possible. If there is a back problem, see your local doctor for a preliminary workup, and a trial of conservative therapy is appropriate. Only when these have failed should surgical intervention be performed. If you are undergoing surgery, find out who the best spinal surgeon is in your area. Like all specialties in medicine, and outside of medicine, some specialists will have better reputations than others.

Moderator: Thank you for joining us today, Dr. Heary.

Heary: Thank you for chatting with me today.

The opinions expressed herein are those of the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.



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