Q: Is There A Back Pain Risk Scale Test that I can take to evaluate my pain?
A: Please answer these questions below and evaluate your score:
| 1) How old are you? | |
| Under 30 – add 0 30 to 39 – add 1 40 to 65 – add 2 Over 65 – add 3 |
____ |
| 2) Do you smoke? | |
| Yes – add 2 No – add 1 |
____ |
| 3) Are you overweight? | |
| No – add 0 If yes and 0-5 lbs overweight – add 1 6-10 lbs overweight – add 2 11-15 lbs overweight – add 3 16-20 lbs overweight – add 4 More than 20 lbs – add 5 |
____ |
| 4) How often do you exercise? | |
| 0 times per week – add 3 1 time per week – add 2 2 times per week – add 1 3 times per week – add 0 4-7 times per week – deduct 1 |
____ |
| 5) How often do you lift heavy objects? | |
| 0 times per month – add 0 1-2 times per month – add 1 3-4 times per month – add 2 5-6 times per month – add 3 7-8 times per month – add 4 More than 8 times per month – add 5 |
____ |
| 6) Have you already experienced back pain? | |
| Yes – add 3 No – add 0 |
____ |
| TOTAL SCORE: | ____ |
| Scoring Scale: 0 Congratulations! You are doing what you can to prevent spine pain, but it is always important to see Dr. Jones at least once a year to make sure that you are on the right track. Please call (713) 766-0061 to set up an appointment. 1-4 Low risk. You are doing many things right to prevent spine pain, but it is always important to see Dr. Jones at least once a year to make sure that you remain at low risk. Please call (713) 766-0061 to set up an appointment. 5-8 Potential risk. You should change some habits and make an appointment with Dr. Jones to avoid any further damage to your health. Please call (713) 766-0061 to set up an appointment. 9-12 Moderate risk. You should make an appointment with Dr. Jones to learn more about how to prevent any further damage. Please call (713) 766-0061 to set up an appointment. 13-16 Significant risk. You need to change habits now to prevent spine pain. It is imperative that you make an appointment with Dr. Jones as soon as possible. Please call (713) 766-0061, now. 17-20 Serious risk! Spine pain is likely, and you need to visit with Dr. Jones immediately. Please call (713) 766-0061, now. |
Q: What are some common spine disorders and intervention?
A: Here are a few common spine disorders and intervention:
 Arthritis/Degenerative Disc DiseasePart of the normal aging process involves the wear and tear of joints and the tissues which support the joints. The facet joints in the spine are extremely vulnerable to this degeneration process. In addition, the disc tends to dry out and narrow, allowing the vertebra to come closer together and become irritated. Bony outgrowths known as bone spurs may form, narrowing the exit for the nerves and therefore causing irritation.Non-steroidal anti-inflammatory drugs (NSAIDS) may help reduce the process of inflammation of the joints and reduce the pain, stiffness and other symptoms associated with arthritis. Movement and gentle exercise are critical in the maintenance of joint nutrition and function. Strengthening of the muscles surrounding the affected joints is also an effective means of improving the stability of the joint, thereby decreasing the pain and dysfunction.
Bulging or Ruptured Disc Decompression of the nerves is accomplished through a laminectomy, where a small piece of bone is removed from the spine to allow Dr. Jones to access to the damaged disc for removal. A discectomy,or removal of the damaged portion of the disc, can also be accomplished through the use of microsurgical techniques, when a small incision is made, and the disc removed with the aid of a microscope. Spondylolisthesis Spinal Stenosis Spinal stenosis occurs when the tissues and joints of the spine are enlarged to due degeneration or inflammation and the resulting space for the spinal cord and the exiting nerves is inadequate. The pressure on the nerves, and sometimes on the blood supply to the nerves, increases in the standing position, causing increased pain and dysfunction. Conservative treatment of spinal stenosis includes physical therapy, activity modification and management of the inflammation. Some patients respond well to epidural injections, with results lasting from three months to a year in some cases. Surgical intervention is almost always indicated to physically increase the space around the spinal column and nerves to give them adequate room. Surgery is successful in alleviating the pain and discomfort in approximately 80% of cases. Unfortunately, the effectiveness can deteriorate if the patient suffers from significant degenerative disease, due to the progressive nature of osteoarthritis.
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| Q: What is Osteoporosis? A: Osteoporosis is a disease in which your bones have become thin and weak. It occurs mostly in women after menopause. That’s because the female hormone estrogen helps women maintain bone strength. As estrogen levels decline, bone is lost. As bones weaken, they can be more easily broken. However, there are things you can do throughout life to help keep your bones strong. Bones that may be weakened from osteoporosis are more likely to break (fracture). The bones in your hip, wrist, and spine are at the greatest risk for breaking. Your upper back may curve if the bones in your spine fracture. You are at increased risk for osteoporosis if:
If you already have osteoporosis, falls or excessive strain on your back can put at risk for fracture. You can protect yourself from the dangers of osteoporosis by taking these steps:
Living with Osteoporosis If you have osteoporosis, you may need treatment. But in addition to treatment, you can do a lot to reduce the effect of osteoporosis on your life. Knowing how to prevent fractures can help you live more comfortably and safely with this disease. The most common fracture sites in people with osteoporosis are the wrist, spine, and hip. Accidents and falls often cause these fractures. Most fractures are painful and may limit what you can do. But hip fractures are very serious. They require surgery, and it can take months to recover. To reduce your risk of fractures:
Your spine is made up of many bones called vertebrae. Osteoporosis can cause the vertebrae in your spine to collapse. Spine fractures may result from placing excessive strain on your back. As a result, your upper back may arch forward, causing a curvature. Your lower spine then must adjust to keep your body balanced. This can cause back pain. You may also lose height. To prevent or lessen the impact of these spinal changes:
You can protect against fractures by exercising and by doing other physical activities. Exercises that increase muscle strength and improve flexibility help prevent falls. It’s best to do a variety of exercises. Physical activity may slow further bone loss. It can also be fun.
Resistance exercises build muscle strength and make you less prone to injury. Weight-bearing activities such as dancing, walking, and gardening, help your whole body and help you maintain bone mass. Non-weight-bearing exercises, such as swimming or water exercises, may help prevent back strain and pain. They do this by building the trunk and leg muscles. Q: How Can I Prevent Back Pain? A: An unhealthy back often originates from an unhealthy habit like poor posture. In addition, repeated or continuous standing, sitting, or bending causes wear and tear on the joints and muscles of the spine and can lead to painful conditions. To prevent back pain, you must keep the spine healthy by correcting posture and utilizing proper body mechanics in all the activities you perform. Movement is essential in maintaining a healthy back, but the movement must be the right amount and in the right way. Proper posture and good body mechanics are the keys to safe movement. You must remember that your spine bears your weight throughout the day, in every motion you perform. Therefore, you must learn the positions that place excess stress on your spine, causing pain or fatigue. Avoid or limit the amount of time in those positions, and strive to maintain the three normal curves of the spine (see the anatomy series on this site) in the correct positions to limit the wear and tear on your spine and its supporting structures. Q: Can You Explain Why Physical Therapy and Rehabilitation Are Important? A: After a back or neck injury, many people become inactive. Sometimes it is because of the pain. Other times it is because of the fears of reinjury or making the pain worse. But inactivity leads to weak muscles, and weak muscles make it harder to get back to normal activity. A vicious cycle develops. We treat many high-level amateur athletes and otherwise active individuals, and emphasize that they must continue to exercise to keep the injured muscles strong and to develop strength in other muscles to compensate for the injury. The process of using exercise, stretching, muscle substitution, and good muscle mechanics, to help injuries to heal is referred to as rehabilitation. Many patients with back or neck injuries have not had adequate rehabilitation. They may have gone to physical therapy, but only received hot packs, ice, electrical stimulation, and massage. While these modalities feel good, the most effective long-term benefit is from exercise. The job of our physical therapist is to design an exercise program that is safe, effective, and has a low risk of injury for each patient. Our experienced physical therapist will work with you on your exercise program, emphasizing trunk stabilization and strengthening. Eventually you will be discharged from formal rehabilitation, and transferred to an independent program at home or at a gym. A personal trainer is available to work with you on an independent basis to accomplish your long term strength and training goals. Q: How do you make an acurate spinal diagnosis? A: The best mode of management for a spinal problem is based on an accurate diagnosis. Stanley C. Jones, MD and his staff combine the latest diagnostic technology available with their years of experience and their highly specialized expertise to make a complete and accurate diagnosis, and then offer patients the most effective and efficient treatment for their unique problem. Although it is appealing to undergo the newest procedure, or the least invasive procedure, it is critical that the most appropriate intervention be chosen for the dysfunction that is presented by your signs, symptoms and results of diagnostic tests. Some of the diagnostic procedures you may undergo include
You may be sent to our office with these records, or we will refer you to a facility to be tested. If referred to a facility, you will return to our office when the test results are received, and your spine specialist will review and discuss the results with you and determine the best mode of care. You can be confident that Stanley C. Jones, MD and his professional staff work in your best interest to help you achieve total spinal wellness. Q: What do you mean by Spine Anatomy and what are some of the associated conditions? A: Function of the Spine A healthy spine is arranged in three natural curves forming an “S” shape that maintains the structure of the trunk. These curves keep your body in balance as you move and help to distribute your weight evenly throughout the spine. The spine also serves as an attachment for strong, flexible muscles that help support your body, and acts as protection to the spinal cord and its exiting nerves. Bones — 24 moving Vertebrae 7 Cervical Vertebrae Discs Joint/Facets Foramen Ligaments Muscles Q: If I must undergo surgery, what are some of my options? A: Laminectomy/Laminotomy Spinal surgery usually involves either a laminectomy or laminotomy, or the removal or partial removal of a bony part of the spine called the lamina. During a laminectomey, the bone, or lamina, is removed to allow access to the damaged parts of the spine, such as an injured disc, where surgery is needed. The removal of the bone also often relieves the pressure on the nerve. Laminectomies are used when pressure is very extreme. A laminotomy, although used infrequently, removes just a small portion of the lamina. It is performed when Dr. Jones needs to have access to only a small part of a slightly damaged disc. Discectomy Spinal Fusion Cervical Fusion The Fusion Procedure
If Extra Support is Needed Anterior Lumbar Fusion The Fusion Procedure
If extra support is needed then metal supports called instrumentation may be used to help steady your spine while it fuses. These supports are not removed. Dr. Jones may use one or more types of support, including cages, screws, plates or hooks. Posterior Lumbar Fusion Fusing the Transverse Processes
Fusing the Disk Space
If Extra Support Is Needed Metal supports called instrumentation may be used to help steady your spine while it fuses. Dr. Jones may use one or more types of support. Below are two common types of support used with posterior lumbar fusion:
Kyphoplasty Kyphoplasty is designed to provide
Q: If Dr. Jones and I decide that surgery is the best option for me then what should I expect? A: Scheduling Surgery and Procedures will consist of a lead-time of 15 days before surgery is requested. This allows time to meet the requirements of your insurance, and to find time that is convenient to you your doctor. For some insurance companies this may need to be extended. Please contact your insurance company to confirm whether a second opinion is required. Consent forms must be signed prior to scheduling surgery.
Pre-Operative Testing All patients must have testing done prior to surgery to insure that they are healthy enough for surgery. The testing can be done anytime 30 days before surgery up until the day before surgery, at the very latest. It is best to complete this testing as soon as you know you are going to have surgery. If ther is something wrong with your health, of which you are unaware, we will have time to have you evaluated. This may prevent us from having to postpone your surgery. If you have medical problems such as high blood pressure, heart disease, diabetes or any other health problems you will need to have an evaluation by your family doctor or a specialist prior to surgery. As you will not be allowed to donate any blood for surgery until you have this doctors clearance and you will have to take a note from him or her to the blood center with you prior to donating blood. Required testing includes: CBC, UA, SMA-18, PT, PTT (AS A VERY MINIMUM) EKG, CHEST X-RAYS (IF 50 OR OLDER, ANY HEALTH PROBLEMS THAT MAY INDICATE THE NEED TO THESE) Pre-Operative Medicine You will need to make a list of the name of all your medications and their dosages that you are taking. This list should be given to Dr. Jones prior to surgery. You will be told which medications you may take the morning of surgery. ALL MEDICATIONS THAT HAVE ASPIRIN IN THEM SHOULD BE DISCONTINUED 7-10 DAYS PRIOR TO SURGERY. THIS INCLUDES MANY OF THE ANTI-INFLAMMATORIES THAT PATIENTS ARE TAKING. SUBSTITUTIONS WILL BE GIVEN BY DR. JONES FOR SOME MEDICATIONS. All patients are asked to take vitamins prior to surgery and after surgery. This will help you with the healing process. VITAMIN B COMPLEX VITAMIN C 1000 mg VITAMIN D3 Any brand is ok but try and get as close to these amounts with whatever tablets you may take. The Day of Surgery You will be admitted to the hospital the morning of the planned surgery. Do not eat or drink after midnight the night before the surgery. This includes chewing gum. The only exception should be the medications you will be instructed to taken by Dr. Jones. Intra-Operative Neurophysiological Monitoring Of Nerves And Muscles Monitoring of nerves and muscles during certain surgical procedures at the request of our physicians. (All Lumbar Fusion, Endoscopic Procedures and certain difficult Lumbar Laminectomies). There are times and certain procedures that are performed by Dr. Jones that are considered to be much safer if the nerves and muscles are monitored by equipment that would let physicians know immediately if he or any equipment being used is to close to a nerve or muscle that could cause possible damage to either. This equipment is put on the patient prior to the procedures and the nerves and muscles are monitored the entire procedure by a certified technician and under the direction of a Medical Doctor who is certified in these procedures. It is another way to insure to the patient that every thing is being done to protect the patient from any possible injury to nerve or muscles. There is a charge by the company that monitors the patients for the use of this equipment and for the services of the technician that will be billed to your insurance company. Q: Do you have a list of guidelines that I can follow for a healthy back? A: Dr. Jones suggests that you follow these simple guidelines to keep your back in good shape:
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Commonly known as a “slipped disc”, a ruptured or herniated disc is usually the result of excessive wear of the disc and surrounding joints from exaggerated or repeated movement. As the disc wears out, the inner, the jellylike substance that cushions and absorbs the shock of movement for the spine, deteriorates and begins to bulge into the outer rings of the disc, the annulus. The pressure on the annulus can cause a tear and result in pain due to the many pain fibers present in this tissue.
As a disc bulges, its middle or nucleus, moves closer to the outer edge of the annulus. Sudden or repeated motion can cause the annulus to rupture, allowing the material of the nucleus to squeeze out and irritate a nerve. Occasionally, symptomatic bulging or ruptured discs heal spontaneously, requiring no other interventions once the pain has diminished. If pressure on a nerve continues, however, neurological signs such as decreased muscle strength, diminished reflexes, or sensation changes ensue. Permanent nerve damage can result if the pressure on the nerves is not relieved.
Spondylolisthesis is a condition in which one vertebral body slips forward on the next level vertebral body. In most people, no significant pain or other symptoms occur. In about 20% of people who acquire spondylolisthesis, the slippage causes additional disc degeneration and nerve root impingement can result. Most patients suffer low back pain and leg pain is present less commonly. As with other conditions in the back, some patients respond to conservative care such as physical therapy, inflammation management, and altered activity levels. For others, the management of spondylolisthesis can include surgery to remove damaged disc material. A spinal fusion may be indicated to stabilize the spine.
Annulus — Outer rings of cartilage-type material protecting the nucleus.