spine pain

Tips For Managing Chronic Back Pain If You Have A Desk Job

/ Thomas Cohn, MD

chronic back painMillions of Americans work desk jobs or in a position where they are very sedentary for an extended part of their day. If you sit for eight hours a day, five days a week, it’s not uncommon to develop back discomfort or even chronic back pain. However, if you are a little proactive in how you approach your job and life outside the office, you can work to reduce or completely alleviate your back pain. In today’s blog, we share some tips for reducing lower back discomfort if you work a desk job.

Combating Back Pain If You Work A Desk Job

You don’t need to completely overhaul your life to combat back pain if you work a sedentary job, you just have to make a few tweaks to your daily routine, and odds are you’ll notice a big improvement in your symptoms. Here’s a look at some of the ways to help reduce back pain if you’re stuck at a desk for an extended period each day.

1. Break Up Long Seated Periods – When you’re seated for a long time, your spine is holding static stress, oftentimes in the lumbar spine. This may not feel all that strenuous in the moment, but over time it will break down structures and contribute to continued pain. Try to get up and move for a couple minutes at least once an hour. Even if that’s just walking to the end of the hall and back or to refill your water bottle in the break room.

2. Stand – Standing will help to take pressure off your lumbar spine and better disperse the stress of gravity and your body weight. See if you company will invest in a sit-to-stand workstation, or find ways to incorporate more standing in your day. Take that conference call on your feet!

3. Exercise – When you’re not in the office, commit some time to an exercise routine. Make sure that these exercises don’t overlook your core, because core stability helps to support your spine. Don’t just focus on your arms and your legs, do some core strengthening exercises, and you back will become stronger and better able to handle stress.

4. Mind Your Diet – A poor diet can be pro-inflammatory, whereas a healthy diet can help to calm inflammation that could be compressing areas in your spine. Plan ahead so that you have healthy meals at the office and you don’t fall in the habit of grabbing fast food because you’re ill-prepared.

5. Posture Checks – Poor posture can also put additional stress on your lumbar or cervical spine, so if you are going to be seated for an extended period, make sure that you have ideal posture. Regularly check your posture to make sure that you’re sitting up straight, with your head directly above your shoulders. Make corrections any time you notice that you’re out of alignment.

6. Connect With A Specialist – If you’re still dealing with chronic back pain even after pursuing some of these techniques, connect with a specialist like Dr. Cohn. He can get to the bottom of your spine pain and suggest additional conservative techniques to help manage discomfort. If more hands-on care is needed, he can provide pain-relieving injections or perform a minimally invasive procedure to put an end to your pain.

For more information, or to talk to a specialist about your back discomfort, reach out to Dr. Cohn’s office today at (952) 738-4580.

How To Win Out Over Chronic Back Pain

/ Thomas Cohn, MD

chronic back painChronic back pain affects tens of millions of Americans on a regular basis, and it’s one of the most common conditions that we help treat. Because the spine is complex and pain is so individualized, figuring out the best way to treat the issue can be difficult. In today’s blog, we take a closer look at some of the best things you can do to help reduce or eliminate your chronic back pain.

Tips For Treating Chronic Back Pain

There’s no perfect playbook for treating chronic back pain, but we’re confident that if you pursue a few of the below tips that you’ll have a good chance of making some headway.

Visit A Specialist – Now is not the time to turn to the internet or your general practitioner for answers about your back pain. It’s been going on for far too long, and now is the time to visit a chronic pain specialist like Dr. Cohn. A specialist will have a wealth of experience in all aspects of your chronic pain condition, and they’ll be better versed to provide you with an accurate diagnosis that will lead into a comprehensive treatment plan.

Adjust Your Diet – Eating an extra helping of vegetables won’t miraculously cure your back pain, but improving your dietary intake can help your back get the healthy vitamins and nutrients it needs to perform optimally. A healthy diet can also help you lose some weight, which will take some stress off your spine and can help to curb your symptoms. Diet adjustments can be a key part of reducing your chronic back pain.

Exercise – Exercise is one of the best and easiest things we can do for our spine health and our total body wellness. Regular exercise improves blood flow and strengthens key structures so that they are better able to handle the physical stress we put on our bodies. Combine exercise with the above point and you can shed some weight and take pressure off your spine. Strive to get 30-45 minutes of moderate-intensity exercise 4-5 times a week to help strengthen your spine.

Physical Therapy – Along a similar vein, physical therapy is one of the most commonly prescribed treatment techniques for a range of chronic back pain conditions. PT will specifically target underdeveloped muscle groups or work to stabilize key structures, so the benefits are directly tied to the affected area. You just need to make sure you are consistent about following through with your exercises.

Mental Health Improvements – Finally, as we’ve talked about on the blog in the past, a chronic pain condition is rarely just a physical issue. Being in constant pain for an extended period of time can do a lot of damage to your mental health, which is why treatment also needs to focus on your mental health. Your chronic pain specialist can help explain how stress, anxiety and the effects of your chronic pain condition are impacting your mental health, and they can work to develop an individualized care program for it. Do some things that challenge and exercise your mind each day just like you are for your physical health.

For more information, or for help with your chronic back pain condition, reach out to Dr. Cohn’s office today.

How To Battle Back Against Nagging Spine Pain

/ Thomas Cohn, MD

nagging back painBack pain is one of the most common health conditions in the world, and tens of millions Americans deal with one form of the condition every single day. Spine pain can make even the most mundane activities painful, and it can really impact our quality of life, so it’s not something you should try to ignore and push through. Only treating the problem head-on will help put an end to your nagging back pain. We explore some ways to fight back against nagging back pain in today’s blog.

Treating Chronic Back Pain

This is far from a one-size-fits-all solution to chronic back pain, but odds are you’ll find some form of relief by pursuing one or more of the following techniques. So if you want to take back control over your nagging back pain, consider:

Getting A True Diagnosis – The spine is a complex structure, so if we’re researching our symptoms online, it can seem like we’re dealing with one thing when we’re actually dealing with something else. If you treat the wrong underlying condition, odds are you aren’t going to find relief. Head to a pain management specialist to get a comprehensive diagnosis and a treatment plan catered to your individual needs.

Pursue Active Treatment – For the majority of spinal conditions, rest alone isn’t going to solve the problem. We need to actively work to strengthen injured or nearby structures so that our body is up to the physical tasks we demand of it. Exercise, targeted stretching and physical therapy are all great ways to strengthen your spine and help achieve symptom relief.

Proper Medication Management – We’re not here to tell you to ditch the opioids and pain medications because we know from first hand experience just how integral they are to some patient’s pain care plan. However, you need to make sure that you are maximizing the benefits of these opioids, because eventually you’re going to build up a tolerance. If painkillers help make movements less painful, use that time to go to the gym or perform your PT exercises. Pain medications play a key part in pain management, but for full benefit they need to be paired with active treatment options.

Treat Your Mind – It’s also important to care for your mental health while you’re trying to tackle back pain. Your mindset plays a key role in the success of treatment as well as your willingness to partake in helpful activities like rehab or PT. Talk to your doctor about any negative thoughts or anxious feelings you’re having, and find healthy ways to help take your mind off back pain. Psychological and physical well-being are often connected, so don’t ignore one while trying to treat the other.

Stick With It – Finally, really dive into a care plan routine and see it through. You’re not going to lose weight and make your New Year’s resolutions if you stop going to the gym after a week, and you’re not going to see much progress if you skip physical therapy sessions or make poor dietary choices. Really commit to a back pain treatment plan, and we’re confident you’ll see positive results soon enough.

For help with any aspect of your back pain management, reach out to Dr. Cohn’s office today.

Is Low Back Pain Inherited?

/ Thomas Cohn, MD

back pain inheritedA frequent question I receive from patients is whether low back pain is just your fate and if it’s inherited. This is an especially hard question to answer, but genetics may influence the fact that you develop problems with your back. There are many conditions that may cause low back pain, and some of them are linked to your genes and thus could be inherited.

Back pain that may have genetic causes include scoliosis, inflammatory arthritis, osteoporosis, spondylolisthesis, obesity and possibly even lumbar degenerative disc disease. Back pain in younger people tends to be more related to traumatic causes such as force exhibited on discs, joints and muscle sprains. In older adults, the lists of causes of back pain are often associated with lifestyle issues as well as genetic causes.

Inheriting Back Pain

There are certain causes we know that have definite genetic causes and have direct links to back problems. One of the most common is scoliosis. About 3 percent of the population has scoliosis, and in most cases it is usually a minimal curvature without any significant impact on the back mechanics, and therefore it does not cause pain. Most scoliosis is considered idiopathic, and that implies that we have no idea why it is present, but there is a family association of roughly 30 percent and thus there is likely some sort of genetic component. Another five percent of scoliosis is associated with a variety of neurologic and musculoskeletal disorders, like Marfan’s syndrome or muscular dystrophy, and these diseases are definitely related to genetic causes. A lot of these latter diseases are associated with significant curvatures of the spine and the structural abnormalities are painful.

Another category of genetic causes of back pain are related to certain inflammatory disease that are linked to arthritis. These are disease like rheumatoid arthritis, lupus, psoriasis, and ankylosing spondyloarthritis. All of those problems can cause a variety of structural changes to the spine, especially to the joints as well as to the discs and bones. These conditions can lead to structural and motion changes, whic could cause spinal narrowing and nerve irritation. The combination of physical changes in the spine often results in pain.

Degenerative Disc Disease and Osteoporosis

Research out of Kings College in London in 2012 identified a gene known as PARK2 that occurred in some 65-80% of those people whom have lumbar degenerative disc disease. As everyone ages, the discs do degenerate by losing hydration and shrinking in height. This may lead to some changes in movement patterns in the spine, and also lead to bony changes in joints and discs. Sometimes these changes can cause narrowing where the spinal cord is and where the nerves exit the spine. In some people these changes are painful, and in many they are not since the body can adapt to many things, especially if the change is very slow.  

One common but often not recognized disorder that more commonly affects women is osteoporosis, which is commonly inherited. Thinning of the bones oftentimes occurs in the spine, which may cause the vertebral bodies to fracture and collapse downward. Sometimes these fractures are painful, and many times they are not, but the overall changes to the spine may lead to motion changes, muscle changes, and spinal narrowing, which may cause pain.

The overall answer to the question of whether your low back pain is due to genetics and is inherited is maybe. There are many things that can contribute to back pain and some of the most common issues are lifestyle related. A lack of exercise and obesity may be one of the most serious problems in our modern society. Many of us sit at desks all day long, eat too much food, and spend the evening in front of the television. Changing factors that one can control like the amount and type of exercise is often one of the most important strategies to treat back problems. One can not often change the inherited factors, but one often can change their impact by controlling your environment and lifestyle.

Discograms – What are they & When are they Useful?

/ Thomas Cohn, MD

discogramA discogram is a special x-ray study of the intervertebral discs in the spine.  The test is used to determine the structural integrity of the disc and whether the disc is painful when pressurized.

The Procedure

During the study, a needle is placed in the disc and dye is injected into the disc.  The study is done under real-time fluoroscopy. Normal discs are not painful.  Abnormal discs may or may not be painful.  Tears in the outer layers of the disc and whether the disc actually leaks contents can be determined with a Discogram.  Any disc in the spine can be examined in this way but it is most useful in the lumbar region.

When Discograms are Useful

Discograms are not common tests. They are used when other tests are inconclusive and surgery is being considered.  MRI scans can give a physician a wealth of information about the structural integrity of a disc, but it cannot determine if it is causing pain.  It can show a herniated disc that is pressing on a spinal nerve root and from that it may be inferred whether it is causing damage.  Combining the information from a MRI scan with other studies, like an EMG that can determine whether a specific nerve is damaged, can limit the need for a Discogram.

Today, discograms are used mostly to identify abnormal and painful discs in the lumbar region prior to surgery when other studies are not providing adequate information, and conservative care has failed.  Performing discograms in the thoracic region and cervical region is often considered very questionable, since the disc structure is different and the information provided may not be accurate.  The most useful information provided from a Discogram is that only a single abnormal disc is present and that it is causing symptoms perceived by the patient.  When multiple abnormal discs are present, surgery is usually a poor option since pain is likely to be generated from multiple sources and will not be improved with intervention.

The Future of Discograms

In the future, abnormal discs that have cracks and bulges, but are not herniated and causing pressure, may be able to be treated without surgery.  The center of the discs contain acid, when cracks develop as they age and are stressed, the acid can leak out and cause a chemical irritation to nerves.  At this time, researchers are developing compounds known as bio-sealants to seal cracks and prevent this leaks that are causing pain.  Discograms will be useful in the future if these materials being studied actually work.

An experienced interventionalist – either a radiologist or pain physician, should perform a Discogram.  Discograms are very painful studies for most patients, and sedation can be used to control the pain.  They do have risks, especially for serious infection if not performed properly.