Proper Lifting, Posture and Low Back Pain review by KBNI Houston, Katy, Woodlands, Sugarland, Memorial City, Texas Medical Center TMC

spine, low back pain, proper lifting, posture,  Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

spine, low back pain, proper lifting, posture, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Proper Lifting, Posture and Low Back Pain review by KBNI Houston, Katy, Woodlands, Sugarland, Memorial City

Patients with low back pain worldwide can, following their injuries, attest to the importance of lifting correctly and using good posture of the body and of the spine. Improper lifting technique typically results in three different types of injury to the lumbar spine: 1) muscle injury, which can tear muscle tissue and affect mobility, 2) spinal disc injury, in which the shock-absorbing capability of the disc between our vertebrae is compromised, and 3) joint injury, in which repetitive load-bearing stress can wear out the pliable cartilage which covers the end of each spinal joint.  Keeping the spine and body in a proper posture will decrease strain on the muscles, joints and discs of the spine.  This will help to decrease the incidence or prevent low back pain.

spine, low back pain, proper lifting, posture,  Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

spine, low back pain, proper lifting, posture, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

The key to avoiding spinal injuries while lifting is proper lifting technique and posture. First, be certain to keep the chest forward while bending at the hips, rather than at the lumbar spine. Bending over at the lumbar spine and lifting will dramatically increase intraspinal pressure, which increases incidence of muscle tears and herniated (ruptured) spinal discs. Bending at the hips, on the other hand, keeps the weight close to the body’s center of gravity and does not raise intraspinal pressure to nearly the same levels. Secondly, torsional movement (twisting) while lifting even small objects can produce a serious spinal injury relatively quickly. For larger objects that are too wide to grasp fully and keep close to the body, obtain the help of another person to minimize risk. Always keeping in mind proper posture is important.

After lifting and moving all of the requisite objects, low back pain may occur as a result of muscle fatigue. Be certain to give your back adequate time, rest, and healthy fuel to recover. If low back pain levels in or around the spinal column have not subsided within three days, medical consultation is advised. Physicians will typically conduct a series of physical tests designed to determine a patient’s range of motion. If mobility is compromised or if the patient’s range of motion is otherwise reduced, these tests will help lower the number of causes for the specific variety of spinal injury in question. Physicians may also require imaging tests (X-Rays, CT scans, and magnetic resonance imaging) to confirm their diagnosis, and to prescribe an accurate, effective course of treatment.

spine, low back pain, proper lifting, posture,  Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spine, low back pain, proper lifting, posture, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

Chiropractors and physical therapists can help patients with education on the proper techniques for lifting and exercising, to prevent or treat low back pain.  Both chiropractors and physical therapists are experts in posture and biomechanics of the body, and injury prevention.  Chiropractors and physical therapists are experts in not only rehabilitating and strengthening the spine after an injury, but also in using good posture and biomechanics to prevent an injury to the spine.

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience treating patients who have suffered an injury to the spine, and also in advising on the proper biomechanics and posture of the spine and body to prevent injuries to the spine and low back pain or neck pain.  They offer a wide range of treatment options for treating spine injury, and neck and low back pain.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: spine, low back pain, proper lifting, posture, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spine, low back pain, proper lifting, posture,  Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spine, low back pain, proper lifting, posture, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Osteoporosis vs Osteopenia review KBNI Houston, Katy, Sugarland, Woodlands, Memorial City, Texas Medical Center TMC

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Osteoporosis vs Osteopenia review KBNI Houston

Osteoporosis (low bone density) is a disease that saps bones of their strength by reducing their density, producing a higher incidence of fractures. Since peak bone density usually occurs somewhere around age 25, older adults are at a higher risk for developing osteoporosis and the dangerous fractures that may accompany it. Over time, our osteoblasts (bone-creating cells that generate bone tissue) are gradually reduced relative to our osteoclasts (bone-eating cells that consume old bone tissue). As the balance between osteoblasts and osteoclasts changes, bones become weaker and more prone to fractures and osteoporosis.  Osteopenia is weakening of the bone which has not yet progressed to osteoporosis.

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Osteoporosis (and osteopenia) has particularly negative repercussions for the spine. As with other key joints in the body, such as the hip joints, the integrity of spinal joints is essential for continued mobility and a high quality of life. Our spinal discs (the shock-absorbing pads between our vertebrae) degenerate naturally over time, and as we grow older our soft tissues (such as the muscles, ligaments, and tendons in the torso which help support the spinal column) become less effective at regeneration post-stress, just like bone tissue. Cartilage on spinal joints also wears down, increasing the likelihood of compressed spinal nerves, nerve pain, and decreased mobility. Low bone density can magnify all of these programs by destabilizing the spinal column.

Fortunately, there are several ways in which the incidence of osteoporosis (and osteopenia) may be reduced. Proper care begins with preventative lifestyle choices: nutritional supplements and a healthy diet will help maintain bone density at near-peak levels. Avoiding smoking is also enormously important, as nicotine has been shown to be highly toxic to bone regeneration, contributing to osteoporosis. Nicotine kills off osteoblasts while leaving osteoclasts intact, which means that the body’s natural balance of bone tissue regrowth and bone tissue consumption is thrown out of balance. More bone is consumed than can be regenerated, gradually making bones weaker.  Anti gravity exercises and resistance exercises may help strengthen bone, and reduce osteoporosis.  It is important to note that for even the short time that astronauts are in a weightless environment in space, they lose bone density.  Medications known as bisphosphonates are commonly used to treat osteoporosis.  They are commonly known as Fosamax, Actonel, Boniva, Reclast and Zometa.  In women, estrogen helps to maintain bone strength.  After menopause, estrogen levels drop, and loss of bone density increases, increasing the risk of osteoporosis.

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

Imaging exams (such as X-rays) will help monitor the progression of osteoporosis so that the most effective course of treatment can be found. Patients can experience compression fractures of the spine, typically in the thoracic or lumbar spine, as a result of osteoporosis.  When a compression fracture of the spine occurs, a patient may experience significant pain localized to that area of the spine.  A procedure known as a kyphoplasty or vertebroplasty may be used to inject cement into the fractured vertebral body.    DEXA scans (dual energy x ray absorptiometry) can show the bone density on a quantitative basis.  Results called “T scores” are generated.  A T score compares the patient’s bone density with that of a healthy young adult.  The T score is the number of standard deviations that the patient’s T score is above or below that of the healthy young adult.  A T score of > -1 is normal.  A T score between -1 and -2.5 is considered osteopenia, which is a condition of low bone density which may lead to full osteoporosis.  A T score of -2.5 and below indicates osteoporosis.  Physicians may recommend structural changes within the home, such as the installation of shower bars and stepping stools for the bedroom.

When compression fractures of the spine occur due to osteoporosis, a kyphoplasty or vertebroplasty may be performed.  During kyphoplasty, the spine surgeon places a needle (Jamshidi needle) percutaneously through the skin, through the pedicle of the vertebral level, into the vertebral body which has suffered a compression fracture due to osteoporosis.  A kyphoplasty is typically performed bilaterally, which means on both sides of the vertebral body, through the right and left pedicles.  A kyphoplasty then involves placing a balloon through the Jamshidi needle, and expanding the balloon to try to expand the portion of the vertebral body which is collapsed as a result of osteoporosis.  After the height of the vertebral body is raised, bone cement (methyl methacrylate) is pushed through the Jamshidi needle into the expanded cavity in the bone, under low pressure.  The question of what is the difference between kyphoplasty vs vertebroplasty can be answered as follows:  during a kyphoplasty, a balloon is used to expand the compression fracture, and the methyl methacrylate cement is instilled into the osteoporosis fracture cavity under a low pressure; during a vertebroplasty, the methyl methacrylate bone cement is pushed through the needles into a nonexpanded compression fracture, under a higher pressure. Depending upon surgeon preference, kyphoplasty or vertebroplasty may be used, with kyphoplasty giving the added advantage of not only strengthening the bone, but trying to restores some of the height of the vertebral body, and lordotic curve of the spine.

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston, TX, have significant experience in treating osteoporosis and osteopenia as it affects the spine.  The neurosurgeons have vast experience in treating spine fractures, both through conservative approaches which may include bracing, and through the surgical approach, often with a kyphoplpasty.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

osteoporosis, osteopenia, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Magnetic Resonance Imaging MRI and Herniated Disc by KBNI Houston, Katy, Woodlands, Spring, Sugarland, Memorial City, Texas

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland

Magnetic Resonance Imaging MRI and Herniated Disc by KBNI Houston, Katy, Woodlands, Spring, Sugarland, Memorial City, Texas

Patients often wonder what the best test is to determine whether they have a herniated disc in the spine.  Without a doubt, magnetic resonance imaging MRI has revolutionized the imaging field of medicine, and allowed immense clarity and accuracy when trying to diagnose a herniated disc.  There are several different primary imaging exams that physicians use to aid in making an accurate diagnosis. When it comes to the spinal column anatomy, an incredibly complex system of powerful load-bearing bones and facet joints all working in conjunction with spinal discs and nerves, making an accurate diagnosis can be difficult. Typically, physicians will begin with a series of physical exams that test a patient’s mobility and back pain levels. Based on these findings, physicians will have a much better approximation of the possible causes for the patient’s back pain. Consequently, a series of spinal imaging exams may be recommended to confirm the diagnostics. X-rays are normally used when spinal fracture is suspected, but if soft tissue damage (such as spinal nerve compression) is the main cause of a patient’s back pain, magnetic resonance imaging MRI is used to gain an accurate estimate of the damage.

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland

Magnetic resonance imaging MRI uses powerful magnetic fields and radio wave energy to map the body’s soft tissue systems. This information is then relayed to a computer so that different systems can be studied in more detail. Magnetic resonance imaging MRI also has the advantage of remote viewing, where clinics that have access to other physicians’ MRI recordings can make recommendations based on samples that have been relayed electronically. MRI scans can be done on what is known as a closed machine or magnet, or an open machine or magnet.  Typically, for patients who have difficulty with claustrophobia, an open magnet or machine may be easier to tolerate.  For patients with claustrophobia, a mild oral sedative or an intravenous ( IV ) sedative may help them to tolerate the machine.  Most patients are able to have their MRI scan done on a closed machine, with accommodations made, even if they have mild claustrophobia.

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

Different MRI sequences on the MRI scan can help the radiologist and spine surgeon (neurosurgeon or orthopedic spine surgeon) to help determine whether the herniated disc is more acute or chronic in nature.  In addition, MRI images can be taken in different planes.  This means that the orientation of the images of the spine can be seen in sagittal (as if looking from the side), coronal (as if looking from the front of the body) or axial (as if looking from the feet with the patient lying on their back) views.  With a high quality MRI scan, individual nerve roots can be seen in cross section, and a herniated disc which compresses the nerves can usually be easily visualized.  Typically, an MRI scan of the cervical spine shows the spine from the skull base to the top of the thoracic spine.  A cervical herniated disc can be easily seen in cross section or sagittal views on a cervical MRI.  A thoracic spine MRI scan typically shows the spine from the bottom of the cervical spine to the top of the lumbar spine.  A thoracic herniated disc can be seen on axial and sagittal MRI views.  A lumbar MRI scan usually shows the spine from the bottom of the thoracic spine to the sacrum, which lies below the lumbar spine.  An axial or sagittal MRI scan will usually show a lumbar herniated disc.  A spine surgeon finds that an MRI scan provides critical information for a herniated disc surgery.

Within the spinal column, magnetic resource imaging MRI allows for complete renditions of the spinal discs (herniated disc) , which help in determining conditions like advanced disc degeneration, herniated disc, cartilage degeneration between the facet joints, and integrity of the spinal canal that houses the central nervous system’s spinal nerves. MRI scans can also be used as a secondary imaging exam if the results of an X-ray or CT scan (computerized tomography) are inconclusive. MRI scans are not always able to pinpoint the origin of a patient’s back pain, however, due to the fact that some patients may exhibit extreme pain while showing relatively few signs of soft tissue degeneration. Other patients may show much more degeneration in the spinal column, facet joints, or spinal disks, but have much lower levels of back pain during routine movement. As with other imaging exams, MRIs are used in conjunction with other imaging exams to ascertain whether more serious methods of treatment (such as back surgery) are necessary.

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

When a patient is not able to undergo an MRI scan, possibly due to an implanted pacemaker or spinal cord stimulator, they can undergo a myelogram. A myelogram is a study in which a spinal tap is performed, usually in the lumbar spine, and a water soluble iodine dye is placed into the spinal canal.  This iodine dye shows up on x ray and CT scans of the spine.  After the myelogram is performed, with iodine dye in the spinal canal, a CT scan of the spine is performed to show an outline of the spinal nerves, and determine whether there is pressure upon the nerves.  In this manner, a herniated disc in the lumbar, thoracic or cervical spine can be seen.  The CT scan will also who any hard bone spurs or calcium within the herniated disc.

Neurosurgeon spine experts at the Kraus Back and Neck Institute (KBNI) in Houston, TX, have expertise in using MRI scans to evaluate the cervical, thoracic and lumbar spine, and diagnose a herniated disc, among other spinal disorders.  With accurate scanning and imaging techniques, KBNI physician experts can help to diagnose the cause of pain or weakness in the neck, back, arms and legs, and to find a treatment strategy which will help the patient recover.  In the majority of cases, patients will achieve good relief of pain without the need of a spine surgery.  When surgery on the spine is needed, neurosurgeons at the KBNI utilize the latest techniques in minimally invasive spine surgery techniques, when appropriate.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

herniated disc, mri, houston

herniated disc, mri, houston

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Foraminotomy vs Laminectomy vs Discectomy by KBNI Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Seal, Baytown, Pearland, Beaumont, Port Arthur

foraminotomy, laminectomy, discectomy, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

foraminotomy, laminectomy, discectomy, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

Foraminotomy vs Laminectomy vs Discectomy Houston, Woodlands, Katy, Sugarland, Spring

A foraminotomy is a surgical procedure designed to lower pressure within the spinal canal by enlarging the passageway through which a spinal nerve root branches from the spinal canal. A laminectomy is a procedure to remove a greater portion of the bone (lamina) covering the roof of the spinal canal.  A discectomy is a procedure to remove a portion of a herniated disc in the spine, which is bulging and pushing on a nerve. Understanding spine anatomy is important to understanding the difference between the different procedures to relieve pain.  The sensitive spinal nerve roots are responsible for transmitting signals for voluntary muscle control as well as relaying sensory information for most of the rest of the body. The spinal discs (shock-absorbing pads between our vertebrae) give the spinal nerve roots enough room to exit the spinal canal. Sometimes, however, impact trauma, daily stress on the spinal discs, bone growths, or tumors may create an obstruction for the spinal nerve roots. Patients may experience extreme low back pain and / or decreased mobility if the pathways for the spinal nerve roots are compromised, or if the nerves themselves become compressed due to trauma and disk degeneration.  A foraminotomy focuses more on removing a smaller portion of bone where the nerve root leaves the spinal canal.  The opening in the spine through which the nerve root leaves is known as the neural foramen, and opening of this area is thus known as a foraminotomy.  A laminectomy is a more extensive removal of a greater portion of bone covering the spinal canal.  Of note, the neural foramen is an opening created by a roof of the superior articular facet of the vertebral body below, and the inferior articular facet of the vertebral body above.  A discectomy is performed by making an opening in the lamina, in order for the spine surgeon to gain access to the disc space, where the herniated or bulging disc is situated, in order to perform a discectomy, free up the nerve root, and alleviate the pain resulting from nerve compression.

foraminotomy, laminectomy, discectomy, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

foraminotomy, laminectomy, discectomy, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

There are several different spinal conditions that may prompt a physician to consider a foraminotomy. Degenerative disc disease, a condition in which the natural degeneration of spinal discs is accelerated by other factors, is a possible cause. Herniated (displaced or ruptured) spinal discs, bone spurs, spondylosis / spinal stenosis are all also conditions that may necessitate larger passageways for spinal nerve roots. When there is a more diffuse narrowing of the spinal canal, as is the case with spinal stenosis, a foraminotomy may not be sufficient to decompress the nerves, and a laminectomy may be required.  When the source of compression is located centrall within the spinal canal, and is caused by a focal disc bulge or herniation, rather than a diffuse central canal compression, then a discectomy may be a good option.  In summary,  back surgeries that may be effective for relieving pressure on the spinal nerves are foraminotomies, laminotomies and discectomies, as well as laminectomies.

foraminotomy, laminectomy, discectomy, Houston

foraminotomy, laminectomy, discectomy, Houston

Since back surgery is often a costly procedure with a lengthy period of post-operative care, patients are advised to seek thorough medical consultation prior to any procedure that may have implications for the spinal canal. If patients are experiencing muscle weakness, sharp or shooting pains down one or both legs, numbness in the extremities, or if their low back pain is not resolved by core strengthening exercises and weight management, physicians will typically recommend a series of spinal imaging tests. X-rays, magnetic resonance imaging, and CT scans may all be used to determine whether the integrity of the spinal canal is at risk. Post-imaging, physicians will be much better equipped to make an accurate diagnosis and prescribe a course of treatment. Post-operative care will normally include physical therapy that focuses on core strengthening exercise, building the muscles in the torso to assist in managing the stresses of everyday movement.

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients with back problems, back injuries and other sources of back and neck pain, arm and leg pain.  They frequently see patients who are suffering from the symptom of neck pain, low back pain, and mid back pain, and have never received imaging studies of the spine.  The physicians have expertise on spine surgery including foraminotomy and laminectomy and discectomy.  Physicians at the KBNI will order the appropriate spinal imaging studies of the cervical, thoracic or lumbar spine as needed, and review the results with the patient.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

REFERENCE SITES

www.SpinePain.com

www.SpineSurgery.com


Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

foraminotomy, laminectomy, discectomy, Houston

foraminotomy, laminectomy, discectomy, Houston

Keywords: foraminotomy, laminectomy, discectomy, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Spinal Imaging Cervical Thoracic Lumbar Spine with MRI and CT by KBNI Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Spinal, Imaging, Cervical, Thoracic, Lumbar, Spine, MRI, CT, KBNI,Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Spinal, Imaging, Cervical, Thoracic, Lumbar, Spine, MRI, CT, KBNI,Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Spinal Imaging Cervical Thoracic Lumbar Spine with MRI and CT by KBNI Houston

Spinal imaging tests of the cervical, thoracic, and lumbar spine are essential for correctly diagnosing spinal deformities, injuries, and other related problems. Physicians normally start with a patient history and a physical exam to test the patient’s mobility, range of motion, and look for points of tenderness. Based on the findings, physicians can then make recommendations for the best course of treatment. Minor injuries such as muscle pulls may be treated with pain relievers, anti inflammatory medications and rest, and core strengthening exercises. If the patient’s neck or back (cervical, thoracic or lumbar spine) pain is not mediated by these measures, however, then a physician may recommend a series of spinal imaging tests to determine whether the problem is structural.  Spine imaging can consist of X ray,MRI or CT scans of the anatomy of the cervical, thoracic or lumbar spine.

Spinal, Imaging, Cervical, Thoracic, Lumbar, Spine, MRI, CT, KBNI,Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

Spinal, Imaging, Cervical, Thoracic, Lumbar, Spine, MRI, CT, KBNI,Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center

X ray, CT scans and MRI scans of the cervical, thoracic and lumbar spine show the physician different information about the body.  X ray of the spine shows alignment very well, as well as fractures of the vertebral bodies.  They can show collapse of the disc spaces (disc degeneration), and slippage of the bones (vertebral bodies) upon each other, known as spondylolisthesis.  X rays do not show herniated discs pushing into the spinal canal, unless the disc is calcified, in which case the calcium in the bone spur may show up on x ray.  X ray is good for showing the placement of hardware for spinal fusion (such as pedicle screws in the lumbar spine, and anterior cervical plates in the cervical spine) in the spine.  Bone growing between vertebral bodies and between transverse processes of a spinal fusion are also well seen on X ray and CT scans.

myelogram, cervical,  thoracic,  lumbar, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

myelogram, cervical, thoracic, lumbar, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

CT scans of the cervical, thoracic or lumbar spine anatomy show very detailed views of the cross sectional anatomy of the spine.  The images are taken as cross sections of the body, and these thin slices of information can be processed by the imaging computer, and reconstructed to show the spine as seen in the sagittal plane (from the side) or coronal plane (as seen from the front).  A CT scan of the cervical, thoracic or lumbar spine can show fractures very well.  They also show the placement of screws into the spine, after surgery, very well.  CT scans of the spine do not show great detail of the soft tissues of the spine, such as the nerve roots passing through the spine, of the spinal cord running through the spine.  If a CT scan of the spine is performed after the patient undergoes a myelogram, the spinal nerves and spinal cord can be better visualized.  A myelogram is performed when a radiologist performs a spinal tap on a patient, by placing a spinal needle into the lumbar spine.  Even though this sounds like a difficult procedure, it is generally accompanied with minimal pain.  After the needle is in the spinal sac, or dural sac, the next step is to place a dye (which can be seen on CT scan) or contrast agent within the thecal sac.  Once this is completed, a CT scan is done through the appropriate portions of the spine (cervical, thoracic or lumbar), and the contrast dye shows up as white on the CT scan, while the nerve roots or spinal cord show up as dark shadows against the bright spinal fluid.  The myelogram procedure can accurately show disc herniations into the nerve roots or spinal cord.

MRI, scan, cervical,  thoracic,  lumbar, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

MRI, scan, cervical, thoracic, lumbar, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring

MRI scan of the cervical, thoracic or lumbar spine shows soft tissue, such as disc bulges (which may cause sciatica), spinal stenosis, spinal cord and nerve roots, very well.  It can also be used to see areas of contusion within the spinal cord.  It shows images in the axial plane (cross sections through the spine or body), as well as the coronal and sagittal planes.

Magnetic resonance imaging (MRI), for example, is often used when the physician suspects damage to the soft tissues around the spinal cord. The spinal cord runs most of the length of the spinal column and houses the central nervous system’s spinal nerves, which are responsible for transmitting sensory information to the brain in addition to signals for voluntary muscle control. Physicians can use magnetic resonance imaging to see if these nerves or other soft tissues have been damaged by spinal fracture, impact trauma, or otherwise compromised by spinal deformities. CT scans (computerized tomography) and X-rays do not produce detailed images of soft tissue, so physicians typically do not require them to analyze soft tissue damage in the spine—unless that damage is suspected to be the result of a damaged vertebra. Magnetic resonance imaging can also reveal spinal abscesses and spinal tumors before they have a chance to compress spinal nerves, which often causes extreme pain.

If spinal fracture is suspected, physicians may require CT scans and X-rays to determine the extent of the fracture’s damage, as well as a magnetic resonance imaging exam to ensure the integrity of the spinal cord. Patients may think that these tests are excessive given that many spinal fractures occur during everyday motion (such as picking up a bag of groceries), but physicians must be absolutely certain that the soft tissues of the spinal cord are not compromised. Spinal column integrity greatly reduces the chances of the spinal nerves becoming compressed by nearby vertebrae, though the spinal disks (shock-absorbing pads between the vertebrae) can still degenerate to the point where compressed spinal nerves are a significant problem. All of these imaging exams serve to ensure that patients make safe recoveries.

Summary of Uses of Various Spinal Imaging Modalities:

X Ray: useful for evaluating curvature of spine, such as scoliosis; fractures; spinal alignment; instrumentation placed in the spine (pedicle screws, rods, plates); fusion between adjacent vertebral levels

CT scan of cervical, thoracic or lumbar spine: useful for evaluating fractures of spine; alignment of spine; bone spurs in cervical thoracic and lumbar spine

CT with myelogram: useful for evaluating nerve roots in cervical, thoracic and lumbar spine; spinal stenosis; fusion between adjacent vertebral levels (often used instead of MRI if patient has a pacemaker or implanted spinal cord stimulator)

MRI scan of cervical, thoracic or lumbar spine: useful for evaluating herniated disc, spinal stenosis, spondylolisthesis

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients with back problems, back injuries and other sources of back and neck pain.  They frequently see patients who are suffering from the symptom of neck pain, low back pain, and mid back pain, and have never received imaging studies of the spine.  Physicians at the KBNI will order the appropriate spinal imaging studies of the cervical, thoracic or lumbar spine as needed, and review the results with the patient.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

REFERENCE SITES

www.SpinePain.com

www.NeckPain.com

www.SurgerySpine.com


Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: spinal, imaging, cervical,  thoracic,  lumbar, spine, MRI , CT, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Spine Health Core Strengthening with Spine KBNI Houston, Katy, Woodlands, Sugarland, Memorial City, Texas Medical Center TMC

spine health, core strengthening, spinal health, Houston, Sugarland, Woodlands, Katy

spine health, core strengthening, spinal health, Houston, Sugarland, Woodlands, Katy

SPINE HEALTH CORE STRENGTHENING HOUSTON

Spine health maintenance is imperative for a healthy body.  A number of factors are important for maintaining proper spine health.  Proper posture, core strengthening, rest, nutrition, cessation of smoking, and proper shoes are a good foundation.  The spine is integral to all of our routine movement. Even when we are standing still or simply sitting, the spine is still responsible for bearing much of the stresses placed on the body. Like other parts of the body, the spinal column is a collection of ligaments, muscle tissue, tendons, articulated vertebrae (the bones of our spine), and spinal discs (shock-absorbing pads that are between vertebrae and assist in load-bearing stress and movement). With so many components in constant use, it is easy to see why spine health is essential to a high quality of life.

The spinal column also protects the spinal cord, which in turn houses the central nervous system’s spinal nerves, which wind through the vertebrae and transmit sensation and signals for voluntary muscle control to the rest of the body. Protecting these sensitive spinal nerves from trauma is crucial for high function. This involves proper hydration and nutrition for the spinal disks, as well as core strengthening exercises to build the support network of ligaments, tendons, and muscles in the torso to assist the spinal discs in bearing the stresses of movement. Core strengthening will thusly decrease wear on the spinal disks, which significantly reduces the possibility of the vertebrae compressing spinal nerves and causing extreme pain.  Core strengthening exercises can be done alone, or with the expert guidance of a physical therapist for physical therapy, or a chiropractor for chiropractic training.  These experts will also guide patients in the proper use of good body mechanics for bending, lifting and twisting.

spine health, core strengthening, spinal health, Houston, Sugarland, Woodlands, Katy

spine health, core strengthening, spinal health, Houston, Sugarland, Woodlands, Katy

Choosing comfortable, well-fitted shoes is another simple way of maintaining spine health. Shoes are so common they are often overlooked as a source of pain, but improperly fitted or worn shoes are much less effective at providing shock absorption for the body. Spinal joints and discs, as a consequence, receive more load-bearing stress in all daily movements. A healthy, varied diet, nutritional supplements, and proper weight management will all also aid the spinal column in managing the stress of everyday movement. Excessive weight can actually displace disks within the spinal column, causing them to rupture or compress nearby spinal nerves. Through weight management, a healthy diet, and a regimen of core strengthening exercises, patients can maximize spine health while minimizing pain levels and wear on the spinal column.

spine health, core strengthening, spinal health, Houston

spine health, core strengthening, spinal health, Houston

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients with back problems, back injuries and other sources of back and neck pain.  Many times, proper guidance from an expert as to body mechanics, posture, core strengthening and nutrition may improve spine health and reduce spine pain.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

REFERENCE SITES

www.SpinePain.com

www.NeckPain.com

www.SurgerySpine.com


Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

spine health, core strengthening, spinal health, Houston

spine health, core strengthening, spinal health, Houston

Keywords: spine health, core strengthening, spinal health, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Recover from Spinal Fusion discussion by KBNI Houston, Katy, Woodlands, Sugarland, Galveston, Texas Medical Center

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy

Spinal fusion is a back or neck surgery in which vertebrae within the spinal column are fused together to eliminate movement at points of articulation (joints) between them. This can lower spinal mobility overall, but often spinal fusion can have a net positive effect for a patient due to decreased pain levels and increased spinal stability. When a spinal fusion is performed in the cervical spine (neck), it is known as a cervical fusion.  When the spinal fusion is performed in the lumbar spine (low back), it is called a lumbar fusion.  It can take some time to recover after this type of surgery.

To recover from a spinal fusion can be difficult based on the invasiveness of the surgery itself and the length of the post-operative care period. To recover, patients may need to make significant lifestyle changes in order to aid recovery and ensure that a stable fusion takes place as the bones of the spinal column grow back together. Eliminating smoking entirely is absolutely essential. Cigarettes contain elevated levels of nicotine, which is a chemical shown to be highly toxic to bone growth. Nicotine kills the body’s osteoblasts (bone-growing cells), while leaving our bone-eating cells (osteoclasts) alive. Spinal fusion patients who smoke during post-operative recovery are much less likely to maintain a stable spinal column, and may restrict bone growth while extending their less successful recovery by several months. If a patient wants a stable spinal fusion that minimizes the possibility of subsequent corrective surgeries, eliminating smoking is possibly the single greatest factor that aids recovery.

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy

To recover, patients must also be certain to follow guidelines regarding physical therapy, exercise, and motion during their post-operative care period. Core strengthening exercises can be guided by a chiropractor or physical therapy. Physical therapy or chiropractic guidance and education can also help to teach about how to prevent future spine injuries.  Spinal fusion is one of the more intensive varieties of back surgery, and physicians must document the recovery process accurately to ensure that the patient’s spinal column is stable enough for everyday motion. This requires subsequent visits for imaging tests (typically X-rays, in the case of spinal fusion) to monitor bone growth. There may be strict guidelines for the amount a patient can lift or the length of time in which the patient may stand, sit, or walk during the course of their daily routines.  The amount of time needed to recover may vary widely depending on how old the patient is (younger patients generally re-grow bone more quickly than older patients) as well as the physical requirements of their occupation.

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

In some cases, the physician who performed the spinal fusion may have the patient wear an external brace to help recover.  This will help support the body, and reduce movement of the fused area of the spine, while new bone is attempting to grow, and accomplish the spinal fusion.

Some patients may wear an external bone growth stimulator, if prescribed by their doctor.  The bone growth stimulator provides an electric current around the body, which stimulates bone growth.

Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients and helping them to recover after undergoing spinal fusion.  Many times, surgery can be avoided, but when necessary, the neurosurgeons at the KBNI have the most current techniques in minimally invasive spine surgery available when appropriate.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

REFERENCE SITES

www.SpinePain.com

www.NeckPain.com

www.SurgerySpine.com


Patients suffering from a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or  cervical laminectomy, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Lumbar Stenosis, Cervical Stenosis, Arthritis, Spinal Stenosis and Effects of Aging on Spine discussion KBNI Houston, Katy, Woodlands, Sugarland, Beaumont, Texas Medical Center TMC

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

As the body and spine age, degenerative changes of arthritis and spinal stenosis can affect the spine.  When this occurs in the cervical spine (neck) , it is known as cervical stenosis, and when it occurs in the lumbar spine (low back) , it is called lumbar stenosis.  Aging typically has an impact on every aspect of daily life, and movement of the spine is no exception. The spine is involved in almost every kind of routine movement: twisting, standing, sitting, walking, and running included. Aging can lower mobility, endurance, strength, and balance, but certain exercises and lifestyle choices help to prolong (and even counteract) some effects of aging, particularly in the case of the spine. The network of muscles, ligaments, and tendons in the torso begins to lose mass as we grow older (as do all muscles in the body), and it becomes more difficult to build muscle mass due to our cells not reproducing as vigorously as they do while we are young. Water loss in tendons (which attach muscles to bones) also makes these tendons stiffer and less capable of managing load-bearing stress. A regimen of core strengthening exercises can prolong torso strength, as well as assist in managing the body’s weight distribution. Regular core strengthening will also help reduce wear on the spinal disks (shock-absorbing pads between our vertebrae) by reducing stress placed upon the spinal column during movement.

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

The lumbar spine anatomy and the cervical spine anatomy consist of vertebral segments, which are held together by ligaments, which cross over the disc spaces, and over the facet joints (which separate one vertebral level from the next).  There is ligament in front of the vertebral body known as the anterior  longitudinal ligament.  The ligament behind the vertebral body is called the posterior longitudinal ligament.  The ligaments around the facet joints are the capsular ligaments.  The ligament between the spinous processes is the interspinous ligament, and the ligament between the transverse process is the inter transverse ligament.  Of particular importance for the aging spine is the ligamentum flavum, which is a ligament which is found on the inside of the spinal canal, just under the lamina (which is the back roof of the spinal canal).  As the spine ages, this ligament can become thickened, and compress upon the nerves of the spinal canal, a condition known as spinal stenosis (cervical stenosis, lumbar stenosis) .  When this occurs, patients may experience pain in the neck or low back, or arms or legs.  When the spinal stenosis occurs in the neck, it is cervical stenosis. When the spinal stenosis occurs in the low back, it is lumbar stenosis.

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring

Arthritis also affects the aging spine.  Arthritis is inflammation of the joints.  The spine has many joints, and these can become inflamed, resulting in pain and stiffness.  There are two major typed of arthritis, osteoarthritis and rheumatoid arthritis.  Osteoarthritis is a result of normal aging or wear and tear upon the spine.  Rheumatoid arthritis is a result of an autoimmune disorder.  Generally, the goal of arthritis treatment is to improve quality and function of live.  When the spine undergoes arthritis, bone spurs can grow inside of the spine and outside of the spine. The facet joints can become thickened and overgrown, and the arthritis can result in bone overgrowth and compression upon nerve roots.  The nerve compression from arthritis can affect the spinal nerves in the central canal (where all of the nerves of the spine pass as they traverse the distance from the brain to the rest of the body) and the arthritis can affect the nerves as they leave the spinal canal through the neural foramen, which are openings in the side of the spinal canal located just next to the facet joints.

Our spinal disks, along with our spinal joints, help our spine articulate, but they also gradually wear down and undergo disc degeneration. They can become thinner, causing a loss in height, as well as a rupture (herniated disc )as a result of regular load-bearing stress, sudden impact trauma (such as a fall), or due to increased body mass. Proper hydration, healthy weight management, a varied and nutritious healthy diet, nutritional supplements, and regular rest will all help prolong the effects of aging on the spinal disks, in addition to maintaining bone density at near-optimal levels. High bone density means less incidence of osteoporosis (low bone density), and a much lower probability of bone density-related spinal fractures (osteoporotic compression fractures). Vertebral compression fractures can press upon the nerves of the spine.   Smoking can also have an adverse effect on overall spine health.

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

Our heart muscle gradually loses efficiency, meaning that on a year-by-year average, we are less capable of pumping blood in a given amount of time. This means we get tired more quickly and our muscles take longer to recover from stress. For the spine, this means that the support network of bones, ligaments, and muscles around the spine receive less and less nutrition, especially during periods of load-bearing stress. Regular cardiovascular exercise, proper hydration, and a healthy diet as well as weight management will help maintain heart muscle as we age.

In summary, the aging process can take a severe toll upon the spine.  Arthritis in the spine can develop, and along with this, the ligaments can become firm and thickened, resulting in spinal stenosis, lumbar stenosis and cervical stenosis.  Proper physical activity, proper nutrition, core strengthening exercises, sciatica exercises, and stretching can help to slow down and even reverse the aging process, as it relates to the spine.

Spine experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have expertise at taking care of patients with aging symptoms of the spine, in particular arthritis, and spinal stenosis including lumbar stenosis and cervical stenosis.  In the majority of cases, patients may undergo a treatment course and improve without the need of an operation.  When surgery is necessary, Neurosurgeons at the KBNI utilize the most advanced techniques in minimally invasive spine surgery when it is appropriate.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

REFERENCE SITES

www.SpinePain.com


Patients suffering from a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or  cervical laminectomy, can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

lumbar stenosis, cervical stenosis, spinal stenosis, arthritis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Laminectomy, Lumbar Laminectomy, Cervical Laminectomy for Lumbar Stenosis, Cervical Stenosis in Houston, Katy, Woodlands, Sugarland, Beaumont, Texas Medical Center TMC

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

A laminectomy is a spinal procedure designed to lower pressure within the spinal canal (spinal stenosis). When it is performed in the low back region for lumbar stenosis, it is known as a lumbar laminectomy, and when in the neck region for cervical stenosis, it is a cervical laminectomy.  During a lumbar laminectomy or cervical laminectomy, the back region of the vertebra, called the lamina, is removed to expand the spinal canal and relieve pressure on the spinal cord (cervical stenosis in the cervical spine), or the nerve roots ( lumbar stenosis in the lumbar spine). Spinal discs (the shock-absorbing pads in between the vertebrae) may rupture or otherwise become displaced. This can raise pressure within the spinal canal or even compress the spinal cord, causing extreme pain and possibly a loss of mobility. As the spinal canal houses the spinal nerves that run through the spinal column, any bone growths, spurs, or herniated disks have the potential to compress these spinal nerves or spinal cord, depending on the level of the spine where the compression occurs. Thickened ligament in the spine may also compress the nerves in the lumbar spine, or the spinal cord in the cervical spine, because the spinal cord travels through the cervical spine, but ends at the top of the lumbar spine, below which only the spinal nerves run within the lumbar spine.  The ligament which often thickens with aging, is known as the ligamentum flavum.  Depending upon where the source of compression of the spinal canal occurs, the surgeon can approach the spine from the front or the back.  When the decompression is from the back, to remove the lamina of the spine, the procedure is known as a laminectomy.

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

Most commonly, a laminectomy is performed on patients who suffer from spinal stenosis, a condition in which the spinal canal at certain points is narrower than normal. Symptoms vary widely, with some patients reporting extreme pain and a loss of mobility from compressed spinal nerves or spinal cord.  In a much less common situation, bladder problems can occur from pressure placed on spinal nerves (lumbar stenosis) in the lumbar spine on the cauda equina nerves traveling to internal organs. Patients with cervical stenosis may experience neck pain, or pain in the upper extremities, or in more severe cases, may experience partial or complete paralysis.  When patients with cervical stenosis suffer an injury, they may experience trauma to the cervical spinal cord, resulting in a spinal cord injury.  This could result in paralysis below the level of injury of the spinal cord, or another type of cord injury in which the arms are weak, but the legs are strong (known as central cord syndrome).  Other patients’ quality of life may be relatively unchanged, although if sufficient pressure is placed on the cervical spinal cord, a posterior cervical laminectomy may be recommended to reduce the chances of further trauma.

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, West Houston, Sugarland, Woodlands, Katy, Memorial City, Spring

Depending on the extent of the pressure placed on the spinal canal, the surgeon may remove parts of the lamina on both sides of the spinal column, in addition to any fragments of bone or disk that are causing the obstruction. Spinal fusion, a procedure in which vertebrae are fused together to ensure stability, may be necessary depending on the total bone loss sustained during the laminectomy, and any foreseen instability of the spine resulting from extensive bone removal. At times, the degeneration of the spine and overgrowth of bone spurs is so severe, that in order to fully decompress the spinal cord in the neck (cervical stenosis) with a cervical laminectomy, or the spinal nerves in the lumbar spine (lumbar stenosis) with a lumbar laminectomy, part or all of the facet joints (which connect the vertebral body above with the one below) may need to be removed.  When this occurs, the spine may become unstable at that segment, and a spinal fusion at that segment may be considered.

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston

laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston

Patients who are experiencing numbness or pain down one or both legs are advised to seek medical attention. Although there are several different possible causes for the compression of spinal nerves, symptoms may not fully indicate the seriousness of the condition. Continued compression can eventually cause permanent loss of sensation, as well as paralysis of the extremities. Paralysis of the legs, from lumbar stenosis, is very uncommon, but in rare situations, can occur, particularly is the lumbar stenosis is sudden and severe in onset, such as a severe and large herniated disc, or a spine injury fracture.  Patients who experience numbness or pain down one or both arms are also advised to seek medical attention.  If a patient feels a “electric shock” traveling down the spine, known as  a Lhernitte sign, the patient may be suffering from spinal cord compression in the neck (cervical spine).  In this situation, the patient should definitely make an urgent appointment to see a spine surgeon.  Following a cervical laminectomy or lumbar laminectomy, a physical therapy regimen to maintain mobility and strengthen the core will give patients the best chance at restoring stability to their spinal columns.  Core strengthening can be accomplished with physical therapy or by chiropractic treatment with a chiropractor.

Expert neurosurgeons at the Kraus Back and Neck Institute (KBNI) in Houston, TX, have significant experience in treating cervical stenosis and lumbar stenosis.  At times, they are able to treat patients and improve their symptoms without the need for surgery.  When the cervical stenosis or lumbar stenosis is moderate or severe, or the symptoms the patient experiences are unrelenting, a lumbar laminectomy or cervical laminectomy may be performed.  The KBNI neurosurgeons utilize minimally invasive spine surgery techniques when appropriate.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or  cervical laminectomy, can

contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: laminectomy, lumbar laminectomy, cervical laminectomy, lumbar stenosis, cervical stenosis, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Spine Anatomy, Lumbar Spine, Cervical Spine, Thoracic Spine discussion KBNI Houston, Katy, Woodlands, Sugarland, Texas Medical Center TMC

spine, lumbar spine, cervical spine, thoracic spine, Houston, Sugarland, Woodlands, Katy, Spring

spine, lumbar spine, cervical spine, thoracic spine, Houston, Sugarland, Woodlands, Katy, Spring

The anatomy of the spine is varied and complex, with strong bones working in tandem with discs (shock-absorbing pads between the vertebrae), as well as flexible ligaments, tendons, and muscles. The lumbar spine, cervical spine and thoracic spine each have their own very unique structure, allowing for different stresses and strains to be supported, and allowing for very different ranges of motion.  A large collection of very sensitive nerves also dwells in the spinal column, transferring sensory information and motor control from the central nervous system to other parts of the body. There are eight different nerves associated with the cervical spine, twelve with the thoracic spine, and five with the lumbar spine.  The nerves from the cervical spine generally supply movement and sensation to the arms.  The nerves from the thoracic spine are mainly sensory, and supply sensation to the chest and back.  The nerves from the lumbar spine mainly supply motor and sensory function to the legs.

As described above, when talking about the spine, it is generally  divided into three primary regions: the lumbar spine (lower back), thoracic spine (middle back), and cervical spine (neck), while the base of the spine sits on a triangular bone called the sacrum. Each vertebra in the spine also has several parts. For example, vertebrae are divided into the body, which supports the weight of the spinal column, as well as the lamina, which covers the opening that would otherwise allow direct access to the spinal cord. Facet joints (one pair facing upward and one facing downward) link each vertebra in the spinal column and provide articulation points for movement. Repetitive load-bearing stress, poor weight management, and physical trauma can degrade the cartilage on the facet joints to the point where vertebrae are at risk for compressing nearby spinal nerves.

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At times, generally from trauma or degenerative changes (wear and tear on the body), intervertebral discs located between the vertebral bodies, may herniated, and may push against the nerves leaving the cervical spine, lumbar spine, or thoracic spine.  Disc herniations causing symptoms are much more frequent in the cervical spine and lumbar spine than they are in the thoracic spine.  This is because the cervical and lumbar spine are subject to much movement, while the thoracic spine is held in a more rigid position as it is supported by the rib cage.  A herniated disc in the lumbar spine may cause pain in the leg, and weakness of the leg.  A herniated disc in the cervical spine may cause pain in the arm, or weakness of the arm.  When a herniated disc in the cervical spine compresses the cervical spinal cord, it may result in a spinal cord injury and possibly partial or complete paralysis, from the level of the spinal cord compression and below.  For example, if there is severe pressure on the spinal cord at the level of C5/6, a patient may have good strength in the deltoid muscles at the shoulders, but be otherwise paralyzed in the more distal arms and legs.  A herniated disc in the thoracic spine may cause pain around the chest and rib cage, but when pressing on the thoracic spinal cord, may also cause partial or complete paralysis from the level of the compression and down.

Spinal nerves are particularly susceptible to injury, given that they do not regenerate once they have endured sufficient physical trauma. This is why conditions that threaten the integrity of the spinal cord—such as spinal tumors, bone spurs, and spinal fractures—must be diagnosed and treated as soon as possible. Physicians often require several imaging exams, such as CT scans, X-rays, and magnetic resonance imaging, to determine whether there are any structural problems within the spinal column that may compromise the spinal cord.

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From an anatomical perspective, many patients who suffer from low back pain and strains and sprains often simply need to develop their torso through a series of core strengthening low back strengthening exercises. Increased blood flow will help aid the network of ligaments, tendons, and muscles that assist the spinal column of the lumbar spine in distributing the body’s weight. Back pain, when understood and treated, can be improved without surgery.  As such, core strengthening is often a hallmark of physical therapy regimens for patients who have undergone spinal procedures.  The same can be said for neck pain.  Strengthening of the neck and paraspinal muscles adjacent to the cervical spine may help with neck pain.  Strengthening of the muscles surrounding the thoracic spine may also help with mid back thoracic pain.

Spine experts at the Kraus Back and Neck Institute (KBNI) in Houston TX treat disorders of the cervical spine, thoracic spine and lumbar spine.  Many patients are seen after experiencing years of spine pain, or after having suffered a car or truck accident.  Regardless of the cause or duration of pain, physicians at the KBNI obtain the appropriate imaging studies and nerve studies to look for the source of the pain.  After the source of pain is localized, treatment can begin to attempt to treat and improve the pain.  Neurosurgeons at the KBNI have found that the majority of patients suffering from pain do not need an operation on the spine, but when surgery is needed, they have the ability to perform the spine surgery using the latest techniques in minimally invasive spine surgery when appropriate.

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The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from a herniated disc can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: spine, lumbar spine, cervical spine, thoracic spine, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Herniated Disc Houston, Herniated Disc Surgery Houston review by KBNI Houston, Katy, Woodlands, Sugarland, Beaumont, Baytown, Memorial City, TMC Texas Medical Center

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A herniated disc is an extremely common problem and diagnosis in the United States, leading many to consider herniated disc surgery. The spinal discs are flexible pads that sit between each of our vertebrae and act as shock-absorbers for the spine and body. Each spinal disc is composed of a tough exterior (annulus fibrosus) wrapped around a softer, jelly-like interior nucleus pulposus). Over time, our spinal discs naturally degenerate, becoming thinner, harder, and less capable of absorbing the stresses of everyday movement. This condition is known as degenerative disc disease.  Excessive wear and tear (such as from bending and twisting or repetitive heavy lifting) will accelerate the natural wearing process and increase the chances of compressed spinal nerves and severe back pain or leg pain (sciatica) or arm pain  . Normally, we are able to weather the changes in our spine as we age without severe pain, but sometimes this is not the case. Certain structural problems, like herniated discs, can reduce mobility significantly.

A herniated disc occurs when a disc is damaged to the point that some of the soft inner material of the disc protrudes through a hole in some of the disc’s tough exterior. Holes may occur in many different ways, including age or sudden physical trauma. After the protrusion occurs, the disc is now displaced in the spinal column and may impinge on nearby spinal nerves, causing extreme back pain or leg pain (sciatica) or arm pain. This is not the case for all herniated disc patients, however. Sometimes the injury is gradual and patients do not feel as much pain, even though their spinal discs may have suffered serious trauma. If a spinal herniated disc problem is suspected, patients should seek immediate medical attention. Your doctor will give you a complete physical examination to narrow the possible causes for your back pain or sciatica. Imaging tests (x-rays, magnetic resonance imaging) will help determine if the soft tissues of the spinal discs and nerves has been damaged and to what extent.

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herniated disc, herniated disc surgery, herniated disc Houston, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Beaumont

Fortunately, in most cases it is possible for herniated disc patients to preserve their mobility and improve  their pain levels. Physical therapy or chiropractor treatment designed to strengthen core muscles in the torso and along the spinal column will help patients immeasurably during their recovery. Core-strengthening exercises help patients by allowing muscles in the torso to better assist in load-bearing during the body’s routine movement. A stronger core therefore means a lower incidence of re-injury, relief for nearby spinal nerves, and a higher overall quality of life for patients. For some herniated disc patients, however, their back pain may be too severe to be mediated solely by physical therapy or other conservative treatments. These patients may need corrective back surgery or herniated disc surgery to remove parts of the damaged disc and re-stabilize the spinal column with metal plates and / or screws (spinal fusion) in the lumbar spine or an anterior cervical discectomy with fusion in the cervical spine. Physical therapy is also typically involved in post-operative care for back surgery patients.

Expert physicians at the Kraus Back and Neck Institute (KBNI)  in Houston TX have expertise in treating patients with herniated disc Houston.  At the KBNI, neurosurgeon experts believe that most patients with a herniated disc can be treated without the need of an operation, and they can frequently implement a course of treatment which improves patient’s pain without the need of a surgery.  When herniated disc surgery Houston is needed, neurosurgical experts at the KBNI employ the most current minimally invasive spine surgery techniques when appropriate.

herniated disc, herniated disc surgery, herniated disc Houston

herniated disc, herniated disc surgery, herniated disc Houston

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

Patients suffering from a herniated disc can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit www.SpineHealth.com to schedule an appointment online

……. KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: herniated disc, herniated disc surgery, herniated disc Houston, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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Chiropractor Near Me and Sciatica Exercises with Chiropractor Houston, Sciatica Treatment discussion by KBNI Houston

chiropractor near me, chiropractor Houston, sciatica exercises, sciatica treatment, Houston, Sugarland, Woodlands, Katy

chiropractor near me, chiropractor Houston, sciatica exercises, sciatica treatment, Houston, Sugarland, Woodlands, Katy

A chiropractor near me is often requested by many patients suffering from low back pain or neck pain.  Chiropractic care is a branch of alternative medicine that specializes in the prevention and treatment of mechanical problems in the musculoskeletal system (particularly the spine). A chiropractor Houston may be well versed in sciatica treatment, and be able to prescribe the appropriate sciatica exercises to treat low back pain and radicular symptoms known as sciatica.

Radicular symptoms refers the condition where a herniated disc in the neck or low back is pressing upon a nerve in the spinal column.  This causes the body to think that pain is coming from the extremity which is supplied by that nerve.  For example, if a herniated disc is pressing upon a nerve which goes to the leg, in the lumbar spine, the patient will feel pain in that leg.  This sensation of radiating pain, or radicular pain, is known as sciatica. A chiropractor Houston or a chiropractor near me may be able to help this with sciatica exercises.  Patients may have suffered an injury such as a car accident (possible whiplash injury or other), or a sports injury, or no injury at all, and simply having awakened one morning with pain.

Chiropractors believe that a compromised musculoskeletal system adversely affects the nervous system and overall physical health. While some physicians may debate the efficacy of chiropractic care as a form of evidence-based medicine, our spines are most certainly involved in every kind of motion: sitting, standing, lifting, bending, twisting, walking, running, etc. Our spinal discs (shock-absorbing pads between our vertebrae) and facet joints (cartilage-covered joints that link our vertebrae) normally allow for pain-free articulation of the spinal column within a normal range of motion. However, both the spinal discs and facet joints naturally degenerate over time, becoming less capable of managing the body’s movements without producing back pain. Spinal discs become thinner, harder, and less pliable, while the cartilage on the end of facet joints degrades.  Finding a chiropractor near me or a chiropractor Houston may help with improvement of some of the symptoms of spinal disc degeneration, and help with sciatica exercises and other forms of sciatica treatment in Houston.

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chiropractor near me, chiropractor Houston, sciatica exercises, sciatica treatment, Houston, Sugarland, Woodlands, Katy

Compounding all of these natural processes is the risk for physical trauma and structural deformity. If the curve of the spine deviates too far from the norm, severe back pain may result and the patient will likely lose mobility. Chiropractic care can, over several sessions, help to re-align the spine if the patient is suffering from certain structural problems. Physicians will still likely order imaging tests to examine the musculoskeletal system more closely, given that a misdiagnosis can cause serious complications. X-rays and magnetic resonance imaging (MRI) will help to see the spinal discs and nerves in high detail. This information will help physicians determine if the patient may experience benefits from chiropractic care (or if, on the other hand, their long-term mobility may be threatened by it).

If a chiropractor near me for chiropractic care is being considered, many physicians recommend supplementing it with a core-strengthening physical therapy regimen. Keeping muscles along the spinal column and throughout the torso strong will allow them to assist the spinal discs and facet joints in bearing the body’s weight during routine movement. Many physical therapy exercises are able to be completed at home, giving patients a continual, long-term option to maximize mobility and mediate pain levels. Sciatica exercises can be performed throughout life, not only for sciatica treatment, but for prevention of sciatica.  A chiropractor Houston may be able to provide excellent guidance.

Your physicians will most likely request frequent checkups during your course of treatment. Be sure to tell your doctors all relevant information regarding your mobility and strength, as well as any information regarding changes in your pain levels during physical activity. Honesty will help you minimize back pain and maximize long-term mobility by keeping a healthy spinal column as you age.

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chiropractor near me, chiropractor Houston, sciatica exercises, sciatica treatment, Houston, Sugarland, Woodlands, Katy

The Kraus Back and Neck Institute (KBNI) in Houston TX, treats patients with lower back pain, neck pain, herniated discs, spinal stenosis, spondylolisthesis, spinal fractures, osteoporosis of the spine, and other spinal disorders.  Experts at the KBNI believe that most patients experiencing these symptoms can be treated without the need of an operation, but when surgery is necessary, the KBNI can provide the most advanced spine surgery using minimally invasive techniques when appropriate.  The KBNI philosophy is that a multidisciplinary approach to the treatment of low back pain, neck pain, and other spinal disorders, is the best.  Chiropractic treatment, physical therapy, pain management, epidural injections, SI joint injections, and other conservative measures play a very significant role in the treatment of spine pain, in addition to the role spine surgery plays.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

If you have SUFFERED AN INJURY, you can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit  www.SpineHealth.com to schedule an appointment online

…….  KBNI VIDEO on Back and Neck Pain Treatment : Don’t Live in Fear and Pain

Keywords: chiropractor near me, chiropractor Houston, sciatica exercises, sciatica treatment, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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chiropractor, sciatica, Houston, Katy, Woodlands, Sugarland

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Truck Accident Car Accident Car Insurance Discussion KBNI Houston, Katy, Woodlands, Sugarland, Memorial

personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy

personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy

Being involved in a truck accident or car accident can disturb everyday life, both medically and legally speaking. Not only does one need to worry about recovering physically, but the legal fallout following an accident (including personal lawsuits) often pushes families into debt and makes a full recovery much more difficult. Thankfully, there are several steps you can take to minimize your chances of harmful legal action after a car accident.

After you have checked yourself and other parties for injuries, you’ll want to document the entire truck accident or car accident as accurately as possible. When police arrive, get the name and badge identifying number of all police officers on the scene. Knowing about the officers will help all parties involved remember that they are accountable for the information they record and the actions they take. It will also help you if you need to contact the police department in the coming weeks in order to verify details on the police report. Take pictures of the scene itself, documenting any personal injuries as well as the damage done to any vehicles involved. If you are experiencing neck pain or low back pain (indicating back injury or a herniated disc ) or other injuries, be sure to have the police document that in the report. Record the addresses of all parties involved, as well as any other relevant contact information. Having the means to contact the other parties is important to facilitate quick communication if there are any legal consequences.

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personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy

When it comes to discussing the car accident or truck accident itself, discuss details only with the police to avoid confrontation with other parties involved. You may be injured, angry, experiencing neck pain or low back pain or other symptoms, etc. This is not the right frame of mind to objectively describe an accident. Talk with the police, try to remain calm, and recount what happened as clearly and as accurately as possible.

In the coming weeks, talking to a personal injury lawyer ( who can deal with a truck accident or car accident) may be necessary depending on the extent of your injuries. Personal injury lawyers specialize in tort law, which deals primarily with civil wrongs and personal property / reputation / injury claims. Your injuries may give you grounds to seek compensation from the other parties involved in the accident. Your insurance agent will also be an extremely important source of information. Learn all you can about your insurance policy, including anything that pertains to the nature of your truck accident or car accident. Call your insurance agent and ask any questions you might have regarding policy or aspects of the documentation you do not understand. Your insurance agent may also be able to provide you with information on the best course of action moving forward, as well as recommendations for local personal injury lawyers.

personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy

personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy

The Kraus Back and Neck Institute (KBNI) in Houston TX medically treats patients who have suffered from an injury, and may suffer from back pain or neck pain.  Patients who have been injured recently or in the past can be evaluated.  Physicians at the KBNI will evaluate the patients, and obtain appropriate imaging, including MRI scans, CT scans and X rays as needed.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas Medical Center  (TMC), Memorial City and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

If you have SUFFERED AN INJURY, you can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit  www.SpineHealth.com to schedule an appointment online

…….  KBNI VIDEO

Keywords: personal injury lawyer, back pain, car accident, insurance agent, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

personal injury lawyer, back pain, car accident, herniated disc

personal injury lawyer, back pain, car accident, herniated disc


This discussion is not meant to give legal or other advice, but is a discussion of things to keep in mind.  For any advice about what to do regarding an accident, readers are advised to contact their attorney, insurance agent, and any other advisers they use.  KBNI is not providing legal advice.

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Truck Accident Car Accident or Personal Injury What Should a Driver Do from a Medical Perspective KBNI Houston

truck accident, car accident, personal injury, back pain

truck accident, car accident, personal injury, back pain

If you retain consciousness at the scene of a truck accident, car accident or other personal injury,  there are a few steps you can take to maximize your chances of retaining your long-term mobility and minimizing the possibility of a spinal cord injury. First, keep as still as possible. Assess your physical situation: do you have free movement of your limbs? Do you notice any neck pain, back pain, spine pain, numbness, or muscle weakness? If any of your limbs are incapacitated, is it because they have been trapped by the wreckage or because you have lost sensation or are experiencing extreme pain? In either case, seek medical attention as soon as possible. If you have retained the ability to speak, communicate your situation as clearly as possible to any nearby witnesses. If you are alone and do not expect passersby, you must weigh the risk of movement against the possibility that your injuries will worsen over time. If you believe your overall situation will decline without help, then you may have to risk attempting to contact others despite your injuries.

truck accident, car accident, personal injury, back pain

truck accident, car accident, personal injury, back pain

If you notice any neck pain or back pain after a truck accident, car accident or other personal injury, try to keep from moving these regions as much as possible. A serious spinal cord injury is not necessarily the most painful, due to the way the spinal nerves work. Spinal nerve pathways run the length of our spinal cord and provide physical sensation to much of the body. If they are damaged (such as by vertebral fragments during physical trauma), these fragments can pierce the spinal cord and lacerate the spinal nerve pathways. Patients with these spinal cord injuries often lose sensation below the point of trauma (paralysis). Lacerations do not necessarily have to occur, however. Sufficient force can also bruise the spinal cord and cause serious long-term health complications, including paralysis.

If you are experiencing back pain or a loss of sensation following a truck accident, car accident or other personal injury, it’s very important that you seek medical attention as soon as possible. When paramedics, police officers, or other personnel arrive at the scene, communicate your symptoms as clearly and specifically as you can. Do not refrain from inconveniencing medical personnel for the sake of propriety. Seeking medical attention immediately and providing accurate information to medical personnel will give you the greatest chance at making a full recovery and minimizing long-term health complications. Once at the hospital or in the ambulance, medical personnel can begin advising you on how to further increase your chances of an effective recovery. If you retain consciousness during the journey to medical facilities, provide as much information as possible to your physician upon arrival.

truck accident, car accident, personal injury, back pain

truck accident, car accident, personal injury, back pain

Once at a medical facility, the doctors can further assess the situation, and perform a physical examination to determine what type of injury has occurred, and the best way to treat it.  Patients will typically be on a spine immobilizer board until it is determined that they have not suffered a fracture of the spine.  After a truck accident, car accident or other personal injury, patients will typically be placed in a hard cervical collar, sometimes known as a Philadelphia Collar, until it is determined that there is no fracture to the cervical spine (known as “clearing the C spine.”)

After a truck accident, car accident or other personal injury, the initial medical care is sometimes critical in determining what the eventual fate will be of the accident victim.

Neurosurgeons at the Kraus Back and Neck Institute (KBNI) in Houston TX, are experts in caring for patients with spine injuries.  Patients who have experienced a truck accident, a car accident, or other types of personal injury are evaluated.  Whether the accident occurred recently, or in the distant past, patients are seen and cared for.  After meeting with an expert at the KBNI, an history will be taken regarding the details and circumstances of the truck accident or car accident.  Then, a physical examination will be performed, to assess the functioning of the body and nervous system.  Then, imaging studies may be ordered, if necessary, to help determine the problem.

The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

If you have SUFFERED AN INJURY, you can contact the Kraus Back and Neck Institute at
…….  281-713-6296
…….  Or visit  www.SpineHealth.com to schedule an appointment online
…….  KBNI VIDEO

Keywords:  truck accident, car accident, personal injury, back pain, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

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truck accident, personal injury, houston, katy, sugarland, spring, woodlands, conroe

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Houston Personal Injury Lawyer review of care for Houston patients KBNI

Houston Personal Injury Lawyer review of care for Houston patients

Houston Personal Injury Lawyer review of care for Houston patients

If you’ve been in an motor vehicle accident or truck accident (particularly a traffic accident) and are experiencing lingering back pain or other physical or psychological issues, consulting a Houston personal injury lawyer is essential. Specifically, a Houston personal injury lawyer can  provide legal representation to clients who have been injured (psychologically or physically) by someone else’s wrongdoing or negligence. Most of the time a Houston personal injury lawyer will be very familiar with tort law, a branch of law that covers economic and non-economic property damage, civil wrongs, and damage to an individual’s reputation, as well as their personal rights.

Consider word of mouth, online reviews, and local reputation when consulting a Houston personal injury lawyer. Remember that most personal injury cases settle rather than going to trial, so ask your potential Houston personal injury lawyer about their case history to get some sense of their professional ability. For patients experiencing back pain or other more serious injuries (such as a spinal cord injury), a complete physical examination is necessary. Patients are advised to gather all information in their medical histories and ask questions of their doctors regarding any issues they do not understand. Your Houston personal injury lawyer will need a complete grasp of your medical history in order to give you the best chance at receiving a claim.

Houston Personal Injury Lawyer, care for Houston patients

Houston Personal Injury Lawyer, care for Houston patients

It is also important for both patients and their personal injury lawyer to understand the legal and ethical obligations of all parties involved. As with any branch of law, personal injury law requires lawyers to do extensive research to build a case, including finding local or national precedents for similar injuries. This is particularly important in serious injury cases, when large sums of damages are sought, or when the responsibility of the actions is difficult to pinpoint on any one entity.  A Houston personal injury lawyer with extensive tort law experience is necessary for cases in which the patient is asking for a claim from an institution.

Where ethical obligations become more muddled, however, is when the patient claims their injuries are more severe than they actually are, or when patients attempt to claim certain injuries are the result of an accident when they actually occurred later. Both the patient and the personal injury lawyer may come under additional scrutiny if other members of the court (such as the plaintiff) can formulate an argument that brings the veracity of the defendant’s claims into question. Patients are advised to be truthful at all times during the process, particularly when initially describing the injury to a potential Houston personal injury lawyer. Lawyers, like physicians examining patients, rely on their clients’ truthfulness in order to give them the best chance at a positive result.

Houston Personal Injury Lawyer review of care for Houston patients

Houston Personal Injury Lawyer review of care for Houston patients

Medical expert Neurosurgeons at the Kraus Back and Neck Institute (KBNI)  in Houston TX, have extensive experience caring medically for patients who have been injured, and suffer low back pain, neck pain, or pain in the arms and legs.  They can work with attorneys who are also caring for patients.   They serve those who have been injured in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas Medical Center  (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.

If you have SUFFERED AN INJURY, you can contact the Kraus Back and Neck Institute at

…….  281-713-6296

…….  Or visit  www.SpineHealth.com to schedule an appointment online

…….  KBNI VIDEO

Keywords: Houston personal injury lawyer, KBNI medical care, spinal injury

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Houston Truck Accident Lawyer, information by KBNI Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

 Houston Truck Accident Lawyer, Truck Accident Lawyer, Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

Houston Truck Accident Lawyer, Truck Accident Lawyer, Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

A truck accident or a car accident may often leave people with serious injuries or lingering medical issues (e.g. elevated back pain or neck pain from physical trauma sustained during the event). A Houston truck accident lawyer or a Houston personal injury lawyer can help you seek compensation for damages and injuries related to the car accident. How do we go about choosing such a lawyer, though? What should we consider before the process begins, as well as afterward when the Houston truck accident lawyer or Houston personal injury lawyer is building a case? Fortunately, there are a few simple steps to follow in order to give yourself the best chances of receiving the claim you’re seeking.

Choosing an attorney begins with having your facts straight. A truck accident or a car accident is often chaotic, with all parties involved easily becoming frustrated, angry, and confused as a result of the accident itself, particularly if there are injuries involved. First, take note of any injuries you have sustained. Do not jeopardize your long-term mobility or immediate physical health if movement produces any sharp pain. Stay still until medical personnel and / or police arrive. At that point, communicate your situation as clearly as possible. Discuss aspects of the truck accident or car accident only with police, as communicating with the other parties involved will likely lead to conflict. It is crucial at this point in the process that you recount the facts of the truck accident or car accident as accurately as possible. Try to separate the events from your emotions about them, as hysteria may alter police’s assessment of your credibility.

 Houston Truck Accident Lawyer, Truck Accident Lawyer, Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

Houston Truck Accident Lawyer, Truck Accident Lawyer, Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

After you have sought medical attention (if necessary), keep careful notes regarding your condition over the coming weeks and months. Keep all documentation regarding doctor visits as well as the content of those visits. If you have symptoms related to the accident, let your doctor have that information so he or she can begin prescribing an effective course of treatment. Keep all records of the accident and your subsequent medical treatment together, as this information will aid you greatly in the process of choosing an attorney. Like your physician, your Houston truck accident lawyer or Houston personal injury lawyer depends on accurate information in order to give you the best chance at receiving damages for your claim.

Consider word of mouth, your own personal financial situation, and (perhaps most importantly) the reputation of the Houston truck accident lawyer or Houston personal injury lawyer. Having all of your information together prior to seeking legal consultation will help reduce confusion during the process as well as adding to your credibility in the courtroom. Any lingering medical issues (back pain, neck pain, torn muscles or broken bones, etc.) with proper treatment documentation will be examined in great detail by the opposition, so it’s important not to artificially inflate the severity of injuries.  Honesty and truth are important, and will lead to the best medical and legal recovery, for those who have been injured.  The doctor needs the most accurate and honest details to help a patient with medical healing, a Houston truck accident lawyer needs the most accurate and honest details for help the lawyer to help the accident victim.

 Houston Truck Accident Lawyer, Truck Accident Lawyer

Houston Truck Accident Lawyer, Truck Accident Lawyer

The Kraus Back and  Neck Institute (KBNI) in Houston, TX, offers concierge services and serves patients who have suffered injuries throughout Houston and the surrounding areas, including Katy, Sugarland, Woodlands, Spring, Beaumont, Baytown, Sealy, Galleria, Humble, Kingwood, Conroe, Galveston, Port Arthur and other Texas TX cities.  Experts at the KBNI have significant experience in treating patients who have suffered injuries, whether they are major or minor.  Patients may have had a slip and fall, or been in a severe 18 wheeler truck accident, and may have suffered ligament or muscle strain, or a major spine fracture.

To obtain advice and evaluation by the Kraus Back and Neck Institute

……call 281-713-6296 to schedule a visit, or

……visit www.SpineHealth.com to schedule a visit online

Keywords: Houston Truck Accident Lawyer, Houston, Katy, Sugarland, Woodlands, Beaumont, Baytown

houston truck accident lawyer, Truck Accident Lawyer

houston truck accident lawyer, Truck Accident Lawyer

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Spine Injury Fracture review by KBNI serving Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

spine, injury, fracture, Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

spine, injury, fracture, Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

A spine injury  fracture is typically a serious injury that occurs when the integrity of the vertebrae (bones of the spine) is compromised, either by physical trauma or by a medical condition like osteoporosis (low bone density). Physicians use three main classifications for spine injury fractures in order to document the pattern of injury: 1) flexion fracture pattern (when one side of the vertebra loses height, usually from a fall from height), 2) extension fracture pattern (when the vertebra is pulled apart, such as in a car accident), and 3) rotation fracture pattern (severe rotation of the vertebra and surrounding soft tissues). A spinal injury fracture may also be further classified based on whether it ishas affected the integrity of the spinal cord.

If a spine injury fracture is suspected, immediate medical attention is advised. The spine serves as the seat of almost all everyday movement, and if its structure is compromised, the injury can have long-term effects on a patient’s mobility. The situation is particularly dangerous if the displacement of vertebral bone shards have compressed or otherwise injured the spinal cord, which is a structure that houses the central spinal nerves that run the length of the spinal column. These spinal nerves control sensation and voluntary muscle control for much of the body. If the spinal cord suffers sufficient physical trauma from a fracture pattern, the patient may be paralyzed in all the regions of the body that received information from the spinal nerves below the injury site.

spine, injury, fracture, Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

spine, injury, fracture, Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

Spine injury fracture may involve several types of fracture, described as compression fracture, osteoporotic compression fracture, burst fracture, vertebral compression fracture, pathologic fracture, spinous process fracture, or facet fracture.  Some fractures may be stable, and will heal on their own, while other spine injury fractures will require surgery to stabilize them. Some fractures will create a kyphosis deformity of the spine, in which the patient leans forward.

Unfortunately, physical trauma need not be serious in order for a spine injury fracture to occur. Such an injury often occurs in the course of everyday movement, such as when a patient bends to pick something up or lifts a bag of groceries. Sudden sharp pain may even be accompanied by a loss in height, which can indicate the simultaneous collapse of multiple vertebrae. Compression and distortion of the spinal column can compress the stomach, causing stomach pain and digestive problems. Depending on the type and severity of the fracture pattern, patients may also need surgery. Most efforts to surgically repair spinal fractures also result in lengthy periods of post-operative care, supplemented by physical therapy, rest, and subsequent medical examinations to maximize the chances of a positive recovery.

At the Kraus Back and Neck Instiute (KBNI) in Houston TX, patients are treated for spine injury fractures, whether they are acute or chronic.  Doctors at the KBNI will order the appropriate imaging studies, and guide patients to a path of fracture healing and pain improvement.

The KBNI serves patients throughout the Houston and surrounding areas, including Katy, Sugarland, the Woodlands, Memorial City and Kingwood.

To schedule a visit, patients can

….  Schedule an office visit online at www.SpineHealth.com

….  Call 281-713-6296 to arrange an appointment

Keywords: spine, injury, fracture, Houston, Katy, Sugarland, Woodlands, Memorial City, Kingwood

spine injury fracture in Houston

spine injury fracture in Houston

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Herniated Disc, Lumbar Disc, Cervical Disc Treatment in Houston, Katy, Woodlands, Sugarland

Herniated Disc, Lumbar Disc, Cervical Disc Treatment in Houston, Katy, Woodlands, Sugarland Herniated Disc, Lumbar Disc, Cervical Disc Treatment in Houston, Katy, Woodlands, Sugarland

VIDEO of PRACTICE PHILOSOPHY KRAUS BACK AND NECK INSTITUTE

Herniated disc of the lumbar or cervical spine is a very common disorder affecting millions of Americans.  The treatment can often consist of conservative measures, including physical therapy, epidural steroid injections (ESI), exercise, chiropractic, oral pain medicines, non steroidal anti-inflammatory medications (NSAIDS) or transdermal compounded pain medications.

When needed, surgery, including minimally invasive surgical approaches, can be used.

Appropriate imaging studies can help to determine the source of the pain, after a thorough history and physical examination is performed.

Expert doctors at the Kraus Back and Neck Instiute (KBNI) in Houston, believe that the majority of patients can be treated without the need for surgery.  When surgery is needed, the most advanced techniques in minimally invasive surgery are available.

The KBNI in Houston provides for a full spectrum of treatment of herniated disc of the lumbar and cervical spine, including conservative and surgical methods of treatment.

The KBNI serves patients in the Houston and surrounding areas of Katy, Woodlands and Sugarland.

To arrange an appointment, patients can

1)      Schedule online at www.SpineHealth.com

2)       Call 281-713-6296 to schedule

Herniated Disc, Lumbar Disc, Cervical Disc Treatment in Houston, Katy, Woodlands, Sugarland Herniated Disc, Lumbar Disc, Cervical Disc Treatment in Houston, Katy, Woodlands, Sugarland

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Sports Injury, Back Injury, Spinal Injury Review KBNI Houston, Chiropractor, Chiropractic, Katy, Memorial City, Woodlands, Sugarland, Kingwood, TMC (Texas Medical Center), College Station, Bryan, Texas

Sports Injury, Back Injury, Spinal Injury Review KBNI Houston, Chiropractor, Chiropractic,  Katy, Memorial City, Woodlands, Sugarland, Kingwood, TMC (Texas Medical Center), College Station, Bryan, Texas Sports Injury, Back Injury, Spinal Injury Review KBNI Houston, Chiropractor, Chiropractic, Katy, Memorial City, Woodlands, Sugarland, Kingwood, TMC (Texas Medical Center), College Station, Bryan, Texas

Sports injury can result in back injury or other spinal injury to patients.  Prevention and proper treatment are important.  Experts in physical therapy or experts in chiropractic (chiropractor) can help with guidance.  Our spines are the seat of motion for our entire lives. Spinal nerves running through and along the spinal column provide sensation to many parts of the body, in addition to serving as avenues for sending signals to our voluntary muscle groups. While it is essential to our mobility, the spinal cord lacks durability to direct physical trauma, as well as regenerative capacity if sufficiently injured. The soft tissue of the spinal cord is what can have serious repercussions for mobility when it comes to sports injuries. Collisions, blows, dislocations, and other types of physical trauma sustained in impact sports injury can push fragments of bone into the spinal cord or otherwise compromise its normal function or normal anatomy. Once the spinal cord has been damaged, patients can lose sensation or motor function in all parts of the body that were previously governed by parts of the spinal cord below the site of injury. Back injury and spinal injury are a great concern, especially in an active society in which contact sports are popular.  When injury is major, a surgery on the spine may be needed.  When there is no significant structural damage to the spine, but injury involving muscle and ligament sprain or strain, therapy with a physical therapist, or chiropractic treatment with a chiropractor may be of benefit.

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Due to spinal cord’s lack of regenerative capacity, spinal injury that is high on the spinal cord—in the cervical (neck) region—can be particularly serious, potentially causing paralysis in all of the limbs. The upper back (thoracic region) has extra support due to the structure of the ribcage and supporting muscles, tendons, and ligaments, so it is less vulnerable to serious sports injury than the neck. As a result of these vulnerabilities, physicians typically exercise extreme caution when a spinal injury is suspected. During a sporting event, this means immobilizing the patient on a stretcher accompanied by very careful movement to minimize the chance of further damaging the spinal cord. Recovery from sports injury can often be unique to each patient depending on where the spinal cord was injured and in what manner. Intense physical therapy regimens are typically required to minimize further loss of mobility and, in some cases, to partially re-develop a patient’s ability to control their extremities. To reduce the chances of injuring the spine during sports, always complete a thorough regimen of light calisthenics and stretching prior to any intense activity. This will help prepare muscles, tendons, and ligaments for the increased stress that sports require. Experts to help with guidance in this area may be physical therapists, who can use physical therapy techniques, or chiropractic treatment in the hands of a chiropractor, who can educate in proper stretches and warmup activities.  Back injury and other spinal injury can have long lasting and devastating consequences.  Prevention can be accomplished by using good equipment, following proper rules of engagement, especially in contact sports, and by strengthening the surrounding musculature to support and protect the spine.  Experts in strengthening and conditioning the spine may be physical therapists who perform strengthening, or chiropractic treatment with a chiropractor who performs strengthening techniques. In summary, sports injury may result in back injury and other spinal injury, and can often be prevented or avoided, with the proper caution.  If it does occur, proper and prompt treatment are important.  Proper prevention is important, utilizing proper rules, equipment and strengthening.  Physical therapy or chiropractic treatment with a chiropractor may have excellent benefit. Experts at the Kraus Back and Neck Instiute (KBNI) in Houston, serve patients who have suffered sports injury, back injury, and other spinal injury, throughout the Houston and surrounding areas, including Katy, Woodlands, Memorial City, the TMC (Texas Medical Center), Woodlands, Sugarland, Kingwood, College Station, Bryan, and other cities in Texas.  Patients with pain from an injury can be seen.  No imaging studies are needed.  KBNI expert physicians will obtain the appropriate imaging studies and other tests to help diagnose the cause of the pain. Patients can schedule a visit online at  www.SpineHealth.com or call 281-713-6296 Keywords: Sports Injury, Back Injury, Spinal Injury Review KBNI Houston, Chiropractor, Chiropractic,  Katy, Memorial City, Woodlands, Sugarland, Kingwood, TMC (Texas Medical Center), College Station, Bryan, Texas

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SPINE PAIN, SCIATICA and LASER TREATMENT review by KBNI Houston, Katy, Woodlands, Sugarland, Kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

spine, pain, sciatica, laser, Houston, katy, woodlands, sugarland, kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

spine, pain, sciatica, laser, Houston, katy, woodlands, sugarland, kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

There is much discussion about the use of the laser for treatment of pain in the spine, or for treatment of pain radiating down the leg, known as sciatica.  In order to understand more about this, it is necessary to have a better understanding of what is causing the pain, and what the laser actually does.

The laser is a device which delivers a high amount of focused energy into a small spot.  The word LASER stands for “light amplification by stimulated emission of radiation.”  When used in the operating room, the laser allows the surgeon the ability to cut or vaporize tissue.

Pain in the lower back, and pain traveling down the lower extremities, is a very common problem facing society.  The daily impact which the spine encounters as it keeps us erect and wrlking, constantly battling the forces of gravity, do take their toll upon the spine.

Next, let’s discuss what actually causes pain in the spine, or radiating pain in the lower extremity, known as sciatica.  Pain in the spine can come from muscle or ligament strain and sprain, from pressure on nerves, from intervertebral disc injury or tears, or from injury to the facet joints (located between the different vertebral body levels).  Pain in the lower extremities (sciatica) may result from pressure on the nerves, from a herniated disc or from arthritis.  In order to relieve the pain, the pressure must be removed from the nerve.  This can be achieved by removing the portion of the disc which is pressing on the nerve, or drilling away or otherwise removing the bone spur pushing on the nerve.   In the event of removing the disc bulge, this can be done by cutting the disc, or pulling the fragment out, or burning or vaporizing this fragment with a laser.

laser treatment for spine pain sciatica Houston

laser treatment for spine pain sciatica Houston

When we are dealing with pain in the spine (low back pain), the pain can be coming from several sources, as indicated above.  When the pain is coming from the facet joint, a procedure can be done to disable the sensory nerves going to the facet joint.  This can be done by heating the nerves, either by a heated probe known as a rhizotomy, or by the use of a laser.  The nerves which are targeted are known as the medial branches of the spinal nerves which leave the spine.

To summarize, treating back pain or spine pain requires understanding what the source of the pain is.  Once this is determined, treatment of the problem can begin.  The laser functions as a focused source of heat which can destroy or vaporize tissue.  Other methods such as cutting or coagulating can provide a similar result.  The laser serves among other tools in the armamentarium of a spine surgeon or pain specialist, but in itself, is still merely a tool.  The critical role in treating pain of the spine or sciatica is diagnosing what is causing the pain.  The source of the pain can be chronic, or sudden (such as whiplash from a motor vehicle injury).

Experts at the Kraus Back and Neck Institute (KBNI) in Houston focus on discovering what the source and cause of the pain is.  They believe that it is only after the cause has been located, that the actual treatment can truly begin.  Simply treating the symptom of pain, without trying to find the cause, is not a good long term solution.

The KBNI, in Houston, TX  treats patients from Houston, Katy, Woodlands, Sugarland, Kingwood, Beaumont, Memorial City, and TMC (Texas Medical Center).  Patients who are suffering from low back pain, neck pain, and sciatica are welcome to call for an appointment.

They can also visit the website www.spinehealth.com and schedule online.

No testing or imaging studies are needed to make an appointment.  Experts at the KBNI will arrange for appropriate studies.

Tags:  spine, pain, sciatica, laser, Houston, katy, woodlands, sugarland, kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

Houston, katy, woodlands, sugarland, kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

Houston, katy, woodlands, sugarland, kingwood, Beaumont, Memorial City, TMC (Texas Medical Center)

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Whiplash Treatment with Therapy and Chiropractic in Houston, Katy, Woodlands, Sugarland

whiplash, physical therapy, therapy, chiropractor, chiropractic, Houston, Katy, Woodlands, Sugarland

whiplash, physical therapy, therapy, chiropractor, chiropractic, Houston, Katy, Woodlands, Sugarland

WATCH VIDEO ABOUT NECK AND BACK INJURY TREATMENT

Whiplash is the informal term for a medical condition in which the neck muscles, ligaments, or vertebrae have been extended beyond their everyday range of motion, typically as the result of physical trauma from an accident or injury. For example, during a rear-end automobile motor vehicle accident in which a driver does not have time to brace for impact, the cervical (neck) region of the spinal column can be snapped forward and back in a motion similar to the crack of a whip. Hyperextension then occurs in the neck muscles and can also be accompanied by displacement of cervical vertebrae.

For minor strains, neurological injury may not be present, but the patient may experience straining of the muscles and ligaments.  Initial rest followed by strengthening may be beneficial.  Experts at strengthening include those who provide therapy (physical therapy) as well as chiropractic treatment with a chiropractor.

Normally, whiplash occurs as the result of automobile accidents, but may be caused by contact sports or deliberate physical abuse (such as being shaken or punched). Symptoms include dizziness, fatigue, headaches that radiate from the base of the skull, and neck pain or stiffness. Mild whiplash is typically treated with pain relievers and anti-inflammatories with no long-term complications. More severe whiplash may cause pain to radiate down to the shoulders and arms, or produce tingling, numbness, or muscle weakness in the arms. These injuries signal compression of the spinal nerves or spinal cord, which run the length of the spinal column while providing sensation to most of the body. Long-term loss of sensation may occur if these spinal nerves suffer substantial physical trauma.

chiropractic treatment with chiropractor

chiropractic treatment with chiropractor

If a patient’s whiplash induced neck pain levels are not addressed by over-the-counter pain medications, or if the neck pain has not subsided after a few days, immediate medical consultation is advised. Physicians will conduct a physical exam to test the patient’s mobility. Should the cervical region’s mobility be sufficiently compromised, imaging tests (X-rays, CT scans, or magnetic resonance imaging) may be necessary to gauge the extent of the damage as well as to evaluate possible courses of treatment.

In rare cases, surgery may be necessary to repair whiplash damaged vertebrae, ensure cervical stability, or relieve pressure on the spinal cord. As the cervical region is more delicate than other parts of the spine, post-operative care will often include very specific physical therapy designed to strengthen the muscles that support the neck. Stronger neck muscles will lower the incidence of future whiplash, in addition to helping the body more efficiently distribute the weight of the skull without causing long-term complications.

Strengthening of the neck can involve physical therapy or chiropractic treatment with a chiropractor.  There are some differences and many similarities with the therapy provided by physical therapy and the chiropractic treatment provided by a chiropractor.  Ultimately, strong muscles in the neck help to reduce the risk of whiplash and neck injury in the future.  Health of the muscles in important for neck and back health.

The Kraus Back and Neck Institute in Houston, TX, serves patients in the Houston and surrounding areas, including Katy, the Woodlands, Spring, Humble, Kingwood, Sugarland, Pearland, Atascocita, Friendswood, Memorial City, Galleria, Bryan, College Station, Baytown, Beaumont and Port Arthur. In addition, accommodations can be made for patients from Austin, San Antonio, Dallas and Fort Worth.

The Kraus Back and Neck Institute (KBNI)has significant experience with patients suffering injury or trauma to the neck and back.  This may have been from a motor vehicle accident or other injury.  The KBNI has found that, after treating thousands of patients, most can be treated and have their neck pain and symptoms improved without the need of an operation.  When surgery on the spine is needed, they offer the most advanced techniques in minimally invasive spine surgery.

To arrange a consultation at the Kraus Back and Neck Institute in Houston

Call:  281-713-6296
or visit    www.SpineHealth.com to schedule an online appointment

Keywords: whiplash, physical therapy, therapy, chiropractor, chiropractic, Houston, Katy, Woodlands, Sugarland

physical therapy for motor vehicle injury whiplash

physical therapy for motor vehicle injury whiplash

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Spinal Stenosis or Lumbar Stenosis Causes Low Back Pain and Leg Pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur

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lumbar myelogram with stenosis, spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur

Gary Kraus, MD and Masaki Oishi, MD PhD of Kraus Back and Neck Institute, Houtson, TX VIDEO

Depending on where in the spinal column it manifests, spinal stenosis can be an extremely serious condition. Lumbar (low back) spinal stenosis involves the compression of spinal nerves that run along the spinal column. Spinal nerve compression typically causes decreased mobility accompanied by very sharp lower back pain. This type of spinal nerve compression also produces sciatica, which is normally a radiating or shooting pain down one or both of the legs. Lumbar spinal stenosis is normally less serious, given that the spinal cord is not at risk for compression. Cervical spinal stenosis, however, is potentially far more dangerous. The cervical spinal cord can be compressed, causing nerve damage and, if left untreated, paralysis.  When a patient experiences lumbar spinal stenosis, symptoms of pain in the lower extremities typically increases when standing or walking, but improves when sitting.  This is because the ligamentum flavum, which is the “yellow” ligament which lies behind the nerves, buckles when standing, but stretches and therefore thins when bending or sitting, thus thinning out and relieving pressure on the nerves in the lumbar spine.  The pain which a patient experiences in the legs when standing is different than the pain of “vascular claudication” which is pain in the lower extremities which occurs when a patient is walking.  This vascular claudication or leg pain results from increases activity of the muscles of the legs, without adequate blood supply to the muscles, because of narrowing of the arteries feeding the muscles in the leg.

MRI lumbar stenosis, lumbar myelogram with stenosis, spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur

MRI lumbar stenosis, lumbar myelogram with stenosis, spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur

There are several different possible causes for spinal stenosis, and physicians will normally need to conduct imaging tests (CT scans, magnetic resonance imaging MRI , and X-rays) to determine the best course of treatment. Excessive bone growth, herniated (slipped) spinal discs, tumors, overly thick spinal ligaments, and physical trauma can all potentially cause spinal stenosis. Since these problems may need corrective surgery, physicians may require several tests to ensure an accurate diagnosis. In the case of spinal tumors, this will often include a biopsy to determine whether the mass is malignant, as well as if the cancer has spread to other regions of the body.

Surgery to correct lumbar spinal stenosis is typically called a decompressive lumbar laminectomy, which is a surgery of the lumbar spine to remove the back of the spine, the lamina and spinous processes, and remove the ligamentum flavum, to give the nerves more room, and take away pressure on the nerves.

Several medications, such as anti-inflammatories, muscle relaxants, and pain relievers, will often be administered during post-operative care. Physical therapy will also form a cornerstone of a patient’s recovery from spinal stenosis. Physicians typically prescribe a regimen of core strengthening exercises to build up the network of ligaments, muscles, and tendons around the spinal column in order to maximize their ability to assist the spine in bearing the stresses of movement. Increased blood flow and nutrition from aerobic activity will also help in maintaining optimal core strength. Patients should complete their entire physical therapy regimen, as well as adopting long-term core strengthening exercises to lower pain levels and reduce the possibility of subsequent back surgeries.

Spine experts at the Kraus Back and Neck Institute have significant experience treating patients with lumbar spinal stenosis and cervical spinal stenosis.  Patients are treated from Houston and the surrounding areas, including Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont and Port Arthur.

“So don’t live in fear and pain.”  Come see the experts at the Kraus Back and Neck Institute in Houston, TX.
KRAUS BACK AND NECK INSTITUTE VIDEO, DR GARY KRAUS AND DR MASAKI OISHI

Keywords: spinal stenosis, lumbar stenosis, spinal nerve, physical therapy, core strength, low back pain, leg pain, Houston, Woodlands, Sugarland, Katy, Humble, Kingwood, Memorial City, Beaumont, Port Arthur

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Healthy Diets for Minimizing Low Back Pain and Neck Pain, from KBNI Houston, Sugarland, Woodlands, Memorial City, Pearland, Katy, Beaumont, Humble, Kingwood, Texas Medical Center, TMC

low back pain, neck pain, proper nutrition, hydration, spinal column, katy, kingwood, humble, memorial city, memorial city, sugarland, woodlands, Texas Medical Center, TMC

low back pain, neck pain, proper nutrition, hydration, spinal column, katy, kingwood, humble, memorial city, memorial city, sugarland, woodlands, Texas Medical Center, TMC

Normally, is not the first thing patients think about when considering how to address their low back pain or neck pain. Yet, proper nutrition can have profoundly positive effects on a patient’s lifestyle, including reducing their overall neck and back pain levels. While anti-inflammatory drugs and pain relievers help to temporarily reduce a patient’s chronic back pain, these medications actually do not address the underlying causes of the pain, some of which may be related to the patient’s diet.

First, proper hydration is crucial in preventing muscle spasms and cramping. Many people do not consume enough water (typically an ounce per pound of body weight, varying according to physical activity) in the course of their daily routines. Severe cramping or muscle spasms can have adverse effects on the spinal column, causing compression in the spinal nerves that in turn produces severe pain. Proper hydration also helps maintain the cartilage between the spinal column’s joints—a dehydrated joint degrades more quickly as a result of the load-bearing stress of daily movement.

Protein—particularly from lean meats and fish—will help maintain the muscles, tendons, and ligaments in the spinal column. Along with physical therapy and core strengthening exercises, protein is a key component in ensuring the muscles of the spinal column can properly assist the spinal joints in load-bearing activities. Healthy fats from coconuts, beef, and fish will help maintain the cartilage in the spinal column’s joints, as well as the joints in other regions of the body. This significantly lowers the chances that a joint will degrade to the point of compressing nearby spinal nerves.

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Calcium, vitamin D, and many trace nutrients will help maintain proper bone density. This is particularly important in older patients, as osteoporosis (low bone density) can cause weak regions in the bones. When subjected to the normal stresses of daily movement, spinal or hip fractures can lead to dangerous falls in elderly patients. Proper nutrition and nutritional supplements reduces incidence of spinal and hip fractures, in addition to keeping bone density at near-optimal levels.

The Kraus Back and Neck Institute in Houston, TX, believes that proper nutrition and a healthy diet is important for preventing low back pain and neck pain, but additionally, if one already has these conditions, it will help to improve healing and reduce the pain.  Proper nutritional counseling may be very important for the healing process.  The KBNI treats patients, from the Houston TX area and surrounding areas including Sugarland, Woodlands, Memorial City, Pearland, Katy, Beaumont, Humble, Kingwood, and the Texas Medical Center (TMC).  Any patients suffering from low back pain or neck pain, in Houston or other areas of the county, are welcome to call for an office appointment.  They may also schedule online at www.spinehealth.com

Video for Kraus Back and Neck Instiute and Low Back Pain / Neck Pain

Keywords: low back pain, neck pain, proper nutrition, hydration, spinal column, katy, kingwood, humble, memorial city, memorial city, sugarland, woodlands, Texas Medical Center, TMC

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Sacroiliac Joint Injections SI Joint and Lower Back Pain Treatment in Houston, Woodlands, Katy, Sugarland, Memorial City, Humble, Conroe, Beaumont, College Station, Galleria

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The sacroiliac joints ( SI joint )are formed between the sacrum (a triangular bone that forms the base of the spinal column) and the ilium (hip bone). A thin layer of cartilage helps the joints articulate, as is the case with the intervertebral joints. Due to their fundamental role in load-bearing and motion, the sacroiliac joints are susceptible to degeneration resulting from repetitive motion, stress, lifting, and excessive use. Patients who suffer from chronic lower back pain may be candidates for sacroiliac joint injections, but accurate diagnosis is essential, given that sacroiliac joint injections administered to a patient with a different condition may be completely ineffective in addressing a patient’s back pain.  Diagnosis is very important in the treatment of lower back pain.  It is not sufficient to treat the symptoms of lower back pain, but it is best to make the best efforts at finding the cause of the lower back pain, and then treat that casue.

Lower back pain experts at the Kraus Back and Neck Institute in Houston TX, have significant experience in helping patients who have been suffering from lower back pain for a short or long period of time.  They treat patients throughout the Houston area, as well as areas neighboring Houston such as the Woodlands, Katy, Sugarland, Memorial City, Humble, Conroe, Beaumont, College Station, and Galleria.  Patients  also travel from Austin, Dallas / Ft Worth, and San Antonio.

Physicians typically administer several different physical exams to help them reach an accurate diagnosis: the Gillette test, the Faber maneuver, the Fortin finger test, and the Gaenslen test may all be used, depending on where a patient reports pain in the spinal column. All of these physical exams deal with the sacroiliac joints performing a specific kind of motion—if the patient’s mobility is compromised, he or she may be a candidate for sacroiliac joint ( SI joint ) injections. Further consensus is reached by specific imaging tests: CT scans, X-rays, or magnetic resonance imaging, which also help to rule out other causes of lower back pain.

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sacroiliac joint injection, SI Joint, lower back pain, physical therapy, corticosteroid, Houston, Woodlands, Katy, Sugarland, Memorial City, Humble, Conroe, Beaumont, College Station, Galleria

The procedure itself typically involves the injection of a corticosteroid into the sacroiliac joint ( SI joint ). A local anesthetic numbs the injection site, while dye accompanies the injection to ensure  coverage of the sacroiliac joint injection (SI joint ). Corticosteroids act as an anti-inflammatory agent within the joint, ideally reducing pain from load-bearing stress for up to a year. A regimen of physical therapy, proper weight management, and healthy dieting with proper nutrition and nutritional supplements will further help to maximize the positive effects of the procedure. If a patient does not engage in physical therapy to strengthen the support network of muscles around the spinal column, further degeneration of the sacroiliac joint will occur at an accelerated pace.  This could lead to worsening or more chronic lower back pain.  Core strengthening is very important to preventing and improving lower back pain.  If one would eventually require a lower back surgery which involves a fusion, it is important to stop smoking before the spinal fusion surgery, as smoking will decrease likelihood  of a successful fusion of bone occurring.

Since the corticosteroid’s effectiveness will eventually wear off, sacroiliac joint injections are viewed as a short-term solution to reducing a patient’s back pain. Long-term focus must be placed on living a healthy, preventative lifestyle designed to maximize the life of the joint and minimize pain. Physical therapy may include instruction on new ways of lifting, standing, walking, and load-bearing.   If lower back pain is persistent, and the SI joint injections improve the pain, then one can consider rhizotomies (burning of the nerves to the SI joint) of nerves to the SI joint, or SI joint fusion.

The Kraus Back and Neck Institute (KBNI) has vast experience in treating patients with lower back pain.   Patients suffering from lower back pain can call the KBNI to arrange for an evaluation. Patients do not need to have had any types of imaging or other studies.   Lower back pain experts at the Kraus Back and Neck Institute will order the appropriate studies.  In  the majority of cases, lower back pain can be treated without the need for surgery.  If surgery is needed, neurosurgeons at the Kraus Back and Neck Institute have tremendous experience in utilizing the appropriate surgery on the lower back, to get patients back to their normal life as quickly and seamlessly as possible.

Patients in the Houston and surrounding areas (Woodlands, Katy, Sugarland, Memorial City, Humble, Conroe, Beaumont, College Station, Galleria) are welcome to be evaluated, or come in for questions.

Keywords: sacroiliac joint injection, SI Joint, lower back pain, physical therapy, corticosteroid, Houston, Woodlands, Katy, Sugarland, Memorial City, Humble, Conroe, Beaumont, College Station, Galleria

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Spinal Fusion including Lumbar Fusion and Cervical Fusion for Pain and Nerve Compression in Houston, Katy, Woodlands, Sugarland, Memorial City, Texas Medical Center, TMC, Humble, Kingwood, Conroe and Beaumont

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Bone fusion (also called arthrodesis) (when performed in the low back  spine is called lumbar fusion, when performed in the neck is called cervical fusion) is the procedure by which bones are joined at specific joints, most often to alleviate pain. The new fused bones are allowed to grow together. This lowers pain levels because at common bone fusion sites (lumbar or lower spine, wrists, ankles, or thumbs, neck or cervical spine) there are often nerves nearby that are responsible for  sensation, as well as recognition of joint position and movement. Bones on either side of the deteriorating joint can compress these nerves and cause extreme pain. Fusing these bones significantly lowers the incidence of nerve irritation, and when bone spurs are removed, can reduce nerve compression.

Causes for a patient desiring bone fusion surgery, or spinal fusion surgery can include rheumatoid arthritis and osteoarthritis, as well as severe back pain due to tumors or herniated (slipped) discs. Like other joints in the body, the discs (shock-absorbing pads) between our spinal vertebrae, can wear out. Nerve compression in the spine occurs much more frequently when these spinal discs have been thinned or ruptured by age and activity. The arthritis, as well as the chronic herniated discs, can compress nerves passing next to them.  As in other regions of the body, bone fusion is a possible solution for reducing pain, but it will eliminate mobility at that particular joint.

Neurosurgeons at the Kraus Back and Neck Institute, in Houston, have a significant experience with utilizing spinal fusion (lumbar fusion, cervical fusion) to treat neck pain and low back pain in patients.  They have offices located in Houston and surrounding areas of Katy, Woodlands, Sugarland, Memorial City, Texas  Medical Center (TMC), Humble, Kingwood, Conroe, and Beaumont.

Bone fusion is somewhat unique in that in many cases, it seeks to mimic the body’s natural healing response. In one version, bone is taken from another region in the body and inserted between the two or more bones that are being fused together. This “foreign” bone stimulates bone growth during post-operative care, as it is placed under pressure and adjacent to other bone, which has been prepared to grow into the new bone graft.  Other versions of bone fusion or spinal fusion may include implantation of wires, metal plates, screws, and other devices to accurately position the new joint, and keep it immobile, while the new bone is trying to grow into the bone graft. Adequate rest and physical therapy during post-operative care are absolutely essential to ensure that a proper bone fusion takes place. If the new joint is displaced by excessive movement, subsequent corrective surgeries may be necessary to re-set the bone.

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The technique of lumbar fusion or cervical fusion  (spinal fusion) can be performed in several ways.  The general principle is to have bone grow across the currently mobile disc space.  A number of techniques are possible.  One approach is to try to achieve this fusion on the sides of the spine, between what are known as transverse processes, which project outward from the vertebral bodies.  In doing so, the surgeon exposes these transverse processes during the operation, and removes the outer coating of the bone, known as the cortex, thus exposing the inner cancellous bone, which is the honeycomb type of bone seen when one breaks open a chicken bone.  With the outer hard cortex removed, the inner cancellous bone will attempt to grow into the bone graft which it is in contact with.  This bone graft can be placed on the side of the spine, which is known as a lumbar posterolateral fusion.  It can also be placed between the vertebral bodies, which is known as an interbody fusion.  When this type of lumbar fusion is performed, it is called a lumbar intervertebral body fusion.  When this type of cervical fusion is performed, it is called a an anterior cervical discectomy and fusion (ACDF).  In the cervical spine, this type of fusion is generally performed through an anterior approach, which means going in through the front of the neck.  When this interbody fusion is performed in the lumbar spine, it can be performed from the back of the spine (known as a PLIF (posterior lumbar interbody fusion) or a TLIF (transverse lumber interbody fusion), the front of the spine (known as an ALIF (anterior lumbar interbody fusion).  It can also be performed from the side of the spine, known as an XLIF (extreme lateral interbody fusion) or a DLIF (direct lateral interbody fusion) (these different names utilized basically the same lateral approach, but were given different names by two different manufacturers of the spinal hardware equipment (Nuvasive and Medtronic).  It can also be performed through an approach going straight up the spine, through an incision made next to the tail bone, known as an AXIALIF (axial lumbar interbody fusion), the instruments of which are manufactured by TranS1.

There are also a number of different grafts which can be used for promoting the bone growth in a spinal fusion.  Cadaver bone can be used, which is harvested from cadavers.  This is known as allograft.  Bone can be taken from the patient undergoing surgery, either from a different site or from the same site.  This is known as autograft.  Substances known as bone morphogenic protein (BMP) ( Medtronic manufactures Infuse) can be used locally to promote bone growth.  Stem cells, taken from the patient’s own blood which has been spun down in a centrifuge, can be placed over the graft to help promote bone growth.

Candidates for bone fusion / spinal fusion also need to be aware of the effects of smoking on the procedure. Osteoblasts (bone-growing cells) are needed in droves to ensure a speedy recovery. One of the addictive chemicals in cigarettes, nicotine, is toxic to osteoblasts and can substantially lengthen the time necessary for a complete bone fusion, or even make it impossible to achieve. Smokers are advised to abstain before and after the procedure.

Patients suffering pain in the neck, low back, or other portions of the spine, can call the Kraus Back and Neck Institute in Houston, TX.  They will be evaluated and appropriate tests will be ordered.  No imaging studies are required for patients to be seen.

http://www.spinepain.com/anterior-cervical-discectomy-with-fusion-kraus-back-neck-institute.html

http://www.neurosurgery.com

http://www.neurosurgeryhouston.com/services/spine-conditions

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Key Words: spinal fusion, lumbar fusion, cervical fusion, nerve compression, pain, Houston, katy, woodlands, sugarland, memorial city, texas medical center, TMC, humble, kingwood, Conroe, beaumont

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Nutritional Supplements for Bone Growth from KBNI Houston, Woodlands, Spring, Katy, Memorial City, Kingwood, Humble, Sugarland

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Proper bone growth during physical development and maintenance of bone mass in the adult years are both extremely important in preventing osteoporosis (low bone density). Osteoporosis can produce many different varieties of hollowness in the bone, lowering overall bone density and increasing the likelihood of fracture. Bones that bear a lot of stress in everyday movement are particularly susceptible to fracture in a patient with osteoporosis. Older persons with osteoporosis are at risk for fractured hips, which may cause dangerous and even life-threatening falls. Regular nutritional supplements for bone growth can minimize the possibility of fracture while also granting patients increased mobility and decreased levels of bone pain. Bones will be stronger and hence more stable and capable of evenly distributing and supporting the body’s weight.

The Kraus Back and Neck Institute in Houston, TX, recognizes that in order for the body to heal, proper nutrition is important.  Nutrition can improved with supplements.  This is critical when the body is healing from injury or from surgery.  Increases in body metabolism after an injury or surgery make it important for the body to have the proper nutrients, or building blocks, so that it can begin the process of repair.  It is also important to try to curtail smoking, as this will decrease the likelihood of a successful fusion healing.  The Kraus Back and Neck Institute (KBNI) is located in Houston, TX.  The philosophy of the KBNI is to use conservative treatments for low back pain and neck pain when possible, but utilizing surgery when necessary.  The KBNI treats patients throughout the Houston area, as well as the surrounding communities of the Woodlands, Katy, Kingwood, Katy, Sugarland, Spring, Humble and Memorial City.  Patients are also seen form areas throughout Texas, including Austin, Dallas  / Ft. Worth, and San Antonio.

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A healthy diet rich in vitamins and minerals is a good place to begin. Calcium and vitamin D have been shown to aid in bone growth, as have a number of trace nutrients like boron, magnesium, strontium, and omega-3 fatty acids. Many of these trace nutrients also have several other helpful uses within the body. Due to the fact that most of the bone mass (approximately 90%) is developed before a person turns twenty years of age, it is never too early to begin a healthy diet further enriched by nutritional supplements. Continuing this trend into adulthood can help maintain bone density and promote bone growth at near-peak levels. This will also minimize the chances that young and middle-aged persons do not develop low bone density.

Healthy dieting, proper weight management, and nutritional supplements can all be aided by regular exercise. Aerobic activity, yoga, Tai Chi, and other activities that emphasize strength, flexibility, and endurance help to develop the supporting network of ligaments, muscles, and tendons. These tissues, when properly maintained, help the bones in distributing and managing the body’s weight during physical activities. Following a total regimen—diet, weight management, and exercise—will maximize bone health and regeneration for patients of any age.

Keywords: nutritional supplements, bone growth, low bone density, osteoporosis, Houston, Woodlands, Spring, Katy, Memorial City, Kingwood, Humble, Sugarland

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How Smoking Affects Spinal Fusion and Surgeries – Back and Neck Houston, Katy, Humble, Woodlands, Sugar Land, Kingwood, Memorial City, Austin, Dallas, Ft Worth, San Antonio

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Spinal fusion is a procedure which fuses two or more vertebrae in the spinal column together. This surgical procedure can compensate for spinal discs (shock-absorbing pads between each vertebra) that have degenerated to the point where the spinal nerves are at risk for compression. The stress of major back surgery is such that smokers will often be tempted to smoke more in the aftermath and during recovery. Dr. Gary Kraus and Dr. Masaki Oishi at the Kraus Back and Neck Institute in Houston TX, have extensive history of performing fusion of the spine, including the cervical, thoracic and lumbar spine.  They have several offices around Houston serving patients in Houston, Kingwood, Humble, Katy, Woodlands, Pearland, Memorial City, Quite simply, it is absolutely preferable that patients cease smoking for at least two months prior to spinal fusion and for at least six months after any major bone alteration within the spinal column. Better still if patients are able to quit smoking indefinitely. Nicotine, one of the primary addictive chemicals in cigarettes, is toxic to bone growth. The balance of the body’s osteoblasts (bone-growing cells) and osteoclasts (bone-eating cells) is severely compromised by smoking during both the pre- and post-operative periods. Large decreases in the number of osteoblasts means that bone generative capacity is vastly reduced, signaling a long (and possibly ineffective) spinal fusion process. Normally, patients decide on spinal fusion and similar back surgery due to increases in back pain and a corresponding decrease in mobility. If patients continue to smoke during the post-operative period, bone fusion—if it even takes place—will take much longer. This means that patients will face many more months of decreased mobility and elevated levels of back pain. Though a nicotine addiction may be strong, abstinence from smoking during the pre- and post-operative period will shorten recovery time significantly. Non-smoking patients will also be more capable of participating in aerobic portions of physical therapy, which stimulate the flow of blood and oxygen to areas around the spinal column. This extra nutrition will further speed the process of recovery. Though the precise method of physical rehabilitation may depend on the complexity of the spinal surgery and the patient’s overall health, the absence of nicotine from the patient’s daily life will optimize his or her chances at an effective spinal fusion. Patients suffering from low back pain and neck pain can easily make an appointment and be seen at the Kraus Back and Neck Institute in Houston and surrounding areas.  No imaging or other studies are needed to be seen.  The doctors at the Kraus Back and Neck Institute will order the appropriate testing.

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http://www.spinepain.com/

http://www.neurosurgery.com

http://lowback-pain.com

http://spinehealth.com

Keywords: smoking, spinal fusion, physical therapy, osteoblasts, back surgery, Houston, Katy, Humble, Woodlands, Sugar Land, Kingwood, Memorial City, Austin, Dallas, Ft Worth, San Antonio

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Reducing Neck Pain…… Houston, Katy, Woodlands, Spring, Kingwood, Humble, Memorial City, Galleria…. 281-713-6296

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neck pain, stretching, physical therapy, muscle tension, spinal column, Houston, Katy, Woodlands, Spring, Kingwood, Humble, Memorial City, Galleria

Along with low back pain, neck pain is one of the most prolific afflictions of the modern workplace. Millions of workers across the globe work in positions that are mainly sedentary, many of which requiring long hours in the sitting position. This translates into increased stress on the cervical vertebrae (upper spine) and the intervertebral discs (shock-absorbing pads between each vertebra), as well as elevated levels of muscle tension in the upper spinal column. As the duration of muscle tension increases, the muscles themselves are deprived of blood and oxygen. They can eventually begin to spasm, which leads to sharp pain and a chance of compressing spinal nerves that run through the vertebrae.

The Kraus Back and Neck Institute located in Houston, TX, has vast experience treating patients with neck pain.  Conveniently located with offices through the Houston area, patients are seen from Katy, Galleria, Memorial City, Sugar Land, Pearland, Inner Loop, the Woodlands, Kingwood, Humble, Splendora, Conroe and Magnolia.  For those patients traveling from Austin, Dallas, Ft. Worth, San Antonio, or other cities across the United States, travel accommodations can be arranged.

Fortunately, due to most incidence of neck pain being the result of sedentary work, there are many ways in which to reduce most patients’ pain levels. First, patients are advised to be conscious of their daily activity. If you find yourself staring at your computer monitor or desk for extended periods of time, give your body frequent breaks. Take five to ten minutes of every hour and get up, walk around, and rotate the neck and shoulder blades. Light aerobic activity and muscle movement will increase blood circulation, bringing nutrition and oxygen to your muscles. This will help prevent cramping and muscle spasms in addition to reducing neck pain.

Other common neck strengthening exercises include slow, deliberate stretches, head rotations / neck rolls, and shoulder shrugs. This will help develop the network of supporting muscles, ligaments, and tendons in the upper spinal column. Some patients, however, may suffer from more than simple hypomobility (low mobility). If a regimen of physical therapy does not significantly improve a patient’s range of motion and decrease pain levels, a structural deformity, disease, or spinal fracture may be the cause. Physicians typically employ imaging exams—CT scans, magnetic resonance imaging, and X-rays—to determine whether structural problems are the problem. Neck surgery may be necessary, in addition to a lengthy post-operative period of physical therapy and rest.

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The Kraus Back and Neck Institute sees patients who have neck pain, arm pain, and other disorders of the spine.  Patients do not need any imaging studies or other tests.  Appropriate testing can be ordered after patients are evaluated.  Most patients suffering from neck pain can be treated successfully without the need for surgery.

Keywords: neck pain, physical therapy, muscle tension, spinal column, Houston, Katy, Woodlands, Spring, Kingwood, Humble, Memorial City, Galleria,

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Core Strengthening Exercises help Low Back Pain: Houston, Woodlands, Katy, Spring, Galleria, Memorial City, Austin, Dallas, Fort Worth, San Antonio, 281-713-6296

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Neck pain and low back pain are some of the most common maladies of modern workers. Due to the sedentary nature of most office work, muscles in the torso can atrophy to the point where they no longer effectively help the spinal column in bearing most of the body’s weight. This in turn places more stress on the spinal column, which can accelerate the degeneration of the intervertebral discs (shock-absorbing pads that lie in between each vertebra).

Neurosurgeon experts Dr. Kraus and Dr. Oishi, at the Kraus Back and Neck Institute in Houston, TX, have found over the years of practice in treating many thousands of patients, that most patients will improve their neck pain and low back pain without the need of an operation.  Core strengthening exercises are part of an entire program of treatment which will help patients suffering from neck pain or low back pain.  The Kraus Back and Neck Institute treats patients from the Houston and surrounding areas, including the Woodlands, Katy, Spring, Galleria, Memorial City, as well as other cities in Texas including Austin, Dallas Fort Worth and San Antonio.

The first line of defense against back pain—even when physicians become involved—is often core strengthening exercises. Developing muscles in the abdomen and around the spinal column will allow natural bodyweight and the stress of movement to be more evenly distributed. This will decrease wear on the spinal joints and discs. Licensed medical professionals may prescribe a regimen of physical therapy designed to reach this goal. Imaging tests, such as CT scans, X-rays, and magnetic resonance imaging, are also options to determine if the problem is related to inactivity (hypomobility) or if the problem is tied to an underlying structural deformity, such as scoliosis or spinal fracture.

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After an accurate diagnosis has been made, it is crucial that patients continue to perform their physical therapy / physical medicine regimens to their requisite frequency and duration. Patients who complete a physical therapy program—and who even afterward continue in maintaining core strength—report demonstrably lower levels of pain, as well as fewer spinal injuries. Proper weight management, a healthy diet, and nutritional supplements will also help greatly during a core strengthening physical therapy regimen. Pain relief or improvement will not be immediate, but proper core strengthening exercises conducted on a consistent basis will have a long term effect on improving low back pain and neck pain.

As for the core strengthening exercises themselves, physical therapy routines may be specially crafted for patients based on where in the spinal column the patient’s pain is originating. Mainstays include exercise balls, light aerobics, and stretching, as well as traditional core strengthening exercises like yoga and Tai-Chi. Emphasis is normally placed on flexibility, strength, prolonging mobility, and minimizing pain. Aerobic activity helps stimulate muscles, flooding the torso with blood and oxygen, while light weight training builds resistance and load-bearing capabilities.

For More Information, please contact the Kraus Back and Neck Institute, or visit online at www.SpineHealth.com .

Keywords: low back pain, neck pain, core strengthening exercises, physical therapy, spinal column, Houston, Woodlands, Katy, Spring, Galleria, Memorial City, Austin, Dallas, Fort Worth, San Antonio

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Minimally Invasive Surgery: Houston, Kingwood, Spring, Woodlands, Katy, Memorial City, Humble: 281-713-6296

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Until relatively recently back surgery required large incisions accompanied by long periods of physical rehabilitation in post-operative care. With recent surgical advancements, however, new procedures have resulted in much shorter periods of physical rehabilitation. These surgical procedures—termed minimally invasive surgery or laporoscopic surgery—have revolutionized the way physicians approach not only back surgery, but several other varieties of major surgery as well.

Neurosurgeons specializing in spine surgery, Dr. Gary Kraus MD and Dr. Masaki Oishi MD PhD, at the Kraus Back and Neck Institute in Houston TX, have a vast experience in performing minimally invasive surgery of the spine.  The procedures can be used to treat low back pain, neck pain, herniated discs of the spine, as well as sciatica.  In some cases, spinal stenosis and  spondylolosthesis can also be treated with minimally invasive techniques.  Patients throughout the Houston and surrounding areas, including Katy, Spring, Woodlands, Sugar Land, Memorial City and the Texas Medical Center have trusted the neurosurgeons at the Kraus Back and Neck Institute for treating their spine with minimally invasive surgery.  Call 281-713-6296 for an appointment.

Minimally invasive surgeries typically involve one or more small incisions into which physicians insert thin plastic tubes. The tubes then provide the means for small observation cameras to be inserted. Using these cameras, surgeons can continuously adjust their technique during the operation, minimizing scarring and ultimately decreasing the patient’s post-operative pain levels and length of recovery. New robotic surgical assistants further contribute to the process by plotting optimal routes of incision and minimizing the number of physical adjustments a surgeon makes.

Many types of back surgery, however, do not have minimally invasive equivalents. Thorough medical consultation should be a top priority for patients considering minimally invasive surgery, as a misdiagnosis could result in a less effective procedure. Should the patient be a good candidate, a shorter, less expensive hospital stay and a faster recovery is the norm. This makes physical therapy all the more necessary—patients may feel that they can skip the process entirely given that their pain levels during post-operative care are much lower. Patients are advised to follow up on their physical therapy sessions as well as any subsequent visits to their spinal specialist. This will minimize the possibility of additional back surgery as well as maximize the chances for an effective recovery.

Physical rehabilitation for minimally invasive surgery is often similar to other kinds of surgery. In the case of most back surgery, core strengthening is often emphasized to assist in load-bearing activities (lifting, sitting, and standing) as well as to pressure from the spinal discs. Patients will also receive information on how to change their daily lifestyles to minimize the chances of re-injury and subsequent surgery.

Neurosurgeons Dr. Kraus and Dr. Oishi, at the Kraus Back and Neck Institute, would be available for consultation to any patients suffering from low back pain, neck pain, sciatica, herniated discs, or any other spinal disorders.  Even though they offer minimally invasive surgical approaches to the spine, they are able to treat many of their patients without the need for surgery.  Patients from the Houston and surrounding areas including Katy, Spring, Woodlands, Sugar Land, Memorial City and the Texas Medical Center, can be seen without any prior testing or imaging studies.

http://www.neckpain.com/minimally-invasive-kraus-back-neck-institute.html

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Herniated Disc Injury (Motor Vehicle Injury, Truck Injury) : Treatment in Houston Katy Woodlands Spring Humble

herniated disc, physical therapy, back pain, spinal nerve, Houston, Galleria, Katy, the Woodlands, Spring, Humble, Memorial City, motor vehicle injury, truck injury

herniated disc, physical therapy, back pain, spinal nerve, Houston, Galleria, Katy, the Woodlands, Spring, Humble, Memorial City, motor vehicle injury, truck injury

Spinal discs are the pads between each vertebra of the spinal column. They act as shock absorbers for the body, compensating for the stresses of everyday movement: running, jumping, sitting, standing, walking, etc. Each disc has a tough, durable exterior but is filled with a soft, jelly-like material. Herniated discs occur when stress (usually from natural wear and tear as we age, but occasionally from improper lifting or other kinds of physical trauma) (motor vehicle injury, truck injury) pushes some of the softer material through a rupture in the exterior portion of the disc. This can aggravate or compress nearby spinal nerves, causing extreme pain. Depending on the seriousness of the spinal nerve compression, back pain may be accompanied by numbness, muscle weakness, tingling, and a shooting or radiating pain in any of the extremities. If any of these symptoms accompany a patient’s back pain, immediate medical consultation is advised. Continual compression of spinal nerves can lead to permanent damage, which may include a loss of sensation.  Experts at the Kraus Back and Neck Institute in Houston, TX, have significant experience treating thousands of patients suffering from the low back pain, leg pain and sciatica of herniated discs in the lumbar spine.  Dr. Gary Kraus and Dr. Masaki Oishi take a very conservative approach to treating patients suffering from these disorders, and in most cases find that patients can be effectively treated, with significant pain reduction, without the need of an operation.  Dr Kraus and Dr Oishi have extensive experience taking care of patients who have been in automobile injuries, truck injuries, or suffered other types of motor vehicle injuries.

Physical therapy in combination with anti-inflammatories and rest may significantly reduce the back pain associated with a herniated disc. A licensed medical professional will, through a specialized regimen of physical therapy, show patients new techniques that minimize the possibility of re-injury. In particular, torsional or lateral movement while lifting should be minimized, as these methods can significantly raise pressure within the spinal column, leading to an increased likelihood of a herniated disc.

For seriously herniated discs, surgical procedures may be necessary. Spinal fusion, a procedure in which the vertebrae are fused together, can eliminate the pain caused by worn intervertebral discs. Artificial discs are also an option—these discs can now match a natural disc in durability. Surgery should be considered only as a last resort, however. The costliness and lengthy rehabilitation periods during post-operative care for most spinal surgeries mean that physicians typically recommend surgery only after physical therapy, healthy dieting, exercise, and weight management have failed to improve a patient’s quality of life or lower levels of back pain.

The Kraus Back and Neck Institute in Houston, TX, treats patients from Houston, Katy, Inner Loop, Memorial City, Galleria, the Woodlands, Sugar Land, Humble and Spring.  Many patients may have been in automobile injuries or truck injuries.  Patients are welcome to call the Kraus Back and Neck Institute.  No films or other studies are needed.  Appropriate imaging studies and other tests may be ordered if indicated and needed.

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Keywords: herniated disc, physical therapy, back pain, spinal nerve, Houston, Galleria, Katy, the Woodlands, Spring, Humble, Memorial City, motor vehicle injury, truck injury

herniated disc, physical therapy, back pain, spinal nerve, Houston, Galleria, Katy, the Woodlands, Spring, Humble, Memorial City, motor vehicle injury, truck injury

herniated disc, physical therapy, back pain, spinal nerve, Houston, Galleria, Katy, the Woodlands, Spring, Humble, Memorial City, motor vehicle injury, truck injury

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Disc Degeneration

Between each vertebra of the spinal column there is a semi-flexible disc that acts as a shock absorber for the body. The intervertebral discs help in load-bearing work, as well as any activity requiring movement or flexion of the spine. Over time, these discs naturally degrade (disc degeneration), but injuries, poor diet, weight gain, repetitive stress, or structural deformities can all accelerate the degenerative process. Sufficient trauma may cause the disc to rupture—a serious condition that can cause the two surrounding vertebrae to compress spinal nerves, causing extreme pain and possible muscle weakness and loss of sensation.  Expert doctors / neurosurgeons / spine surgeons at the Kraus Back and Neck Institute in Houston, TX have a vast amount of experience in treating patients with pain related to disc degeneration, degenerative disc disease , neck pain, low back pain, and sciatica.

If the progression of disc degeneration is significantly faster than normal, the patient may have a structural deformity that is contributing to the problem. A thorough medical exam is advised, during which the attending physician may advise several imaging tests to accurately diagnose the cause of the accelerated degeneration. Typically, the most advanced degeneration occurs in the lumbar and sacral regions of the spine (low on the spinal column), due to the constant load-bearing stress placed on these intervertebral discs in the standing and sitting positions.  Dr. Gary Kraus and Dr. Masaki Oishi, neurosurgeons at the Kraus Back and Neck Institute in Houston, find that most patients suffering from herniated disc of the lumbar spine and cervical spine, can be treated without the need for an operation.  Very often, the pain of the low back or neck pain, and any associated radicular symptoms such as sciatica, often improve without surgical treatment.

Patients who are extremely active in sports or manual labor may find that drastic changes to their daily lifestyle are necessary. A regimen of physical therapy will offer instruction in new lifting techniques, as well as core strengthening exercises that will help develop the muscles of the torso. As core strengthening improves, the network of muscles, tendons, and ligaments in the torso will begin to relieve some of the load-bearing stress from the spine.

More severe cases of disc degeneration may necessitate surgical procedures. Modern advancements in medical technology have improved the artificial disc to the point that it can mimic a natural disc both in function and durability. Other surgical procedures—such as spinal fusion—may be used in severe cases of disc degeneration to reduce the possibility of compressed spinal nerves. Many of these procedures are quite costly and have lengthy rehabilitation periods, however, so they are often advised only when absolutely necessary to improve the quality of a patient’s daily life.

Patients in Houston, as well as other parts of Texas and the United States, are welcome to contact the Kraus Back and Neck Institute, for treatment of their degenerative disc disease, or any other low back pain, neck pain, or sciatica.

The Kraus Back and Neck Institute is very convenient to, and routinely treats patients in Houston, Katy, Memorial, Westchase, Inner Loop, Galleria, the Woodlands, Sugar Land, Conroe, Beaumont, Tomball, and Galveston.

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http://www.spinesurgery.com/conditions/degenerative-disc-disease

Keywords: Houston, physical therapy, disc degeneration, spinal column, core strengthening, sciatica, Katy, Memorial, Westchase, Inner Loop, Galleria, the Woodlands, Sugar Land, Conroe, Beaumont, Tomball, and Galveston

degenerative disc disease houston sciatica low back pain

degenerative disc disease houston sciatica low back pain

disc degeneration houston neck pain back pain sciatica Katy, Memorial, Westchase, Inner Loop, Galleria, the Woodlands, Sugar Land, Conroe, Beaumont, Tomball, and Galveston

disc degeneration houston neck pain back pain sciatica Katy, Memorial, Westchase, Inner Loop, Galleria, the Woodlands, Sugar Land, Conroe, Beaumont, Tomball, and Galveston


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Sciatica : Treatment in Houston

Put simply, sciatica is nerve pain in one or both of the legs. More specifically, sciatica is the term given to pain caused when one of the spinal nerves which are responsible for sensation in the legs is compressed. Compressed spinal nerves may have several different root causes, including: herniated (slipped) disks, spinal stenosis, spondylolisthesis, or Piriformis syndrome. Since the causes can vary widely in seriousness, thorough medical consultation is advised to avoid misdiagnosis. It is crucial to discover the root cause of the nerve compression, since spinal nerves do not regenerate if sufficiently traumatized.  The Kraus Back and Neck Institute in Houston, TX treats a very large number of patients suffering from sciatica, low back pain, leg pain, neck pain and upper extremity pain.  Sciatica can be very effectively treated.

Normally, a complete physical exam will be enough to accurately diagnose sciatica. If a physician suspects alternate causes for nerve compression—such as a possible spinal fracture—imaging tests may be authorized. These can include X-rays to observe the integrity of the vertebrae, as well as magnetic resonance imaging tests to build images of the spine and surrounding tissues. Based on the results of the exam and the battery of imaging tests, physicians can formulate a diagnosis based on the severity of the compressed nerve.

Once sciatica has been diagnosed, there are several different possible courses of treatment depending on the severity of the nerve compression. Anti-inflammatory drugs such as ibuprofen can help to reduce swelling around the damaged nerves. Once swelling decreases, patients often report less pain and increases in mobility. Muscle relaxants also aid in swelling reduction. As for physical therapy, a licensed medical professional can match a regimen to each patient’s specific injury. Stretching, walking, and rest may be employed to ensure that swelling decreases. It is vital that patients keep up with their exercises to reduce recurrence of nerve compression. Healthy dieting and weight management are also effective means to prevent sciatica.

In rare cases, more serious measures may need to be taken. Surgery, spinal injections (most often a cortisone anti-inflammatory), and other spinal procedures may be considered as needed. If patients are not responding well to traditional physical therapy, consider seeking a specialist for further treatment.

For more information, follow up with the Kraus Back and Neck Institute in Houston TX, experts in treating sciatica for patients in the Houston and surrounding areas, as well as across the United States.

sciatica treatment at the Kraus Back and Neck Institute, Houston TX

sciatica houston texas low back pain herniated disc

sciatica houston texas low back pain herniated disc

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Spinal Injury Rehabilitation

spinal injury rehabilitation houston

spinal injury rehabilitation houston

If injured sufficiently, the regenerative capacity of the spinal cord—at least, on its own—is not nearly as great as other parts of the body. Trauma—from automobile accidents, sports injuries, or falls—can damage the nerves responsible for movement in parts of the body. Depending on where the spinal cord is injured, patients may experience paralysis of digits or limbs.

Fortunately, there are many options available for physical rehabilitation. Intense physical therapy from a licensed medical professional can help prevent further loss of mobility. Though the aftermath of a spinal cord injury may be terrible, patients who commit to their physical therapy regiments show demonstrably better mobility over patients who avoid the trials of physical rehabilitation.

New advances in medical technology—particularly techniques employing stem cells—offer patients, physicians, and medical researchers alike hope that even severe spinal cord injuries may someday be completely rehabilitated. Normally, the spinal cord lacks the ability to generate new specialized cells. Stem cells, on the other hand, are human developmental cells found in the umbilical cord that have yet to specialize to perform a specific function within the body. Researchers hope to reliably produce stem cells that can then become specialized cells within the spinal cord, restoring function, sensation, and patient mobility.

Apart from physical rehabilitation, there are also many emotional support networks in place, mainly classified by the extent of the patient’s injury. Physical therapy may help to preserve mobility, but patients and their families often struggle to come to terms with their new lifestyles. Support networks provide emotional therapy as well as an outlet for personal grief. Counseling can also provide families with information on how to adjust their homes and daily routines to better accommodate patients with spinal cord injuries.

Kraus Back and Neck Institute, Houston TX  Gary Kraus MD  Masaki Oishi Md PhD

Houston Back Injury and Houston Neck Injury Experts

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Spinal Muscular Atrophy

spinal muscular atrophy houston back pain

spinal muscular atrophy houston back pain

Spinal muscular atrophy (SMA) is a serious genetic condition in which the function of motor neurons is compromised, severely limiting a patient’s ability to move voluntary muscles. Normally, motor neurons act as communication devices, enabling voluntary muscles—such as the ones in a person’s legs, arms, stomach, and throat—to move. In a patient with spinal muscular atrophy, these motor neurons are attacked and begin to die off. Though SMA can be genetically inherited, there are many different types of the disease and symptoms can vary widely. Some children may have their breathing affected and have a very short life expectancy, while others may live a relatively normal life. If a patient’s spinal muscular atrophy affects their breathing, treatment becomes more difficult and the patient is overall significantly less likely to survive. SMA’s main classifications are focused on when a patient’s symptoms appear as well as how severely they affect daily life. Acute infantile and chronic infantile spinal muscular atrophy are usually the most serious, as muscles never get a chance to develop properly before motor neurons begin to die. Physicians are also unable to communicate properly with very young patients, making adjustments in the course of treatment much more difficult. Other major classifications include chronic juvenile SMA and adult onset SMA. Generally, the severity of SMA’s symptoms worsens the earlier it manifests in the developmental cycle. At this point, a cure for spinal muscular atrophy is beyond the reaches of medical science. Genetic counseling may prevent a possible solution, given that SMA is normally inherited through a recessive gene from the mother and father both. Though a cure for manifested SMA is currently not possible, there is a wide support network available for both patients and families. Specialized physical therapy regimens, training in first aid, and emotional therapy support groups all exist to help families overcome the difficulties of SMA patients’ daily lives. The physical therapy regimens are especially important, as they help patients maintain control and development of the muscles they are still able to use.

www.spinehealth.com

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Reducing Back Pain

reducing low back pain houston

reducing low back pain houston

Most often, low back pain is a product of one of the following scenarios: 1) improper lifting technique, which may tear muscle tissue or even herniate (displace) the intervertebral disk, 2) overuse or hypermobility, referring to intense labor or repetitive movement that puts increased wear on spinal disks and joints, or 3) low activity or hypomobility, which can lead to weight gain, as well as reducing the flow of nutrients to muscles and disks in the back.

Fortunately, physical therapy, rest, healthy dieting, and regular exercise can often have a long-term positive impact on low back pain levels. Those with acute or chronic back pain may be tempted to resist physical activity, but an approved regimen of physical therapy by a licensed physical therapist depends on regular implementation to be effective. Patients who opt out of the physical rehabilitation process may actually lose mobility as a result.

Core strengthening exercises play a fundamental role in most physical rehabilitation plans. The torso and spinal column are home to many different tendons, muscles, and ligaments that help support the weight of the body and provide stability during routine movement. All of these tissues work in tandem with the spinal column to participate in all load-bearing activities—running, walking, standing, and sitting among them. If core strengthening exercises are omitted from a patient’s physical rehabilitation regimen, the spinal column bears more weight than it otherwise would and low back pain is more likely to recur.

Patients with chronic back pain are advised to seek thorough medical consultation, given that their pain may be resulting from structural problems, deformities, or other abnormalities within the spinal column. Imaging techniques such as the X-ray, CT scan, and magnetic resonance imaging can reveal the integrity of the spinal column as well as allow physicians to design a more effective physical therapy regimen.

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Spinal Acupuncture (Houston, Woodlands, Sugarland, Katy, Humble, Kingwood)

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acupuncture houston low back pain neck pain, sciatica, katy, woodlands, river oaks, memorial city

While spinal acupuncture is not a typical option for treating neck and back pain, there are many patients who will testify to its beneficial effects. While the end results can vary widely depending on the severity of the patient’s back pain, Western physicians generally agree that spinal acupuncture is capable of stimulating a patient’s central nervous system. Patients may experience low back pain, neck pain, herniated dics, spinal stenosis, as well as sciatica.  They may have suffered injury to the spine.  A series of FDA-approved needles—different gauges are used at the physician’s discretion—are inserted to varying depths and at varying locations depending on the patient’s condition. The needles are extremely thin, usually around twenty times thinner than most hypodermic needles used in typical procedures. Many patients may not consider spinal acupuncture due to a fear of these needles, but acupuncture needles are also solid, which means that they do not remove tissue, whereas a hypodermic needle does. A thin, solid acupuncture needle, then, typically causes less pain than a hypodermic needle of equivalent size.

At the Kraus Back and Neck Institute, Dr. Kraus and Dr. Oishi are extremely experienced at treating spinal injuries with conservative as well as surgical measures.  There is a significant role for many types of conservative treatments, including the role of acupuncture in the treatment of spinal disorders and pain.  The Kraus Back and Neck Institute treats patients from Houston and the surrounding areas, including Tomball, Katy, Memorial City, Spring, the Woodlands, Humble, Atascocita, Conroe, Kingwood, Galleria, the inner loop area, River Oaks, Sugar Land, Pearland, Galveston, Beaumont and Port Arthur,  and other cities in Texas including Austin, Dallas, Ft. Worth and San Antonio.

Spinal acupuncture patients most often report tingling sensations around the spine, an increase in sensation that can be the result of increased blood flow. This blood flow can offer relief for patients diagnosed with hypomobility (low mobility) of the spinal joints, as it brings oxygen and nutrition to the affected areas, especially when employed in conjunction with a regimen of physical therapy. It should also be noted that spinal acupuncture seems to be at least partially dependent on patient psychology—meaning that its effectiveness may be increased (or decreased) by the way the patient chooses to engage mentally with the treatment.

In some medical circles, acupuncture is also thought to stimulate the release of endorphins, which are the body’s naturally manufactured means of reducing pain. Though it may be tempting for patients to rely solely on the endorphins released during acupuncture sessions, other medical consultation is strongly advised. A regimen of physical therapy, healthy dieting, and proper weight management can all do their part in reducing low back pain over the long term.

For more information about conservative care of the spine, for the treatment of low back pain, neck pain, herniated disc in the low back or neck, sciatics, degenerative disc disease as well as spinal stenosis and spondylolisthesis, contact the Kraus Back and Neck Institute, in Houston TX.  Call 281-713-6296 to schedule an appointment.

The Kraus Back and Neck Institute treats patients from Houston and the surrounding areas of the Woodlands, Spring, Kingwood, Sugarland and Humble.  They also treat patients from Austin, Dallas, Ft Worth and San Antonio, among other cities in Texas.  They see patients who have not had any imaging studies, and will order the appropriate testing.

Keywords: spinal acupuncture, acupuncture, hypodermic needle, low back pain, physical therapy, sciatica, low back pain, neck pain, Houston, Woodlands, Tomball, Katy, Memorial City, River Oaks

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acupuncture needles sciatica, low back pain, houston, katy, memorial city, woodlands, kingwood, humble

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Physical Therapy For The Spine

physical therapy for the spine

physical therapy for the spine

What is even more alarming is that many people believe that once low back pain manifests, back surgery is the only option capable of addressing the problem. Fortunately, physical therapy can often have extremely beneficial effects, including reducing or eliminating pain and restoring function and flexibility.

Methods used in physical therapy for the spine can vary widely depending on the patient’s condition and level of pain. Thorough medical consultation is advised to prevent misdiagnosis, as physical therapy for the wrong condition may not alleviate (and actually may worsen) the patient’s problems. Once a course of physical therapy has been prescribed, several subsequent visits may be necessary to ascertain a patient’s progress against an established recovery plan.

Physical therapy for the spine often includes multiple components to maximize the chances of reducing back pain over the long term. First, a licensed physical therapist instructs a patient in how movement, lifting, and exercise will be different as a result of the patient’s condition. Once a patient has appropriated these new motions, the physical therapist then implements a regimen of specific exercises catered to the patient’s condition. Common exercises often include light aerobics and core strengthening exercises, which increase the load-bearing capability of muscles, ligaments, and tendons around the spine. The load on the spinal column is subsequently reduced. Core strengthening is especially important, as it can contribute to improved performance in all athletic activities.

Other physical therapy options may include ice packs (which can reduce inflammation and sensation) and heating pads (which increase surface circulation). Exercises that minimize joint impact while simultaneously promoting circulation and flexibility—such as yoga or Tai Chi—are emphasized. Healthy dieting, nutritional supplements, and proper weight management are all also essential components of a successful physical therapy regimen. Proper nutrition will aid in muscle development, while weight management will minimize the incidence of low back pain as well as the possibility of recurrent structural problems.

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Sacral Vertebrae

sacrum low back pain

sacrum low back pain

They are also triangular, while the central portion of the sacrum is turned backward to allow more space in the pelvic cavity. Typically, there are nine discrete segments of the sacral vertebrae in early development. Five of these segments usually form the sacrum and sacral vertebrae, while the other four become the coccyx. Essentially, the orientation of the sacrum and its corresponding sacral vertebrae are partially responsible for how humans walk. If the sacrum were turned at a different orientation, bipedal motion would not be possible. Even a slight change to the orientation of the sacrum and corresponding sacroiliac joints would result in a vastly different walking motion.
Due to their orientation in articulation with the ilium (hip bone), the sacral vertebrae are susceptible to sacroiliac joint dysfunction (SJD). In SJD patients, pain is usually more prominent on one side of the lower back, though it may radiate down one leg or the other. Though the precise cause of sacroiliac joint dysfunction may be difficult to pinpoint, typically SJD is caused by either 1) overworking the sacroiliac joints, such as in labor or hard exercise or 2) too little physical activity. These problems (hypermobility and hypomobility, respectively) can also cause problems in other parts of the spinal column and other regions of the body. Hypermobility tends to degrade the sacroiliac joints through increased wear, load-bearing, and stress, while hypomobility can deny the joints nutrition by reducing regular access to oxygen.
Care for the sacroiliac joints echoes care for the rest of the spinal column and the body in general—regular exercise, rest, healthy dieting, and weight management. Maintaining a healthy body weight can reduce the chances of sacroiliac joint dysfunction, while regular exercise helps expose sacroiliac joints to increased levels of oxygen and nutrition.

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Lumbar Vertebrae and You

The lumbar vertebrae are the lowest five bones of the spine, designated as L1-L5. These bones are significantly larger than other vertebrae in the spinal column, as well as differing substantially in shape. The lowest part of the spinal column is also responsible for bearing much of the body’s weight in the sitting and standing positions. This means that the intervertebral disks—pads in between each vertebra that help the body absorb the shock of repetitive movement—are the most prone to injury in the lumbar spine. Though the lower part of the spinal column is designed for both power and flexibility, there are sundry ways in which its function can become impaired.
Many of these lumbar spine-related problems are the result of injury, such as repetitive load-bearing stress sustained during manual labor. Other common causes include excessive weight, which can in turn cause herniated disks in the spinal column. When evaluating lower back pain, patients are advised to monitor closely any pain that seems to travel or “shoot” down the legs or arms. This can be a sign of compressed spinal nerves, caused when the disk provides insufficient protection against the stress and the vertebrae press down upon the spinal nerves. Due to the lumbar vertebrae’s location and role in load-bearing activities, an injury can be especially painful and debilitating. Patients are advised to seek medical consultation in order to better evaluate possible courses of action.
Should the integrity of the lumbar spinal column be compromised, physical rehabilitation will often form an essential component of a patient’s recovery. Physical therapy will include core-strengthening exercises to boost the spine’s support network of muscles, ligaments, and tendons. A stronger core translates into less load-bearing for the lumbar spine, which can reduce the possibility of future injury as well as aid in reducing a patient’s back pain. More serious injuries—such as severe trauma or structural deformities—may necessitate spinal surgery. If physical therapy, core strengthening, and weight management have proven ineffective, spinal specialists can help in determining what surgical procedures may alleviate the problem.

lumbar vertebrae kraus back and neck institute

lumbar vertebrae kraus back and neck institute

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Cervical Vertebrae

cervical vertebrae

cervical vertebrae

The cervical vertebrae (C1-C7) are the first seven vertebrae connecting the base of the skull to the rest of the spine. Like the rest of the spine, between each cervical vertebra there is a shock-absorbing pad called a disk. These disks, along with the structures of the cervical vertebrae, allow the human neck to be a highly mobile region of the body.
Structurally, the first two cervical vertebrae (C1-C2, or the atlas and axis, respectively) are substantially different due to their role in supporting the weight of the human skull. As is the case with the thicker, stronger lumbar vertebrae at the base of the spine, cervical vertebrae are specialized to fulfill their function of granting people painless, continuous mobility of the neck and upper spine. Cervical vertebrae are further supported by a network of tendons, muscles, and ligaments which all work in tandem to provide additional support.
Unfortunately, neck pain is one of the most common causes for people to miss work. Long hours of stationary positioning (typical in office work) can cause chronic tension and deprive neck muscles of oxygen. This in turn can cause spasms, which can compress nerves that run through the spinal canal. Since the neck is so highly mobile and painless operation is a crucial component of quality of life, patients are advised to take measures to reduce the incidence of neck pain. Regular exercise—even simply pausing to roll the neck and shoulders once an hour—can restore oxygen and nutrition to neck muscles. Light aerobic activity is also recommended for 5-10 minutes per hour of stationary work.
Should neck pain become chronic, surgical procedures may be prescribed. Patients should be especially mindful of neck pain that shoots down into the arms or legs, as this may indicate nerve damage. Be certain to obtain thorough medical consultation, however, given that surgery on highly mobile regions of the body can have negative long-term effects. Healthy dieting, nutritional supplements, and regular installments of physical therapy can help aid patient recovery during post-operative care. Several post-operative checkups may also be necessary to monitor any structural changes within the cervical spine.

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Post-Operative Spinal Care

post operative spine care

post operative spine care

Depending on the seriousness of the back surgery, patients often have a wide variety of physical therapy treatments available. Physical rehabilitation can be further augmented by several different medications, including muscle relaxants, pain medication, and steroid injections.
Patients may also be required to take antibiotics to guard against infection. Spinal surgical procedures typically require an incision which can vary in length and depth depending on the patient’s condition. Patients should check the incision periodically for any indications of infection—these signs can include redness and / or the appearance of pus around the wound. Follow-up visits to your physician and spinal specialist are also necessary. Physicians will monitor the patient’s progression along previously established guidelines for procedural recovery. Adjustments to each individual patient’s needs are then made based on age, physical rehabilitation, weight, and other factors. New courses of treatment can then be continuously recommended based on the findings.
Though physical rehabilitation is a crucial aspect of post-operative care for some back surgery patients, many physicians advise a period of mandatory rest that differs depending on the procedure. Patients must allow the spine adequate time to heal prior to exercising even in moderation. If physical rehabilitation is undertaken too quickly, patients run the risk of disturbing the adjustments made by the surgery—which can then severely damage their recovery, possibly even making further corrective surgeries necessary. Post-operative care during the rest period often includes restrictions on how much a patient can bend, lift, walk, or even move. These restrictions are especially important after surgical procedures that implant pins or other artificial devices into the spine. The body must be given time to adjust to these foreign bodies. If patients follow these steps, however, recovery is normally assured.

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Spinal Surgery : Reality and Myths

Spinal surgery can be one of the most costly, physically taxing methods of treatment on the healthcare market today. Fortunately, many patients overestimate the need for such serious measures. Many types of neck and back pain can be addressed and resolved with other methods of treatment, such as physical therapy, pain medication, exercise, and healthy dieting. These are typically the courses of action prescribed by physicians as well, given that spinal surgery may have unintended side effects on the patient’s daily life.
Some patients, however, will find that their pain and / or structural problems are not resolved by these treatment plans. With advancements in modern medical technology, there are now dozens of different spinal surgical procedures available to correct many types of structural problems. Disk degeneration, spinal tumors, bone spurs, spinal stenosis—all of these disorders and others may necessitate spinal surgery should they have a substantial negative impact on a patient’s quality of life.
For example, patients who have advanced degeneration of the spinal disks

spine surgery

spine surgery

(the shock-absorbing pads between our vertebrae that break down naturally over time) may be candidates for artificial disk implantation. During this procedure, an artificial disk mimicking the body’s natural shock absorber is implanted in the spine. Spinal fusion, a procedure that fuses vertebrae thus eliminating the possibility of further damaging the disks between them, may also be an available option. Patients are advised to seek thorough medical consultation when considering spinal surgery. Several imaging techniques, such as CT scans, X-rays, and magnetic resonance imaging, may be prescribed to evaluate courses of action. Specialists may be referred to address problems that have not been corrected through physical rehabilitation.
Post-operative care is crucial for patients who have undergone spinal surgery. Many surgical procedures require long recovery times with periods of mandatory rest and physical rehabilitation. Several subsequent post-operative visits to primary care physicians and specialists are necessary to monitor the patient’s recovery.

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Spine Infection

The organs, tissues and bones of the human body are susceptible to invasion by opportunistic pathogenic microorganisms. When this occurs, the result is very often an infection that may cause injury to the body part and progress to overt disease through cellular or toxic mechanisms. The most common cause of infection is the staphylococcus aureus bacteria, also known as mersa or staph. It can also be caused by streptococci bacteria, pseudomonas aeruginosa bacteria (“blue-green pus” bacteria), escherichia coli (E coli), viral-fungal-parasitic organisms and other pathogens (e.g., cysticercosis, listeria monocytogenes, toxoplasma gondii, brucellosis, etc.). In rare instances, in industrialized countries such as the United States, it may be caused by the mycobacteriumtuberculosis bacteria (sometimes seen in IV drug users). In some cases, the source of the infection can not be identified.

Infection of the spine, although rare relative to the incidence of infections in other parts of the body, is very deleterious and can lead to spinal instability and other serious problems. Spine infection is most commonly caused by staphylococcus aureus bacteria. The infection is classified by its location on or in the spine such as (1) infection of the intervertebral disc or disc space (discitis); (2) infection of the vertebral bones of the spinal column (osteomyelitis); or, (3) an infection of the tissue (dura) covering the spinal cord and spinal nerve roots (epidural abscess). In most cases, an individual will experience only one of these clinical entities. Some critically ill patients, however, will present with all three. Failure to accurately diagnose and properly treat spinal infections can lead to catastrophic neurologic damage, paraplegia, and death.

Q: How does infection begin in the spine?

A: Spinal infection can occur spontaneously in the spine. However, infection is usually transmitted to the spine from adjacent tissue or another part of the body through the blood stream (bacteremia or sepsis). Infection most often occurs in the lumbar region of the spine, followed by the thoracic spine and, to a much lesser extent, the cervical spine (found in IV drug users).

Q: Who is at risk for spinal infections?

A: Individuals at risk of spinal infection include the elderly, smokers, the obese, patients who are immunocompromised (e.g., patients who have received organ transplants), patients with significant health problems such as diabetes mellitus, cancer, malnutrition, urological infection, and patients with wound infections. Spine infections can also arise from trauma to the spine and is increasingly found in IV drug users and those with long-term use of steroids.

Any surgery on the human body holds the risk of infection. This includes spine surgery, especially where instrumentation is involved, or when there has been implant/instrumentation migration. In the case of implant/instrumentation migration another surgery is required to correct the situation. Failure to confirm the absence of other infection in the body prior to the surgery is also problematic.

Q: How is spine infection diagnosed?

A: Diagnosing the presence of spine infection can be challenging. One reason is that the symptoms of spine infection – pain, inflammation, weakness, neurological deficits, weight loss, etc. – often mimic other spine condition symptoms or system irregularities such as pancreatitis, meningitis, radiculitis, appendicitis as well as non-specific back pain. When this occurs, an accurate diagnosis may not be made for days, if not weeks or months. Misdiagnosed or late-diagnosed patients may experience unnecessary operations as surgeons attempt to control the suspected pathology.

Once spinal infection is suspected the physician will confirm the diagnosis with blood cultures (e.g., white blood count), erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP)), imaging studies (MRI with contrast medium (e.g., Gadolinium) and X-ray), nuclear medicine scans (PET), and biopsy (usually image guided). These studies may be repeated to evaluate the success of treatment protocols.

Q: After spine infection is confirmed, what are the treatment options?

A: The objective of spine infection treatment is to cure the infection and limit the possibility of further damage.The actual treatment modality depends largely on the severity and duration of the infection and the identification of the micro-organism involved. Once the micro-organism has been identified, specific antibiotics can used be to eradicate the bacteria.

Treatment options include intravenous and oral antibiotics, or injection of antibiotics directly into the infected area. This is often accompanied by bed rest and/or bracing to limit spine movement. If the infection is severe or fails to respond to initial treatment, long-term intravenous antibiotic or antifungal therapy may be required. In this instance, extended hospitalization may be required.

Despite the use of various antibiotics and antifungal agents, the treatment of a spine abscess often requires surgery to reduce pressure on the spinal cord or drain and remove infected material. Surgery is also required when there is evidence of bone destruction, spinal instability, vertebral collapse, spinal deformity, cauda equina syndrome, or other signs of neurologic dysfunction.

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Spine Tumors: Primary and Secondary

“Tumor” is a word about which nothing good can be said. It can cause terror in the mind of the listener, especially if the person speaking is their doctor. The word “Tumor” is an ancient Latin word that meant “swelling” on or in the human body. It was thought to be one of the five signs of inflammation (i.e., pain (dolor), heat (calor), redness (rubor), tumor (swelling), and loss of function (functio laesa)). In the contemporary medical lexicon, tumor still means an abnormal swelling of the flesh. It is also considered synonymous with neoplasm, which is a medical term for an abnormal, uncontrolled growth of new cells.

TumGraphic of a Spine Tumorors & Cancer

To the lay person, a tumor is more often than not considered to be synonymous with cancer. However, a tumor can be non-cancerous (benign), pre-cancerous (carcinoma in-situ), or cancerous (malignant). A benign tumor does not consume other tissues and will not become malignant overtime. It will, however, continue to grow in size and can cause pain and system dysfunction. A pre-cancerous tumor falls somewhere in between a benign tumor and a malignant tumor. It has the potential to become cancerous, but its growth has not yet become uncontrolled. In its pre-cancerous state the tumor should be a cause for concern and periodically monitored. Pre-cancerous tumors often appear as moles or uterine fibroids.

In a malignant tumor the cells grow uncontrollably and more quickly than benign tumor cells. They seek out other tissue to consume. Unlike a self-contained or non-spreading benign tumor, a malignant tumor will continue to spread to other parts of the body. Malignant tumors are, by definition, always cancerous. Fortunately they are not contagious, but they are also not preventable.

Q: Where are tumors most often located?

A: Tumors, either benign or malignant, can be located anywhere in the body. They can occur in the vital organs (e.g., brain, liver, lungs, kidney, etc.), soft tissues, bone/bone marrow, blood vessels, etc. Tumors in bone, including the spine, are classified as being primary or secondary. The primary spinal tumor first appears in the bones of the spine, whereas a secondary spinal tumor (always malignant) first appears elsewhere in the body and metastasizes (spreads) to the spine. Some spinal tumors occur as a result of genetic defects (e.g., neurofibromatosis 2), for the remainder the pathogenesis or cause is unknown.

Q: How often does spine cancer occur?

A: The answer to this is difficult to quantify. However, the spine is the most common site for bone metastasis. There are estimates that suggest between 30 and 70% of all patients with cancer will have spinal involvement.

Q: Where are the spinal tumors located?

A: Primary and secondary spinal tumors can occur (1) inside the spinal cord (intramedullary), (2) in the membrane (the meninges) that covers the spinal cord (extramedullary-intradural), or (3) between the meninges and the bones of the spine (extradural). Although a small number of tumors occur in the nerves of the spinal cord (e.g., ependymomas and gliomas), the majority of spinal tumors are extradural. Primary spinal tumors are much less common than primary brain tumors. As a spine tumor grows it can place pressure on the spinal cord as well as the bones of the spine, spinal blood vessels, nerve roots and the meninges.

In men, the secondary tumors that most often spread to the spine originate in the prostate and lung. In women, the secondary spine tumors most often originate in the breast and lung. Malignant spine tumors can also originate in the kidney, thyroid, and malignant melanoma. The cancerous cells are then transported to the spine via the lymphatic system or blood.

Q: Is there more than one type of spinal tumor?

A: There are a number of different types of both benign and malignant spinal tumors.

Among the benign tumors that may be present in the spine are:

Aneurysmal bone cyst – an abnormal growth that affects the vertebrae. Treatment includes embolization (cutting off blood flow) and surgical removal

Hemangioma – usually found in the thoracic and lumbar spine. Treatment includes embolization (cutting off blood flow), surgical removal and radiation

Giant cell tumor – an uncommon tumor found in the sacrum and lumbar spine. Treatment includes embolization (cutting off blood flow), surgical removal and possibly radiation

Osteoblastoma – found in the vertebrae and sacrum. Treatment is most often surgical removal

Osteoid Osteoma – found in the spinal column. Treatment is most often surgical removal.

More than 70% of all spine tumors are malignant, of which only 10% originate in the spine.

Among the primary malignant tumors that may be present in the spine are:

Multiple myeloma (cancer of the bone marrow) – most common malignancy of the spine. Treatment includes surgical removal, radiation and chemotherapy. The chemotherapy may be administered before the surgery to shrink the tumor (neoadjuvant chemotherapy) or after the surgery (adjuvant chemotherapy) to destroy any remaining cancerous cells.

Chondrosarcoma – most commonly found in the thoracic spine. Treatment is most often surgical removal

Chordoma – usually found in the lumbar spine and sacrum. Treatment is most often surgical removal if it can be done without affecting nearby nerve structures. Radiation may also be used for treatment.

Non-Hodgkin’s lymphoma – sometimes found in a vertebra and spinal canal. Treatment includes surgical removal, radiation and chemotherapy

Osteosarcoma – rarely found, affects the lumbar and sacral spine. Treatment includes surgical removal, radiation and chemotherapy

Ewing’s sarcoma – rare in persons over 30. Found in the sacrum, lumbar and thoracic vertebrae. Treatment is most often surgical removal combined with radiation and chemotherapy

Plasmacytoma – affects the thoracic vertebrae and can cause compression fracture. Treatment includes surgical removal and radiation

Astrocytomas – affect the nerve cells of the spinal cord. Treatment includes surgery and radiation.

Q: What are the symptoms of a spinal tumor?

A: The symptoms of a spinal tumor depend on the location, type of the tumor and rate of growth. Non-mechanical pain in the thoracic and lumbosacral regions of the back is the most frequent symptom. However, pain in the back is common to many spinal pathologies (cysts, infections, compression fractures, herniated discs, medication complications, etc.) and therefore an accurate diagnosis of a spinal tumor is critical. Other symptoms of a spinal tumor include bone fracture, swelling and inflammation, sciatica, loss of sensation, loss of bowel or bladder function, scoliosis or other spinal deformity. To isolate and pinpoint the spinal tumor the back and neck specialist will usually order a variety of lab tests to be performed (e.g., complete blood count with diff, comprehensive metabolic panel, serum protein electrophoresis, acid phosphatase, urinalysis with Bence Jones Protein, etc.).

In addition, one or more imaging studies may be undertaken, e.g., plain x-ray, MRI with contrast medium, CT Scan with Myelogram, Technetium bone scan or other nuclear medicine bone scans, or positron emission tomography (PET) scan.

Q: Assuming a tumor is found, what next?

A: To determine the exact type of tumor the back and neck specialist will have the patient undergo a needle biopsy (with image guidance) to obtain a sample of the tumor tissue so that the exact type, stage (severity) and grade (how quickly the cancer is likely to spread – low grade tumors being the least aggressive) of the cancer can be determined. Once this is done, a decision is made as to the treatment that will be pursued. This may mean a non-surgical treatment approach such as observation, the use of corticosteroids, palliative drug therapy, radiation, chemotherapy (administered in pill form, injection, intravenously, or via an implanted vascular access device (VAD)), bone marrow aspiration, radio-frequency ablation, or, in some cases, stem cell transplants.

Surgery is recommended when (1) other treatments have failed, (2) it is deemed necessary to stabilize the spine, or (3) the spinal nerves are being compressed. In this case all or a part of the tumor will be removed. During this procedure the surgeon will attempt to stabilize and reconstruct the spine by performing a spinal fusion with bone grafts, use of bone cement and instrumentation. Tumors that were found to have aggressive microscopic (histopathological) characteristics are subject to post-operative radiation therapy.

Q: Is spinal tumor surgery a high risk operation?

A: There are risks associated with any spinal surgery. These include infection, post-operative neurological problems, residual pain, failure to excise the entire tumor due to structural considerations, etc.

Q: If the decision is for the spine tumor to be removed by surgery, how long can I expect to be in the hospital?

A: Hospital stay can be up to 10 days or longer depending on complications, followed by bed rest and possibly rehabilitation.

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Vertebral Compression Fracture

The human spine extends from the skull to the pelvis and is the primary structural component of the body. It consists of 33 bones (vertebrae) stacked in a vertical column held in place by a complex assortment of back muscles, ligaments and tendons. The spinal column serves to (1) protect the spinal cord and the 31 pairs of nerve roots that branch off the spine; (2) provide stability and support for the head, chest and shoulders allowing the body to stand and walk upright; and, (3) and enables flexibility and mobility of the upper body. Adjacent vertebrae are separated by a fibrocartilaginous disc that serves as a shock absorber by cushioning the stress forces placed on the spine when the individual walks, runs or jumps. The intervertebral discs account for one-quarter to one-third of the spine’s length. The hollow center of the vertebrae create a canal or tunnel that houses a collection of nerve fibers known as the spinal cord, which originates at the base of the brain and ends at the first lumbar vertebra. The spinal cord and the brain are the primary components of the central nervous system.

The vertebrae of a healthy spine can withstand considerable pressure, but when the compressive force being applied exceeds the load limit of the bone, one or more vertebrae can collapse causing a decrease in the intervertebral space and the height of the vertebra. This is usually accompanied by a vertebral compression fracture that is most commonly located in the thoracic spine (primarily at T7-T8 and T12 and L1 – the thoracolumbar junction). Vertebral compression fractures can also be caused by trauma to the spine as a result of (1) automobile accidents, falls, sports injuries or improper lifting of heavy objects; (2) localized infection of the bone (osteomyelitis); (3) cancer in the vertebra that has metastasized from the liver, colon, prostate, breasts or lungs; or, (4) long-term use of steroid medication.

The most common cause of compressive spinal fractures is osteoporosis. In the U.S. alone, it is estimated that this bone-weakening, metabolic disease is the cause of between 750,000 and 800,000 vertebral compression fractures annually. If the osteoporotic or other type of compressive fracture impacts the spinal cord or nerve roots the individual usually experiences acute pain. However, in the case of osteoporosis, more than two-thirds of the fractures are atraumatic (i.e., clinically silent) even though they may occur at several levels of the spine. This means that the individual experiences little or no discomfort from a neurological deficit (the risk still exists that additional compressive fractures may occur). If mild pain does occur it usually goes away within a few weeks. In older patients the pain is often attributed to the natural aging process and is tolerated by the individual without seeking a medical evaluation. Symptoms of a compressive fracture other than pain include loss of body height, pain when standing or walking, evidence of kyphosis (dowager’s hump or humpback at the top of the back which is common in older women), loss of balance, psychological disturbances or neurological symptoms such as numbness and tingling.

If not treated properly vertebral compression fractures can lead to (1) a progressive misalignment, segmental instability and deformity of the spine; (2) loss of body height and mobility; (3) feelings of isolation and depression; and (4) gastrointestinal and pulmonary problems. When an osteoporotic compression fracture occurs in a vertebra, there is a 40% chance that an adjacent vertebra will experience a similar fracture within one year.

In order to diagnose a vertebral compression fracture the spine and neck specialist develops a complete case history, performs a physical examination, and employs imaging technology (x-ray, CAT scan, or MRI) to confirm the presence and severity of the fracture. If a fracture is confirmed, the specialist will usually recommend a conservative course of treatment including rest, over-the-counter and prescription pain medication, and bracing to limit spinal movement. In those cases where the individual is experiencing severe pain, the back and neck specialist may undertake a minimally invasive vertebroplasty or kyphoplasty procedure.

If a vertebroplasty is selected the patient receives a local anesthetic and intravenous sedation. The specialist then uses a fluoroscope to place a trocar (large bore needle) into the collapsed vertebra. Once proper needle placement has been achieved, bone cement (polymethylmethacrylate) is injected under pressure into the vertebra to stabilize the fracture and support the spine. The cement hardens quickly, preventing the fracture from collapsing further while it heals. The procedure, which is usually performed on an outpatient basis, takes less than two hours.

If the kyphoplasty procedure (aka Balloon Assisted Vertebroplasty) is selected, the specialist inserts two fluoroscopically guided needles, each containing a deflated balloon, into the vertebra. The balloons are then inflated to increase the height of the vertebra. After the balloons are deflated and removed, bone cement is inserted into the space created by the balloons. Patients usually experience immediate pain relief with either procedure. Complications following vertebroplasty or kyphoplasty are extremely rare. However, there is a very slight risk that the cement will leak, causing pressure on the spinal nerves. In addition, numbness, tingling and infection at the injection site have infrequently been reported.

In some instances, the patient’s intractable pain and imaging studies showing a severe fracture may indicate that open surgery is necessary. In this case, the back and neck specialist may elect to fuse the vertebrae and/or insert spinal instrumentation (plates, rods, hooks, pedicle screws, or cages) to stabilize the spine.

Patients with any one of the following should not undergo a vertebroplasty or kyphoplasty:

  • There has been a greater than 80 percent collapse of the vertebra
  • Osteomyelitis or discitis is present in the vertebra
  • The compression fracture has been present for more than one year
  • There is spinal curvature (scoliosis or kyphosis) that is due to causes other than osteoporosis
  • There is spinal stenosis or herniated discs with nerve or spinal cord compression and loss of neurological function not associated with the compression fracture
  • The patient has coagulopathy (a disease or condition affecting the blood’s ability to coagulate)
  • There has been significant compromise of the spinal canal caused by an impeding bone fragment or tumor

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Pain at the Base of the Spine

LowerBack PainThe coccyx (pronounced: cox-ix) is a small, triangular-shaped, bony structure located at the base of the spinal column. Most of us give no thought to it until we inadvertently fall on it. Normally exhibiting little movement, the coccyx is composed of three to five coccygeal vertebrae (four being the most common) that may be fused into one structure, or into segments of two or more vertebrae. Unlike the higher spinal vertebrae, the coccyx has no hole in the middle to allow passage of the spinal cord, nor is it assigned an abbreviation or number as is the case with the other spinal vertebrae (e.g., seven cervical vertebrae numbered C1 to C7, twelve thoracic vertebrae numbered T1 to T12, five lumbar vertebrae numbered L1 to L5, and the five sacral vertebrae numbered S1 to S5).

The length of the coccyx is varies by individual, with a range of roughly one to four inches. It usually curves gently from the end of the spine into the pelvis. The coccyx is larger at the inverted base (where it connects with the lowest vertebrae of the sacrum (L5) forming the sacrococcygeal joint), then tapers downward to a rounded or cleft (bifid) point at the distal tip (apex). Since it gave the appearance of an animal’s tail, in the past it was widely referred to as a tailbone.

Until the 1970s, the coccyx was considered to be a vestigial remnant that served no function other than to remind us of our evolution from apes to man. We now know that the coccyx is an integral part of a complex system of support (the pelvic diaphragm) for our internal organs. Among the nine muscles attached to the coccyx are the gluteus maximus, the levator ani, the sphincter ani externis and the coccygeus. These muscles play a vital role in pelvic floor support and our ability to stand and maintain bowel control.

Of the 31 pairs of nerves that emanate from the spinal cord, the coccygeal nerve is the 31st and lowest nerve pair. The coccygeal plexus (collection of nerve fibers) located in the pelvic cavity arises from the S4 and S5 vertebrae. Its function is to transmit sensory information to the brain from the skin overlying the coccyx.

When pain (coccydynia) occurs at or near the coccyx it can be mild to severe and will often compromise an individual’s quality of life. The pain can be caused by sprains, chips, bruises, cracks, pulled ligaments, dislocations or fractures (a rare but painful occurrence) of the coccyx. These conditions may have been the result of falls (e.g., slipping on ice, ice-skating, etc.), repetitive friction from rowing, cycling or horseback riding, and sports-related blunt trauma (gymnastics, football, etc.). Coccydynia can occur at any age in both males and females. It is said to occur more often in women than men due to the shape of the female pelvis. Racial predisposition has not been reported.

Coccydynia can also be caused by a cyst at or near the tip of the coccyx (e.g., pilonidal cyst), infections, and, in rare cases, malignant tumors (either primary or metastatic). Women sometimes experience painful coccyx bruising when the baby descends through the pelvis during childbirth. The sensation of pain at the coccyx may also be idiopathic (cause unknown), and in some cases, psychosomatic (in the head). The pain, irrespective of cause, is generally more intense when the individual is sitting on a hard surface, stands for long periods of time, engages in sexual intercourse, becomes constipated, or has bowel movement. In some instances, coccyx pain may not be felt at the site of the coccyx itself, but is instead referred to the back, hips, thighs or legs. The wide variety of coccyx pain causes emphasizes the need for a thorough case history and examination by a back and neck specialist to determine the best treatment alternative.

The symptoms of coccydynia include (1) pain that worsens when the coccyx is palpated (touched); (2) non-specific pain around the hips, pelvis or lower back; (3) the inability to stand in place or sit still for periods of time; (4) pain that worsens with constipation and feels better after a bowel movement; (5) pain during sex; and, (6) visible bruising if injury is due to trauma.

The treatment of coccydynia is most often conservative with the application of compresses, bed rest, non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation, and stool softeners to prevent constipation. Depending on the severity of the pain and its impact on daily activities, the back and neck specialist may recommend prescription pain medications, physical therapy, ultrasound or fluoroscopically guided injections of local anesthetics or corticosteroids into the collection of nerve cells (the ganglion impar) located at the sacrococcygeal junction. Immediate pain abatement usually follows the injection into the ganglion impar and can, in some cases, last indefinitely.

In those cases where extensive conservative treatment fails to provide pain relief the surgical removal of the coccyx (coccygectomy) may be undertaken. The removal of the coccyx has the same risks as other surgeries, e.g., wound healing problems, infection, and the possibility that the surgery will not result in pain relief.

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Golf-Related Low Back Injury

The sport of golf is played by more than 27 million Americans – young and old, male and female, novice and professional. Although certainly not a contact sport, golfers experience their share of sport-related injuries to the neck, hand, elbow, and shoulder. The most common injury is to the low back or lumbosacral region of the spine – the discs, muscles and tendons associated with the L5 and S1 vertebrae.

Golf is unique in that it is considered a life-long sport. Frequent extended play, combined with poor golf mechanics (e.g., poor posture, over swinging, improper swing technique, etc.) can contribute to, if not create, low back pain caused by spinal stenosis, age-related degenerative disc disease, disc herniation, pinched nerves or sciatica. Individuals who have these conditions often continue to play golf in order enjoy the social interaction of playing partners, maintain the competitive spirit, or simply undertake something other than the routine of everyday life. When this occurs, a few hours on the golf course often results in days or weeks of very intense pain.

Q: What is the primary cause of a golfer’s pain in the low back?
A: The simple answer is trying to swing the golf club too fast, particularly when hitting the ball off the tee. The innate desire to put the ball as far down the fairway as possible requires the individual to flex, bend and rotate the spine while simultaneously engaging multiple groups of muscles in the back, arms, hands, abdomen, buttocks and legs in what is best described as a violent outburst. This seemingly unnatural motion places significant shear, compression and torsion forces on the architecture of the lumbosacral spine. Since the average golfer will take between 50 and a 90 full swings over an 18-hole round (plus those on the practice range), there is bound to be some degree of muscle and joint fatigue and/or strain. Complicating the problem of over-swinging is the fact that this action is unilateral (one sided), requiring a right versus left side strength imbalance and asymmetrical musculoskeletal flexibility.

Q: What treatments are usually recommended for golf-related low back pain?
A: If pain is not abated by rest, massage and over-the-counter pain relief medications, it is in the golfer’s best interest to consult a back and neck specialist for examination and diagnosis of the source of the pain. This is usually followed by prescribed pain and anti-inflammation medications and perhaps some low-back exercise instructions and/or physical therapy. In rare cases, surgery to correct the cause of the pain may be recommended.

Q: What can be done to prevent golf-related low back pain?
A: Every professional golfer, golf course pro or physiotherapist can offer suggestions to avoid injury while playing golf. Some of the most frequently recommended include:

  • Learn the proper technique for swinging a golf club – i.e., take a lesson from a golf pro
  • Don’t over swing – incorrectly swinging the golf club as fast as you can results in excessive force and torsion being applied to the low back, resulting in injury or exacerbating an existing cervical or lumbar problem
  • Strengthen the muscles in your lower back and abdomen through exercise to develop torsional flexibility – emphasize the shoulder, torso, hip, and hamstring
  • Warm-up thoroughly before beginning your round (include stretching and simulating your golf swing)
  • If you go to the practice range to warm up, start with the pitching wedge and work your way up to the driver. This incremental approach helps avoid muscle sprain
  • If you chose to walk the course, use proper bag lifting technique, carry the bag properly (bag straps over both shoulders to evenly divide the weight), push the bag cart instead of pulling it, and, if you decide to ride, be the driver so you can anticipate rough terrain.

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Discogenic Low Back Pain

The low back or lumbar spine has five vertebrae with intervertebral discs located between the adjacent vertebrae that serve as shock absorbers. Each disc has two parts, a soft, gel-like interior (the nucleus pulposus) containing mostly water and a fibrous outer, ring-like structure (the annulus fibrosus) that surrounds and protects the nucleus. Nerve fibers are not present in the nucleus or inner two-thirds of the annulus. However, the outer third of the annulus does have nerve fibers. When you have intervertebral disc problems in the low back it is most often caused by a vertebral abnormality that can be identified by the spine specialist’s diagnostic process, e.g., disc herniation, spondylosis, spinal stenosis, lumbar sprain, etc. The pain the patient experiences from these conditions is caused by an irritation of a spinal nerve root (s) or the spinal cord itself.

The imaging studies sometimes show no evidence of vertebral abnormality, yet the patient is experiencing moderate to debilitating low back pain. This condition is often attributed to the slow deterioration of a disc resulting from age-related changes in the chemical and physical composition of the disc itself. The changes cause inflammation and/or tears or cracks in the disc’s annulus (internal disc disruption) that irritates the nerve fibers in the outer third of the disc’s annular ring. In addition, the gradual leakage of fluid from the disc causes the height of the disc to collapse and the nucleus to become dried and firm. Other contributors to discogenic pain include genetic factors, nutrition and mechanical or traumatic disruption.

Pain or other symptoms of neural pathology may not be present in the early stages of chronic disc degeneration. As the condition advances, discomfort in the low back becomes evident. The discogenic pain, which occurs most frequently in patients between 30 and 65 years of age, differs from other low back pain symptoms in that it is usually a dull ache, sometimes accompanied by unilateral radicular pain in the buttock or thigh, but not in the lower leg and foot (as is the case with sciatic pain).

Patients with low back discogenic syndrome are categorized as having (1) chronic persistent (constant) pain or (2) chronic recurrent (episodic) pain. The later presents as intermittent pain episodes that may last for several weeks or months followed by a brief, pain-free period before reoccurring. Pain in both categories will intensify when the pressure inside the disc (intradiscal pressure) increases, e.g., when the individual engages in strenuous physical activity, sits, bends forward, twists, stands in a stationary position, coughs, or sneezes.

The diagnosis of discogenic pain follows the spine specialist’s examination of the patient, followed by careful analysis of MRI and/or CT scans. In some cases the specialist may use a discogram to confirm the location of the pain and assist in the decision as to whether surgical fusion of the lumbar disc should be undertaken. The minimally invasive discogram procedure is somewhat controversial in that it induces pain in the patient in order to more precisely locate the actual source of the disc pain.

As with most other spine-related abnormalities, there are a number of treatment options for discogenic pain that the spine specialist may consider including conservative treatments such as non-steroidal anti-inflammatory medications, pain medications (including oral steroids), epidural steroid injections, opiods, physical therapy, and spinal bracing. In the event conservative treatments fail to alleviate the pain, or the pain worsens, the specialist may consider using thermal annuloplasty or Intradiscal Electrothermal Annuloplasty to seal cracks in the disc and deaden the nerves. Finally, the specialist may decide to perform endoscopic or traditional open surgery. This usually means that the patient will undergo a lumbar discectomy with fusion. History has shown that when this procedure is performed the cause of the pain is eliminated in 80% or more of cases.

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Whiplash

Each year more than two million Americans experience a whiplash injury (a.k.a. whiplash-associated disorder) to their neck. Numerous studies have shown that the most common cause of whiplash is a 6 to 12 mph rear-end automobile collision where the individual has a sudden, hyper-extension (backward movement) and flexion (forward movement) of the neck. The violent, unexpected motion forces the neuromuscular structure of the cervical region to exceed its normal movement parameters. Collisions at higher speeds have a commensurately higher incidence of severe damage to the cervical spine region.

Whiplash-associated disorder can also be caused by a front-end or side-impact automobile collision, contact sport-related accident, e.g., being struck from behind, diving/swimming pool accident, amusement park ride, or physical abuse (e.g., shaken baby syndrome). The pain the individual feels can be mild to severe and acute (short term) or chronic (long term). It is generally agreed that as many as 40% of patients with acute, whiplash-associated neck pain will develop chronic neck pain.

Soft Tissue Injury

In the majority of cases, the whiplash injury damages the soft tissue of the neck resulting in a sprain or strain of the neck muscles or ligaments. In the past, damage to the soft tissues was nearly impossible to visualize. Even with the aid of various advanced imaging technologies (MRI, CT-scan, standard x-ray with contrast, etc.) visualization remains difficult. There are times when patients will experience soft tissue injury, with pain, yet the imaging studies are completely normal. This means that the key factor in soft tissue diagnosis is the knowledge and experience of the spine specialist.

The symptoms of a soft tissue neck injury include neck pain, arm and hand pain, stiffness, back pain, shoulder pain, ringing in the ears, dizziness, neck-related (cervicogenic) headache, paresthesia (burning, tingling or prickling sensation), or injury to the discs, facet joints of the low back or sacroiliac joints. Some people may also experience cognitive deficits such as memory loss and impaired concentration as well as sleep disorders or psychological conditions, e.g., nervousness, depression or irritability. It is important to keep in mind that while the symptoms of a whiplash-associated disorder usually appear within 24 hours, in some cases the symptoms may not manifest themselves until days or even weeks after the accident.

If a soft-tissue injury is confirmed, there are a number of passive treatment alternatives that may be recommended including bed rest, hot and cold compresses, pain relieving medications such as non-steroidal anti-inflammatory drugs, and muscle relaxants. The decision as to which medication(s) is prescribed will depend on the type and severity of pain being experienced, the individual’s pain tolerance, and their general medical condition. Spine specialists now prefer that the patient pursue their daily activities in as normal a manner as possible. In the past, whiplash patients were advised to wear a cervical collar to limit neck movement. This type of immobilization is no longer considered an effective therapy as prolonged collar wear can cause weakness in the neck muscles.

Most patients with mild to moderate whiplash will have pain relief within a few days to two weeks, with a prognosis of full recovery in 10 to 12 weeks. For those individual’s whose neck pain becomes chronic (more than 12 weeks) or worsens the spine specialist may recommend, in addition to pain medication, some form active intervention including physical medicine, e.g., physical therapy, traction, range of motion exercises, etc. In the rare case of prolonged, debilitating soft-tissue pain the patient may be prescribed anti-inflammatory cortisone injections, opioid analgesics and/or anti-depressants. Surgery is not considered to be a treatment option for a soft-tissue whiplash-associated disorder.

Cervical Spine Injury

The pain symptoms of a cervical spine injury due to whiplash-associated disorder are similar to that of a soft tissue injury. If the spine specialist’s examination and imaging studies reveals damage to the facet joints, intervertebral discs, nerve roots and/or vertebrae of the cervical spine a more aggressive treatment regimen is usually undertaken. This approach may include physical medicine, anti-inflammatory pain medications, injections of cortisone into facet joints, facet joint radiofrequency neurotomy, facet joint laser ablation, therapeutic nerve blocks (steroid plus analgesic), and/or anterior cervical discectomy or laminectomy with fusion.

End Note: Although whiplash injuries occur with ever-greater frequency, the diagnosis of a whiplash-associated disorder is a challenging undertaking. The success of whiplash treatment will be a function of the thoroughness and accuracy of the spine specialist’s diagnosis.

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Sciatica

If you ask a person with sciatica to describe the pain that they feel the answer can range from a mild numbing, burning or tingling sensation to an excruciating pain that severely affects their quality of life. This complex pain syndrome, felt usually on one side of the body, is caused by the compression and inflammation of one of the two sciatic nerves. The nerves are formed by a collection of nerve roots exiting from the vertebral foramen at L4, L5, S1, S2, and S3 on each side of the lumbosacral spine. They are the longest and widest nerves in the body, and serve as an extension of the spinal cord. Each nerve has two branches, the articular branch that controls hip movement and the muscular branch that controls leg and foot movement. The nerves travel through the pelvic girdle and buttocks and continue down the back of the leg to the foot.

Q: What is the cause of sciatica?
A: There are a large number of neurological and musculoskeletal issues that can cause sciatica. A herniated (bulging) vertebral disc in the lower lumbosacral region causing compression of a sciatic nerve root is most often the cause of sciatica. The condition can also be caused by:

  • Narrowing (stenosis) of the lumbar spine
  • Spondylolisthesis – the slippage of one vertebra over an adjacent vertebra resulting in severe leg pain that is aggravated by walking, sitting or standing
  • Spondylitis – infection or inflammation of the spinal joints, osteomyelitis (infection in the bones of the spine), or sacroiliitis (inflammation in the sacroiliac joints)
  • Degenerative disc disease
  • Pirformis syndrome – inflammation of the sciatic nerve due to irritation from the pirformis muscle
  • Spinal irregularities – lordosis, osteoporosis in the low back, spinal tumors
  • Anatomical irregularities – non-symmetric lower limb growth
  • Excessive weight/obesity
  • Physical trauma – injury to the pelvis, buttocks or thigh due to falls, accidents, etc.
  • Improper lifting technique
  • Lack of exercise/poor muscle tone
  • Poor posture

Q: How is sciatic nerve damage diagnosed?
A: It is estimated that 5 to 15 percent of patients with low back pain have sciatica. The first indication that an individual is experiencing sciatic nerve pain as opposed to other forms of low back pain is the referral of the pain (sciatic radiculitis) into the buttock, thigh, knee, calf and foot. Sciatic pain may worsen when standing, walking, twisting, sitting, coughing, or sneezing.

Given the large number of possible causes for sciatica, an accurate and timely diagnosis of the condition by a back and neck specialist is critical to effective treatment. The specialist’s diagnosis includes a thorough medical history, physical examination and evaluation supported by one of more of the following diagnostic techniques:

  • Standard x-ray – with or without discography or a myelogram
  • Computer-aided radiography – CT scan or magnetic resonance imaging (MRI)
  • Thermography, sonography or a bone scan
  • Electromyography (EMG), nerve conduction studies, and/or evoked potential (EP) studies

Q: What are the treatment alternatives for sciatic nerve pain?
A: The success of any sciatica treatment depends on determining the exact cause of the problem. As is the case with other spinal neuropathy, sciatic nerve pain can be treated conservatively (non-surgically) or aggressively (surgery). Most spine specialists prefer that the patient undergo conservative treatment for a specific period of time. If, at the end of the period, the patient has not experienced a significant improvement, surgery is considered. Experience has shown that sciatic pain can respond very well to non-surgical treatment, provided it is diagnosed early.

Conservative treatments for sciatica are intended to relieve pain symptoms, i.e., make the patient more comfortable with his or her pain. Abatement of the pain, should it occur, will most likely occur gradually over a period of several weeks or longer. The non-surgical treatment altenatives (tried singly or in combination) include:

  • Bed rest
  • Application of hot and cold compresses
  • Physical therapy, yoga, physician-directed exercises, low-impact exercise (aerobics, walking, swimming, stationary bicycle)
  • Muscle relaxants, NSAIDs (non-steroidal anti-inflammatory medications such as aspirin, ibuprofen, etc.), anti-depressants
  • Spinal decompression therapy
  • Cortisone injections, epidural steroid injections
  • Hydrotherapy
  • Massage, acupressure, etc.
  • Glucosamine, herbal treatment, bio-feedback (to change your reaction to the pain)

Surgery is generally regarded as an option of last resort for the treatment of sciatica. The goal of the surgery is to remove the cause of sciatic pain. Depending on the severity of the pain, extent of sciatic-related disability, and various other patient characteristics, the surgeon may elect to perform (1) traditional open discectomy or foraminotomy surgery or (2) a minimally invasive (endoscopic) discectomy or foraminotomy surgery.

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Cervical Fusion

Low Back Pain, Neck Pain, Spinal FusionSpinal Fusion

It is estimated that more than 175,000 cervical vertebral fusion surgeries are performed each year in the United States. Fusion (stabilization) of spinal vertebrae is an anterior or posterior surgical procedure that has become the “gold standard” for cervical pain management. The surgery usually follows the failure of conservative, non-surgical treatment alternatives, e.g., rest, pharmacologic treatments (anti-inflammatory medication, opioid or non-opioid analgesics, antidepressants), cervical collar, etc.) to achieve pain relief. The surgical goal of a cervical fusion is to abate the patient’s pain caused by the compression of the spinal cord or spinal nerves as a result of vertebral disc herniation, degenerative disc disease that causes spinal instability, or spinal trauma (e.g., whiplash).

The fusion forms a fixed bridge between two or more cervical vertebrae facilitated by the introduction of a bone graft with or without instrumentation (plates, rods, screws, etc.). In recent years the bone graft material could be obtained from the patient (autograft) or taken from a cadaveric donor (allograft). A second type of allograft manufactured from synthetic material has been widely adopted by spine surgeons.

Although the majority (75 to 98%) of cervical spine fusions result in a positive outcome, the surgical procedure is not without controversy. A sizeable number of patient’s reported that following the surgery they experienced prolonged pain at the surgical site and/or at the autograft removal site. This has prompted the recommendation that patient’s considering cervical fusion surgery discuss in detail the risks and benefits of both types of graft acquisition procedures with the surgeon prior to the surgery. Smoking, obesity, osteoporosis, prior back surgery and other patient-related factors have been linked to unsuccessful fusion surgery.

Autograft

An autograft had historically been a piece of graft bone most commonly taken from the patient’s hip or pelvis. Once removed and shaped, the graft bone is placed between the vertebrae to fuse with vertebral bone and/or packed around the interbody instrumentation that is inserted to insure fusion stabilization. The advantages of an autograft were (1) faster healing due to the graft’s osteoinductive and osteoconductive properties, (2) the autologous bone graft was usually well incorporated into the graft site, and (3) the surgical outcome had been more predictable than when allografts or synthetic bone substitutes are employed.

In 2002 a bioengineered, osteoinductive human protein (rhBMP-2) graft implant was approved by the FDA for spinal fusion surgery. BMP is a growth substance that encourages bone cells to proliferate. BMP was initially used for fusion in all regions of the spine, however, as the use of BMP expanded undesirable side effects in anterior cervical spine surgery were noted. These included hematoma formation in the neck causing painful anterior swelling and respiratory distress as well as compression neurological structures. In some cases these results required longer hospital stays and additional surgery. Many surgeons no longer use BMP for cervical fusion procedures, relying instead on allograft material.

Allograft

An allograft is graft material obtained from a source outside the patient’s body. The most commonly employed allograft continues to be a section of cadaveric bone obtained from a bone bank. The cadaveric bone material has a negligible risk of disease transmission provided approved preparation procedures have been followed. In recent times bio-compatible cell-based, polymer-based or ceramic-based synthetic bone graft substitutes and demineralized bone matrices (DBMs) have been added to the surgeon’s choice of allograft alternatives.

The primary advantage of the allograft is that the surgeon does not have to perform a second surgery to obtain graft material from the patient. This means that the patient spends less time in the operating room (including less time under general anesthesia), experiences less blood loss, and avoids pain and other possible problems such as infection at the graft incision site.

The disadvantages of using an allograft may include (1) slightly longer recovery times and (2) the possibility that the sterilization process (e.g., demineralization, freeze-drying, gamma radiation, etc.) necessary to prevent the transmission of disease from the donor to the patient has decreased the graft’s osteogenic integrity. This could result in the graft having a diminished potential to incorporate with the patient’s bone. If this event occurs, there is a possibility of a failed fusion and the need for another surgery to correct the problem.

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Scoliosis: Onset and Treatment

Low Back Pain, Neck Pain, ScoliosisIn a normal spine the vertebrae are stacked in a straight, forward-facing direction. When the vertebrae have a lateral (side to side), C or S-shaped curve greater than 10 degrees the individual is said to have developed scoliosis. This debilitating, progressive condition affects between seven and twelve million Americans who are usually otherwise healthy. Scoliosis is most often located in the upper back (thoracic spine) but can also develop in the lower back (lumbar spine). It is also sometimes found in the area between the upper back and lower back known as the thoracolumbar spine. Scoliosis appears most often in the thoracic spine of individuals (girls more than boys) who are ten to fifteen years of age, and to a much lesser extent in children and adults.

The condition primarily impacts the body’s musculoskeletal system (spine, ribs, and pelvis). As scoliosis progresses during the adolescent growth spurt and into adulthood it can affect the individual’s pulmonary and cardiac function, as well as his or her neurological, digestive, and hormonal systems. Scoliosis can manifest itself in rib deformity, shortness of breath, back and hip pain, chronic fatigue, acute headaches, mood swings, and menstrual disturbances. It had been believed that once the individual reached skeletal maturity (stopped growing) increases in the curvature would end. Recent research, however, has indicated that the increase in curvature most often continues into adulthood.

Q: How does an individual develop scoliosis?
A: Approximately twenty percent of scoliosis cases can be attributed to one or more of the following: spinal injury, congenital spine defect (fetal spine fails to form properly), genetic abnormality/hereditary scoliosis, spina bifida, cerebral palsy, muscular dystrophy, vertebral deformity/spine muscle atrophy, spine tumor, infection, unequal limb growth, back muscle spasms, etc.

For the remaining eighty percent of cases the cause is unknown. In this situation the individual is said to have idiopathic scoliosis. There are four categories of idiopathic scoliosis:

  • Infantile idiopathic scoliosis – the condition develops when the child is less than three years old
  • Juvenile idiopathic scoliosis – the condition develops when the child is between 3 and 9 years of age
  • Adolescent idiopathic scoliosis – the condition develops when the individual is between 10 and 18 years of age
  • Adult idiopathic scoliosis – this condition develops when the individual is past the age of a 18 years. There are two forms of adult idiopathic scoliosis. The first is a continuation of adolescent idiopathic scoliosis that may or may not have been recognized and/or treated. The second is degenerative (de novo) scoliosis that develops in the lumbar spine in the middle to late adult years. The causes include traumatic injury, osteoarthritis or rheumatoid arthritis, or a degeneration of the intervertebral discs and facet joints of the spine. De novo scoliosis usually appears in association with a narrowing of spaces in the spine (spinal stenosis) which can put pressure on the spinal cord and/or spinal nerves resulting in back and leg pain.

Q: What are the symptoms of scoliosis?
A: In some instances a scoliosis curve is very noticeable. In other cases there are a number of visual indicators to suggest the presence of scoliosis including:

  • The spine curvature is evident upon radiographic examination
  • Shoulder or hip height is asymmetric
  • There is a difference in shoulder blade height or position
  • There is a difference in the way the arms hang beside the body when the individual is standing straight

Pain in the back or legs is not usually associated with idiopathic scoliosis until the spinal curve reaches an exaggerated stage (greater than 40 degrees). If you suspect a child may be developing scoliosis it is always wise to consult a spine specialist for a determination and/or confirmation of the condition. The specialist’s examination will usually include an x-ray of the spine in the standing position, and if deemed necessary CAT-scan or MRI evaluation. If scoliosis is evident, the specialist will measure the degree of the curvature (Cobb angle) and then prescribe a course of treatment.

Q: Does the scoliosis curve always go in one direction?
A: The scoliosis curve pattern varies according to spine region:

  • Thoracic spine – the predominant curve (90%) is to the right side
  • Thoracolumbar spine – the predominant curve (70%) is to the left side
  • Lumbar spine – the predominant curve (80%) is to the left right side
  • A protruding rib or uneven rib cage
  • Curves that occur on both the right and left sides are known as double major curves

Q: What are the treatment options for the of scoliosis?
A: There are three basic treatment options for scoliosis that are based on the degree of spinal curvature: observation and measurement, bracing and surgery. Until the scoliosis curve reaches 25 degrees conventional wisdom suggests that the curvature be periodically monitored (including x-rays) and measured. Most school districts now have mandatory student scoliosis screening in the fourth through eighth grades to facilitate early detection. Once a curve has been detected it is recommended that the individual undergo a thorough examination and begin a rehabilitation program that takes into consideration the child’s age (spinal maturity), severity and location of the curvature, gender and if other health conditions are present. The rehab program usually includes physical therapy and/or exercises designed to maintain a healthy back. It will not, however, reduce the curve angle or retard curve progression.

Bracing is deemed appropriate when the curve exceeds 25 degrees. If the curve exceeds 40 or more degrees corrective surgery may be recommended. Early detection of scoliosis is essential for treatment option success.

Q: What type of bracing is most appropriate?
A: The subject of bracing is not without controversy. There are reports that provide evidence of bracing success in preventing progression and, in some cases, substantial correction. However, there are other reports that indicate bracing does not serve a therapeutic purpose. While the correction issue can be debated, it is generally agreed that bracing can retard curve progression. Depending on the individual’s age and degree of curvature custom-designed braces made from plastic or other synthetic material are intended to be worn 23 hours/day, while others are to be worn only at night. The spine specialist may select a bracing option from the following alternatives:

  • A thoracolumbrosacral orthosis (TLSO) brace (Boston brace, Milwaukee brace (used for high thoracic curves), etc.)
  • Charleston scoliosis brace – worn only at night, studies have shown comparable outcomes to TLSO braces
  • Risser jacket – brace should be worn 23 hours/day
  • Providence brace – designed to be worn at night
  • Copes scoliosis brace – a dynamic brace that is frequently adjusted to achieve treatment objectives
  • Rosenberger brace – low-profile TLSO brace intended to improve patient instructional compliance
  • SpineCor Dynamic Corrective Brace – effectiveness being evaluated

Q: When should the surgery option be considered?
A: Scoliosis surgery is indicated when a growing child or adolescent has a highly progressive curve greater than 40 degrees, the patient is experiencing severe pain, or the scoliosis curve is greater than 50 degrees accompanied by severe trunk asymmetry. The surgeon most often uses spinal fusion techniques and a variety of instrumentation alternatives including rods, screws, hooks, wires, etc. to reduce and stabilize the scoliosis curve. The particular surgical approach the surgeon selects is function of the following:

  • Spinal maturity—is the patient’s spine still growing?
  • Degree of pain experienced and impact on the patient’s health and lifestyle
  • Degree and extent of the curvature
  • The spine region (s) in which the curve occurs
  • Success or failure of previous treatment alternatives
  • Estimate of probable progression following surgery

Summary: Scoliosis is a frequently occurring spinal abnormality that negatively affects the quality of life of young Americans, but can also affect individuals of all ages. Although treatment alternatives continue to be refined, early detection and treatment of the condition continues to be of critical importance.

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Abnormal Curvature of the Spine

Abnormal Curvature of the SpineIn a normal spine a gradual curvature is present in the cervical, thoracic and lumbar regions. This anatomical architecture is designed to protect the spinal cord from injury by increasing the strength of the spine, assisting in maintaining balance when the body is in the upright position and assisting in the absorption of the mechanical shock of body movement, e.g., walking or running.

More than seven million Americans have an abnormal curvature of the spine. There are three primary types of abnormal spine curvature: kyphosis, lordosis and scoliosis:

Kyphosis: also referred to as humpback or hunchback, is an exaggerated (greater than 50 degrees) outward curvature or rounding of the thoracic and/or cervical spine. There are three categories of kyphosis: (1) congenital kyphosis (CK) occurs when the fetal spinal column fails to develop properly due to the fusing of several vertebrae or an abnormality in vertebral bone formation. CK may progress as the child develops; (2) Scheuermann’s kyphosis (SK) is a more severe form of kyphosis that usually becomes noticeable when the individual is a teenager; and (3) postural kyphosis (PK), which is the most common form of kyphosis, usually occurs during an individual’s adolescent years. It is more common in girls than boys and is usually not associated with pain. PK is generally considered to be caused by poor posture, e.g., slouching, hunching over, etc.

Mild kyphosis, such as postural kyphosis, can be treated with physical therapy and/or non-steroidal anti-inflammatory or pain relief medications. In the case of Scheuermann’s kyphosis surgery may be considered if the patient experiences intense chronic pain, the spinal curve is greater than 75 degrees, or other neurologic, pulmonary or cardiac complaints are present.

Lordosis: also referred to as swayback, is a condition most usually found in the lumbar spine, although it can appear in the cervical region. It is caused by an exaggerated inward curvature of the low back/lumbar spine. If the lordosis is pronounced it can cause pain with movement. Kyphosis, obesity, osteoporosis, spondylolisthesis or dwarfism (achondroplasia) can contribute to the development of this condition. If the condition becomes severe as a result of age-related progression it can result in low back pain, muscle spasm, muscle weakness, etc. When conservative treatment fails to provide relief to the patient, surgery may be performed to apply spinal instrumentation, kyphoplasty (to restore vertebral height), or full or partial artificial disc replacement.

Scoliosis: is an abnormal lateral curvature of the spine in the shape of an S or a C that is greater than 10 degrees distance from a normal spine. It is most usually found in the upper thoracic spine and to a considerably lesser extent in the lumbar spine of young girls. The condition affects more than seven million Americans. The cause of the great majority (80%) of scoliosis cases is unknown (idiopathic). The remaining 20% of scoliosis cases may have been caused by (1) failure of the fetal spine to form correctly; (2) neurological system disorders, e.g., spina bifida, spine tumors, spinal cysts or other neurological deficits; or, (3) neuromuscular disorders such as muscular dystrophy, Marfan’s disease (a condition that affects the body’s connective tissue), etc.

The classification of idiopathic scoliosis is based on the age at which it first develops: congenital scoliosis (develops in the womb); infantile idiopathic scoliosis (child is less than 3 years of age – more prevalent in boys than girls – usually recognized in the first six months); juvenile idiopathic scoliosis (3 to 10 years of age – more prevalent in girls than boys); adolescent idiopathic scoliosis (11 to 18 years of age – more prevalent in girls than boys); and, adult scoliosis (presence of scoliosis past the age of 18 years or skeletal maturity). Adult scoliosis usually originates at an early age and has continued into adulthood. However, there are instances when scoliosis can first develop during the adult years. This condition is known as adult degenerative scoliosis and can be caused by osteopenia (low bone density), osteoporosis of the spine, wear and tear on the spine due to the aging process, advanced disc degeneration, etc.

In a future blog a discussion of the treatment alternatives for the various forms of spinal abnormalities will be presented.

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Back Injuries and Sports

Which sport has the highest incidence of back injuries? If you answered football, hockey or basketball you guessed wrong. Spinal pathology occurs among male and female gymnasts, from children at the earliest competitive level to experienced adolescent and young adult gymnasts at the highest competitive level. Each year more than 80,000 gymnasts at all levels require medical attention. A great number of these injuries are to the back including sprains, strains, and spinal trauma such as herniated discs and fractures. In addition, gymnasts commonly experience injuries to the upper extremities (wrist, hand, elbow, clavicle, etc.) and lower extremities (knees, ankles, hips, tailbone, etc.).

The term gymnastics encompasses seven competitive categories: men’s artistic, women’s artistic, rhythmic, acrobatic, group, trampoline and tumbling. The incidence of injury is highest in the men’s and women’s artistic categories. Both of these groups use various apparatus as part of their competitive routines. The women compete on the balance beam, uneven bars, vault and floor exercise. The men’s competition includes the horizontal (high) bar, parallel bars, still rings, vault, pommel horse, and floor exercise. The etiology of gymnastic spinal injury can include: exaggerated bending, arching and twisting of the spine; the jolt of tumbling routines in the floor exercise; rigorous, repetitive apparatus training; and, falls from the apparatus. In addition, it should be noted that the uneven bars, parallel bars, horizontal bar and rings place an exaggerated traction force on the gymnast.

The two predominant types of spinal injury are strains of the spinal muscles and spondylolysis. Also occurring to a lesser extent is spondylolisthesis. Both spondylolysis and spondylolisthesis are usually manifested at the 5th lumbar vertebra (L5), and to a lesser extent at the 4th lumbar vertebra (L4). Spondylolysis is a medical term for a lateral fracture of is a thin segment of vertebral bone (the pars interarticularis). Spondylolisthesis is the term used to describe the forward slippage of all or part of one vertebra onto an adjacent vertebra. The slippage is thought to be the result of the gymnast’s performance of repetitive hyperextension movement, such as an apparatus dismount. Spondylolysis and spondylolisthesis can occur at the same time, however, spondylolysis is not necessarily a precursor of spondylolisthesis. Another back injury gymnasts experience is Scheuermann’s disease (adolescent kyphosis) which involves two vertebra segments being forced into aberrant wedge-like shape. This causes a distended outward curve of the upper back.

The long term result of the various insults to the bones and muscles of a gymnast’s spine is pain running down the leg, limited mobility and chronic low back pain. “Herniated discs and disc degeneration also occur but to surprisingly lesser extent.” This is thought to be due to the gymnast’s intense conditioning, muscle strength and flexibility. Fortunately muscle sprain and ligament strain can be treated with rest and physical therapy. When pain persists, it is recommended that the gymnast be evaluated by a neurosurgeon or an orthopaedic surgeon. It is also fortunate that catastrophic injury to the athlete is a relatively rare occurrence.”

The prevention of injury is of paramount importance. Parents and coaches should insist that all safety precautions are taken, especially in non-competitive situations (practice) where the bulk of injuries occur. This includes ensuring that spotters are in attendance, the apparatus is in good working order, the athlete uses the appropriate safety gear (hand grips, braces, pads, etc.), and there is a de-emphasis on “working through the pain.”

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Hydration and Back Health

One alternative for relief from pain in the back that is very often overlooked is simply keeping the body properly hydrated, i.e., a necessary and sufficient intake of water. Every organ, tissue, and cell must have an adequate amount of water so that they can function properly. This is particularly true for the vertebral discs and muscles that support the spinal column.

Q: What role does water have in basic human physiology?
A: Water is the primary component of the heart and other muscles (75%), brain (85%), blood (80%), kidney and liver (83%), and lungs (90%). In sum, water accounts for approximately 75% of our body weight. Without water, our body could not survive.

Q: What does water have to do with back pain?
A: There is a strong, positive correlation between back pain and the lack of adequate water intake (dehydration). This is particularly true for the intervertebral discs. The disc serves as a hydraulic shock absorber and experiences downward pressure when we stand or sit. In order for the disc to function properly it must have an adequate water supply. The water in the disc is retained by specialized molecules that are capable of holding more than 500 times their weight in water. This unique capacity accounts for the disc’s hydrostatic pressure when properly hydrated. A disc that becomes dehydrated loses hydrostatic pressure and cannot support the load placed upon it. When this happens the disc becomes inflamed (swells), causing soreness and pain. It can also become herniated and/or susceptible to disc disease. Simply consuming the proper amount of water on a daily basis can prevent back pain due to disc hydration.

Q: What proof is there that discs lose water?
A: Perhaps the most obvious evidence that this happens is referred to as the “Diurnal Change.” This means that our height is greater in the morning than at night by as much as a ¼ to ½ inch. The change is attributed to the fact that gravitational force and various load factors on the spine during the day cause the water content of vertebral discs to diminish. During the sleep cycle the water content of the disc is replenished, assuming adequate water is available. Although some attribute the change in spine length to changes in disc hydration and changes in spine curvature, a recent study found the change is solely attributable to changes in non-degenerated disc height. They also found that 40% of the diurnal change occurs in the lumbar spine. (see John R. Ledsome MD, et.al., “Diurnal Changes in Lumbar Intervertebral Distance, Measured using Ultrasound” at www.johnledsome.com)

Q: What is the proper amount of water intake needed to maintain back health?
A: For years we have been told that we “should” drink 64 ounces of water (8/8 oz. glasses/day). That may well be the correct amount, however, there is no scientific evidence to support that level of intake. The amount of water we need will be a function of the state of your health, level of physical activity, ambient temperature, etc. At a minimum we should take in enough water to replace the amount of water lost due to urination, bowel movements, breathing, perspiration, etc. Of course this amount is highly subjective due to an individual’s physical activity, body weight, age, diet and climate. It should also be noted that we take in about 25% of our water from the foods we eat, e.g., fruits, vegetables, meat, etc.

Q: Does coffee, tea and/or soft drinks and alcohol count towards the needed water intake?
A: They do, but drinking eight cups of coffee a day is not the equivalent of drinking eight cups of water. The reason for this is coffee, tea and drinks other than water are diuretics: they increase the production of urine. Fruit drinks are often overloaded with sugar and power drinks are loaded with caffeine and carbohydrates. It should be noted that consuming multiple cans or bottles of soda pop per day is now thought to be related to various pathologies. One of the most obvious is the development of oral disease, particularly in children and adolescents. Awareness of this phenomenon has caused many school districts to ban soda pop dispensers in their schools.

Q: How will I know if I am dehydrated?
A: Unfortunately, there is a high probability that you already are. This is because various experts estimate that as many as 75% of all Americans are chronically dehydrated. Specific indicators include (but are not limited to) excessive thirst, day time fatigue, dry mouth, infrequent urination, changes in the color of urine, joint pain and non-specific pain in the low back.

Q: Should I drink water even when I’m not thirsty?
A: Yes. This is particularly true as we age. Studies have shown that the perception of thirst diminishes with age. Signs of dehydration in the elderly include back pain, constipation, kidney stones, arthritis and indigestion. A good rule of thumb, irrespective of age, is that we should not wait until we are thirsty to drink water.

Q: Is there such a thing as drinking too much water
A: Yes. This is particularly the case if you have kidney problems or your doctor has you taking prescription diuretics. To be on the safe side, consult your doctor for a recommended amount of water and other fluids you should drink.

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Excess Weight and Back Pain

lower back pain neck painThere is ample evidence to state that excess weight can cause acute and chronic back pain. This is particularly true for those who are considered obese. It is alarming to note that in 2009, more than one third of the adult population in the United States was considered obese. Compare this to 14 percent of this same population in 1980. It has long been known that there is a strong correlation between obesity and the onset of coronary heart disease, diabetes, high blood pressure, and colon cancer.

In addition, various studies have found a strong correlation between low back pain and being overweight or obese. Although painful spinal conditions such as spinal and knee joint arthritis, systemic inflammation of spinal muscles and ligaments, degenerative disc disease, etc. are prevalent among this group of people, they are not fatal. Perhaps this is the reason why research into the relationship between excessive weight and back health has been relatively limited.

Q: Is being overweight and being obese the same thing?
A: No. According to the National Institutes of Health overweight persons and obese persons fall into two separate categories as determined by the Body Mass Index (BMI).

Q: What is the Body Mass Index or BMI?
A:
The BMI is simple number calculated by the relationship of two numbers – your height in feet and inches and your weight. The BMI categories are as follows:

  • Underweight = <18.5
  • Normal weight = 18.5–24.9
  • Overweight = 25–29.9
  • Obese = BMI of 30 or greater

(To find your BMI go to http://www.nhlbisupport.com/bmi/)

Q: How do I reduce my BMI?
A:
The best way is to undertake a regimen that includes a proper diet, exercise and, if necessary, dietary supplements. In extreme cases, a person may also undergo behavioral therapy, surgery, or pharmacotherapy.

Q: Is there a relationship between diet, the BMI and back health?
A:
Absolutely. Eating a proper diet not only reduces the BMI, it also serves to reduce and prevent back pain. By proper diet we mean one that includes:

  • lean meat, fish and chicken
  • plenty of fruit (apple, pear, peach, pineapple, grapes, oranges and papaya) and vegetables
  • low fat dairy foods
  • whole grains, including whole-wheat bread and pasta, cereals and brown rice
  • nuts (e.g., almonds, walnuts and peanuts) and seeds
  • plenty of water – be careful of flavored waters as they may contain unwanted calories

You should also limit or avoid:

  • eating red meat as it can cause or exacerbate chronic back pain and joint inflammation
  • processed meat
  • high-fat dairy products
  • coffee and tea
  • fried foods
  • white flour
  • foods high in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars

More to come on the subject of diet and back health…

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Intimacy and Back Pain

Each day millions of Americans suffer from back pain caused by muscle strain, sciatica, herniated disc, traumatic fracture, bone spurs, spinal arthritis, degenerative disc disease, or other forms of spinal pathology. Depending on the severity of the pain, most people will make physical and behavioral adjustments to their lifestyle in an effort to achieve some level of comfort or relief. One of the first aspects of daily living to be affected by back pain is that of intimacy.

For most people sex is the most important part of intimacy. A recent survey found that 56 percent of those with severe back pain would voluntarily discontinue sexual relations if it resulted in an end to their back pain. The same study revealed that 46 percent of the respondents had chosen to discontinue all sexual activity, while others in the survey had sex less often or had less satisfying sex when it did occur. When back pain negatively affects a previously healthy sex life, problems are likely to arise in the relationship.

If back pain has affected the intimacy that you and your partner previously enjoyed you may want to consider the following:

  • Consulting a spine specialist to obtain an accurate diagnosis of the cause of your problem and a recommendation as to treatment alternatives. This information is critical to understanding what has happened to your back and what the future may hold. Keep in mind also that untreated pain can lead to proven relationship destroyers such as frustration, anger and depression
  • Having a frank discussion with the spine specialist regarding back pain and sex. Your back pain is unique to you. Don’t make the mistake of thinking your partner understands how your pain affects you. For this reason, it is preferable that your partner be present to share their questions and concerns
  • Asking the spine specialist for guidelines regarding positions and movements that will support your back and minimize pain during sex. As you experiment with different positions and movements keep in mind that you need to be gentle, and if it hurts, don’t do it.

Back pain doesn’t have to mean the end of sexual intimacy or the end of sexual satisfaction. It does mean, however, that you have to take affirmative steps to understand and manage it.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Neck Pain Relief via Nerve Block

Neck PainIf you are experiencing neck pain due to whiplash, spinal stenosis, disc herniation or arthritis in the facet joints of the cervical spine, your back and neck specialist will seek to determine the source of the pain. By knowing the exact source of the pain the most effective and long-lasting treatment alternative can be selected. One of the most useful tools in the specialist’s diagnostic armamentarium when dealing with neck pain is the nerve block. The purpose of the diagnostic nerve block is to identify the area causing the pain as precisely as possible. The procedure entails injecting an anesthetic (usually lidocaine to numb the pain) and a contrast agent (to identify the spinal structure) into the affected area. Lidocaine is a fast-acting anesthetic that usually wears off in about two hours. Other slower-acting anesthetics are sometimes used for longer lasting pain relief.

A nerve block can also be very useful in the management of chronic neck pain. The primary difference between a diagnostic and therapeutic nerve block is that the latter contains an anesthetic and a steroid such as cortisone (to reduce swelling). The pain reducing effects of cortisone can last for months. In some cases the specialist may mix morphine or fentanyl (a synthetic narcotic analgesic) with cortisone to obtain increased pain relief. If the nerve block is successful, surgery is not necessary.

Epidural Spine Block

Depending on the objective data, the back and neck specialist may choose to inject an anesthetic and a steroid into the epidural space that exists between the covering of the spinal cord and the inside of the bony spinal canal. An epidural spinal injection is a non-surgical treatment option that may provide long-term relief from neck pain radiating to the arm. The injected medication coats the targeted nerve roots and the outside lining of the facet joints near the area of injection. In some instances the epidural spinal injection can provide permanent relief.

The epidural spine block procedure is performed on an out-patient basis with the assistance of fluoroscopy (x-ray) to monitor the placement of the needle into the epidural space. A small amount of contrast dye is injected to confirm that the needle is placed properly and that the medication is in the area where it’s needed. The procedure usually takes between 15 and 30 minutes.

There is no guarantee that a therapeutic nerve block will work in every instance and there is no way to predict what a particular individual’s outcome will be. Experience has shown that they work about 50% of the time. When they work, a second block is not needed nor is there a need for other treatment (e.g., surgery). In some cases the block is successful but its effectiveness wears out. It is recommended that no more than three blocks be performed per year.

As is the case with all invasive treatment procedures the possibility of side effects exists. Your specialist will describe what these are and provide you with specific after-care instructions for you to follow. In rare instances the specialist may determine it is unsafe to perform a spinal block if certain medical conditions exist.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Texting and Neck & Arm Pain

Texting and Neck & Arm PainNeck and arm pain related to texting is a growing phenomenon. Initially referred to as “BlackBerry thumb,” the repetitive stress that comes from excessive use of a wireless device’s tiny keyboard to send text messages has been found to strain muscles, tendons, and ligaments in the hand, arm and neck. In addition, prolonged flexed-neck posture, or “hunching over,” as the keyboard is manipulated can cause cervical nerve disruption accompanied by acute or chronic neck pain. This non-traumatic pain often radiates down the arm causing a combined pain that is greater that arm or neck pain alone. Similar outcomes have long been associated with using a computer keyboard.

It is predicted that if excessive texting behavior continues unabated, the number of nerve-related disorders such as osteoarthritis and degenerative disc disease will increase and lead to a debilitating pain syndrome that negatively impacts school and/or work performance. A more immediate concern is that inflammation of the basal joint at the base of the thumb due to excessive texting will result in thumb arthritis. This condition manifests itself in hand pain, swelling, decreased strength and limited range of motion.

Simple steps to take to prevent the development of a texting-related pain include:

  • Stopping texting at the first sign of discomfort or pain – if you can’t stop, cut back on the number of messages sent each day
  • Try to avoid hunching over – position the keyboard in such a manner as to limit pressure on your neck and upper back muscles as they work to keep your head from falling forward
  • Don’t sit in the same position for long periods of time
  • Use both thumbs – and give your thumbs a rest when typing long messages.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Your Mattress & Back Pain

Your Mattress and Back PainFour facts are indisputable. First, more than 40 million adults experience recurring or chronic back pain, most of which is non-specific. This means that there is no specific therapy to remove the source of the pain. Second, we spend one-third of our lives lying on a mattress. Third, there is a definite relationship between the mattress you sleep on and your back pain. Restful sleep is essential for maintaining a healthy back and spine. Fourth, choosing the right mattress can (1) improve your condition if you have an existing back pain issue, and (2) prevent you from developing back pain.

Mattresses come in a variety of types – memory foam, innerspring, latex, air, adjustable, etc. If any of these mattresses is too soft, the body will “sink in” causing low back pain and irritated spinal joints. If the mattress is too hard it can cause pressure points and reduce blood circulation. Today it is generally acknowledged that any type of medium firm mattress is preferable provided (1) it conforms to the spine’s natural curves thereby keeping the spine in alignment when you lay down; (2) distributes pressure evenly; and (3) minimizes transfer of movement from one sleeping partner to the other. This last point is important since most of us will change position more than 50 times during our sleep cycle.

Other factors that influence mattress selection include:

  • Preferred sleep position – lying flat, lying on the side, or lying on the stomach (not recommended as it forces the spine into an unnatural angle and may aggravate back and neck problems)
  • A proper cervical pillow will lessen the chances of neck and back pain
  • Your height and body weight
  • Mattress size, material, warranty, test period, cost, etc.

Mattresses have a definite role in the management of back pain. The best mattress for you is one that is tailored to your particular needs. If you have questions about back pain, or are uncertain as to how to proceed with mattress selection, you should consult a back and neck specialist.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Diving & Spinal Cord Injury

Diving and Spinal Cord InjuryRecreational swimming and diving rank third among all physical activities (after walking and camping), and is the most common activity among children. The fun of diving into a pool or other body of water too often turns into trauma that ends up in the emergency room. Each year more than 7,000 young Americans experience a diving accident. Consider the following:

  • The head and neck are the most common body area injured in a diving accident and account for more than half of all sports-related spinal cord injuries. The injuries are almost exclusively located in the cervical vertebrae
  • A large number of water-related spinal cord injuries can be catastrophic. The loss of sensation and movement in the upper and lower body (quadriplegia) or the loss of sensation and movement from the waist down (paraplegia) happens far too often. These injuries require a lifetime of care and medical treatment
  • 90% of diving-related accidents occur in water that is less than six feet deep. Even when the water is deep enough to prevent divers from hitting the bottom, the surface tension of the water can cause spinal injury if the diver hits the water improperly. In this regard, recreational and competitive divers alike are at risk
  • 90% of diving accidents occur in private residential swimming pools (66% in below ground pools/33% in above ground pools)
  • 70% of the injuries are the result of head first dives, 18 percent from jumps or cannonballs, and 12 percent from flips or handstands
  • Even an experienced diver can be seriously injured by diving improperly, diving into water less than 6 feet deep, falling off a diving board or sliding down a water slide head-first.

Diving Board/Platform Diving/Edge of Water Diving
Each year nearly 700 serious spinal cord injuries occur as a result of diving off a board or platform. Collision with a diving board or platform is the leading cause of these injuries. The odds of injury caused by contact with the diving board increases dramatically if a child or adolescent is attempting a flip, handstand or backward dive. Injuries such as broken bones, whiplash, spinal injury and lacerations can result from diving from the waters edge into a pool or other body of water.

Preventing Diving Accidents

The following measures can be taken to prevent diving accidents:

  • Always dive into a pool with your hands in front of you, so if anything hits the bottom of the pool, it’s your hands and arms, not your head
  • Always check the depth of the water and for any obstacles before diving. Diving should not be done in waters less than 6 feet deep
  • If in doubt about water depth, enter slowly, feet first
  • Never dive into murky water
  • Remember that in non-pool waters there may be submerged obstacles such as sandbanks, rocks and tree branches that are not visible from above the surface
  • For adolescents, young adults and older adults – Don’t Drink and Dive

Prevention strategies also include educating young children about water safety to prevent them from jumping into shallow or turbid water, requiring that adult supervision or a certified lifeguard is present, employing visible depth indicators around the pool, learning proper diving technique when attempting new and unusual dives, and installing soft pool bottoms.
Finally, remember that diving injuries to the cervical spine aren’t always visible or immediate. Neurological effects (such as nausea) might occur after the diver is out of the water and the correlation to the incident might not be obvious Other evidence of nerve damage may be observed immediately or after a delay. These include tingling in the extremities, vision problems, concussion and impaired motor function. All diving-related neck injuries should be evaluated by a head and neck specialist – delayed treatment can cause further complications.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Smoking & Spinal Fusion Surgery

Smoking & Spinal Fusion Surgery

smoking, spinal fusion, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin

Patients often ask about the effects of smoking on spinal fusion surgery. Nicotine has a significant negative impact on the human musculoskeletal system by lowering bone mineral density, contributing to intervertebral disc degeneration, and limiting the restoration of the blood supply to bone grafts. Numerous studies have shown that smoking also (1) slows the production of bone-forming cells (osteoblasts) thereby increasing the time required for healing, (2) impairs the absorption of calcium, and (3) increases the risk of bone fracture. Other studies have found a direct link between smoking and low-back pain independent of surgical intervention.

Spinal fusion, the permanent surgical immobilization of two or more adjacent bones (vertebra) of the spinal column, has become the standard of care in the United States with more than 500,000 spinal fusions performed annually on the neck and low back. The effects of smoking should be of particular concern for individuals who undergo a fusion in the lumbar and cervical regions of the spine. Smoking causes an increased rate of pseudarthrosis, the failure of bone to fuse following spinal fusion surgery. This leads to increased postoperative pain. Studies of lumbar and cervical fusions consistently show that successful fusions occur in a significantly higher percentage of nonsmokers than smokers.

Finally it should be noted that cigarette smoking is a significant risk factor for the development of postoperative complications such as deep wound infection, improper healing and bone graft pain.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Neck Pain and Cervical Pillows

Cervical Pillow

Chronic cervical or neck pain is a widespread problem that can be the result of a neck injury (e.g., whiplash), pinched nerve, arthritis (osteoarthritis or rheumatoid), spinal stenosis, degenerative disc disease (e.g., bone spurs), and muscle related conditions such as neck strain, fibromyalgia and severe neck ache and stiffness (e.g., polymyalgia rheumatica (PMR)).

A cervical pillow can provide some relief from cervical pain by providing support to the head and neck while you sleep. Unlike regular pillows, cervical pillows are ergonomically designed to change the shape of the cervical spine whether you are lying on the back or the side. Selecting the best cervical pillow for you can be a trial and error situation since there are a number of factors to consider.

For Example:

  • Pillow Design – there are numerous pillow designs to consider – the contour pillow, roll pillow, dogbone pillow, wave or S shape, wedge, etc.
  • Pillow Material – foam, fiber, memory foam, water-filled, air-filled, buckwheat, etc.
  • Firmness/Softness of the pillow material
  • The Size of the person and the amount of neck support that can be tolerated
  • Size - pillow should support the back of the neck as well as the back of the head
  • Cost
  • Trial Period – is necessary to find the pillow that is most comfortable to you
  • Warranty

Other Factors to Consider Include:

  • A cervical pillow that restricts changes in sleeping postures or places more pressure on the back of the neck than on the back of the head might actually cause neck trouble. Don’t use the cervical pillow if it causes discomfort of any kind.
  • Although cervical pillows can provide temporary overnight relief from neck pain, it is always prudent to consult a head and neck specialist to determine the cause of your neck pain and to discuss alternative solutions.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Osteoporosis in Men

Osteoporosis is a progressive, degenerative bone disease most commonly associated with aging. This abnormal thinning of bones can progress without pain or other symptoms until a break occurs. Osteoporosis is incurable, but it is preventable and treatable.

Although current media attention focuses on osteoporosis in women, the National Osteoporosis Foundation (NOF) reports that more than 2 million men have osteoporosis and another 12 million men have osteopaenia (low bone density), a precursor to osteoporosis. Based on their statistical analysis, the NOF predicts that 25% of men over 50 will break a bone due to osteoporosis and (2) that men over 50 are more likely to break a bone due to osteoporosis than they are to get prostate cancer. Despite the gravity of these statistics, male osteoporosis and osteopaenia too often remain undiagnosed and inadequately treated conditions.

Risk factors for osteoporosis in men include: age, family history of osteoporosis, low body weight, smoking, excessive alcohol consumption, inadequate calcium or vitamin D intake, low estrogen levels, a sedentary lifestyle, previous fracture not related to trauma, and disease or medication affecting bone metabolism (e.g., corticosteroids, certain anticonvulsants, or excess doses of thyroid hormones). In addition, other medical problems such as chronic kidney, lung or gastrointestinal disease, prostate cancer and some autoimmune disorders such as rheumatoid arthritis can contribute to the development of osteopaenia and osteoporosis.

The importance of screening for osteopaenia and osteoporosis must not be underestimated. Early detection is the most important step toward the prevention and treatment of these conditions. A non-invasive, painless bone density test will determine whether you have osteoporosis or are at risk of developing the condition. Because standard x-rays cannot detect osteoporosis in its early stages, the following procedures are commonly employed:

  1. Dual energy x-ray absorptiometry (DEXA) – x-ray beams of differing energy are used to detect bone and soft tissue density separately. This fast and highly accurate technique can be used to measure bone density in the spine, hip, forearm and the total body.
  2. Single energy x-ray absorptiometry – a single x-ray beam is used to measure bone density at peripheral sites like the forearm and heel. In this technique, the area to be tested is wrapped in a tissue-like substance or immersed in water to improve the quality of the results.
  3. Ultrasound – measurements taken during an ultrasound may provide data on the structural integrity of bone. New ultrasound devices such as quantitative ultrasound (QUS) can estimate bone density of the heel within minutes, providing an automatic print-out of results.
    Each of these tests will allow your doctor to (1) detect osteoporosis at its earliest stages, so that treatment can begin, (2) monitor your rate of bone loss, and (3) monitor your response to treatment.

All men 50 and over should take the following essential steps to keep bones strong: (1) engage in regular weight-bearing exercise (brisk walking, weight-lifting, stair-climbing, etc.) and (2) follow a healthy diet, with an emphasis on calcium, low-fat or nonfat dairy products as well as fruits, vegetables, and whole grains.

If you or a loved one have one or more risk factors for osteoporosis, it’s important that you consult with your doctor without delay.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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Questions About The Spine

Q: What are the regions of the spine?
A:
Starting at the top, the spine has four regions with a total of 33 vertebrae:

  1. The first region is comprised of the seven cervical or neck vertebrae (labeled C1–C7).
  2. The second region is comprised of the 12 thoracic or upper back vertebrae (labeled T1–T12).
  3. The third region, known as the lower back, is comprised of the five lumbar vertebrae (labeled L1–L5).
  4. The fourth region is known as the sacrum and coccyx. This group of nine bones (5 in the sacral and 4 4 in the coccygeal region) is fused together at the base of the spine.

Q: Is the spinal column straight?
A:
No. The spinal column has three gradual curves. These curves serve to increase spine strength, maintain balance in upright positions, absorb shock when walking, and protect the spinal cord from injury. Abnormal spine curvature (scoliosis) usually occurs in the thoracic region due to a congenital condition, sciatica, poor posture, one leg being shorter than the other, or paralysis of muscles on one side of the body.

Q: What is the spinal canal?
A:
The spinal canal is a tube formed by the stacked vertebrae.

Q: Are all vertebrae the same size?
A:
No. Although vertebrae differ in size and shape in the different regions of the spinal column, they all share the same structure. The exception is the first and second cervical vertebrae which differ structurally in order to support the skull.

Q: How long is the spinal cord?
A:
An adult male has a spinal cord roughly 18 inches in length. An adult woman has a spinal cord roughly 17 inches in length. The spinal cord extends from the brain to the lower back. An injury to the spinal cord can cause a
loss of communication between the brain and the parts of the body below the injury.

Q: What keeps the vertebrae from rubbing together?
A:
Each of the 24 moveable vertebrae in your spine are separated and cushioned by an intervertebral disc. The discs, which account for ¼ the length of the spinal cord, serve as shock absorbers and allow movement of the spinal column.

Q: Does the spinal cord have nerves?
A:
Thirty-one pairs of spinal nerves branch off the spinal cord. The nerves are numbered according to the vertebrae above which it exits the spinal column.

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My Back Hurts! Motor Vehicle Accidents / Truck Injury / Whiplash: Houston TX, Attorney Assistance, Personal Injury Attorney and Lawyer, Towing

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You may take some comfort in knowing that you are not alone. More than 8 out of 10 adults will experience Back Pain at some point in their life. Your back contains numerous muscles, ligaments, joints, vertebrae, and inter-vertebral discs. All of which can cause pain if injured. Because of this, the source of your pain can be difficult to diagnose.

To schedule an appointment, please call
281-713-6296
or schedule online at www.spinehealth.com

Experts at the Kraus Back and Neck Institute, Houston, TX, are extremely experienced at treating back pain.  The pain may have been the result of a high speed motor vehicle or truck accident or truck injury, or might have occurred after turning the wrong way when getting out of bed.  Even a low speed motor vehicle injury may cause whiplash to the spine.  The Kraus Back and Neck Institute in Houston, treats patients in Houston and surrounding areas including Katy, Sealy, Sugar Land, the Woodlands, Galleria, Humble, Kingwood, Conroe, Baytown, Beaumont, Galveston and Port Arthur.  Dr. Gary Kraus and Dr. Masaki Oishi, both Board Certified Neurosurgeons, have found that they can treat most patients effectively, without the need for surgery.

Q: Which part of the back is most likely to be affected?
A:
Back Pain most often occurs in the lower back (lumbosacral region).  This area can be subject to significant vector forces during a truck injury or accident, or any type of motor vehicle accident.  Poor lifting body mechanics may also be a major cause of low back injury.  It is also important to use good posture when sitting.  Placing a lumbar support below the lower back can help to take pressure and stress off of the low back.
http://www.spinehealth.com/causes-back-pain.php

Q: What are the most frequent causes of Back Pain?
A:
Muscle strain is the most common cause of Back Pain, followed closely by ligament sprain. If not treated properly, both of these injuries can cause an imbalance in the spinal structure, often resulting in chronic (long lasting) pain. Your Back Pain may also be due to fibromyalgia (fatigue and pain in the muscles, ligaments and tendons; herniated or ruptured disc; osteoarthritis; and osteoporosis (compression fractures of the vertebrae).  Many patients also injure their back during sports injury.

Q: What causes back muscle strain?
A:
Poor lifting techniques, excess body weight, poor posture and unexpected twisting are the most common causes of a strained back muscle.  Whiplash injury from a motor vehicle accident or truck accident may also be responsible.  When an analysis is done, it is often improper body mechanics, either chronic or acute, which are the cause of back injury.  Tips and techniques for proper lifting.

Q: When should I seek treatment for Back Pain?
A:
If not treated promptly acute Back Pain can become a chronic (long lasting) condition that can lead to a disability. If there is pain going to the legs, there is most likely pressure being exerted upon a nerve, and it would be appropriate to see a neurosurgeon.  If there is weakness, then the nerve may have some damage, and surgery should definitely be considered.  If there is loss of bowel or bladder control, this may require a more urgent surgery.

Q: How will the doctor diagnose my Back Pain?
A:
To diagnose the cause of your Back Pain the doctor will (1) do a physical examination and develop a medical/family history including your account of the onset, site, and severity of the pain; (2) duration of symptoms, limitations in movement; and, (3) a history of previous episodes or conditions related to the pain.

Q: Do I need an attorney after an injury?
A:
When it comes to the need of expert medical care, one need a doctor.  When it comes to the need of expert legal advice, one needs an attorney.  During a motor vehicle injury, whether it be a car injury or a truck injury, one’s health and the health of all those involved in the injury is of primary importance.  That being said, it is also important to obtain the police, and a qualified attorney.  There will be important questions regarding cause of injury, damages, and it is important to gather appropriate evidence to determine who is at fault.  It must be stressed that no evidence gathering should stand in the way of prompt medical attention, but fact finding is important because there may be serious economic consequences of a severe motor vehicle car or truck injury.  The police will help to gather facts before the towing company removes the automobile.

The Kraus Back and Neck Institute in Houston can help to locate an attorney for those who have suffered motor vehicle accidents or truck injuries.  They can help to navigate through the system, and help to find personal injury attorneys / lawyers.
Call   281-713-6296

Q:How will the doctor confirm the Back Pain diagnosis?
A:
There are a number of techniques the doctor may use singly or in tandem to confirm the Back Pain diagnosis including: x-ray imaging (with or without discography and/or myelograms); computerized tomography (CT); magnetic resonance imaging (MRI); electrodiagnostic procedures such as electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies; bone scans; thermography; and, ultrasound imaging or sonography

Patients who have experienced a motor vehicle injury, truck  injury, any other type of accident or injury, or those who simply turned the wrong way and developed pain, and welcomed to contact the Kraus Back and Neck Institute in Houston, TX.  Patients are frequently seen from the Houston area, and surrounding communities of Katy, Galleria, Cinco Ranch, the Woodlands, Sugarland, the Woodlands, Pearland, Westchase, River Oaks, Conroe, Baytown, Beaumont, Port Arthur, Humble, Kingwood, Atascocita, as well as other regions of Texas and the United States.

To schedule an appointment, please call

281-713-6296
or schedule online at www.spinehealth.com

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How to Lift: Tips from the Kraus Back and Neck Institute, Houston

low back and neck injuries from lifting, Houston, Kingwood, Humble, Katy, the Woodlands, Beaumont, Baytown

low back and neck injuries from lifting, Houston, Kingwood, Humble, Katy, the Woodlands, Beaumont, Baytown

At the Kraus Back and Neck Institute in Houston, TX,  patients with low back injuries and neck injuries are seen very frequently.  One of the most common things which we do every day, yet give  very little thought to, is lifting.  Because we do it so frequently, lifting can cause significant injury to the low back.  This can occur as a result of lifting heavy objects once or light objects multiple times.  If you proper techniques of lifting, back injury can be avoided.

First we will focus on bending itself.  One of the worst things which we can do is to bend at the waist.  This place is huge stresses upon the lumbar spine.  It is much better to bend at the knees while keeping the back in a relatively straight and upright posture.

The position of the feet is very important when lifting objects.  Keep the feet at least a shoulder width apart from each other.  This helps provide extra leverage and stability.

The position of the object  which we are lifting in relation to our body is very important.  Make sure to keep the object as close to the body as possible.  The further the object is away from our body, the greater the torque is placed on our lumbar spine.

Balance the objects which you are carrying so that both sides of the body have an equal weight distribution.  We often see people carrying a heavy object such as a suitcase in one hand while leaning to the other side to balance the weight.  This places excessive stress upon the lumbar spine.  It is much better to try to carry equal weights on either side and create a balanced load for the lumbar spine.

Avoid lifting objects which are too heavy for you.  This will of course vary depending upon the abilities of the individual.  It is best to avoid a level of extreme strain and struggle as this has a much higher risk of causing injury to the back.

While lifting objects, keep your body straight  and pointed at the object.  One of the worst things we can do is twist the body while lifting at the same time.  This does place significant stress and strain upon the lumbar spine.

When possible, avoid lifting objects and especially heavy ones, above the waist and shoulders.  When one lifts bear arms up in the air, the curvature of the lumbar spine increases.  If one is lifting an object at the same time, excess strain will be placed on the lumbar spine.

Since injury to the low back and neck, or any other portion of the spine, can occur as a result of improper lifting techniques, it is important to pay good attention to proper body mechanics.

If one pays attention to these guidelines, many back injuries will be avoided.  Remember that back injuries can occur as a result of repetitive injury to the spine or from an isolated single injury.  It is easy enough to remember to incorporate these simple lifting techniques into our daily routines at the same time significantly decrease chances of a low back injury.

Take our interactive quiz about what is causing my back pain

Learn about causes of neck pain

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The Kraus Back and Neck Institute, located in Houston, TX, specialized in the surgical and non-surgical treatment of low back pain, neck pain, degenerative disc disease, disc degeneration, herniated disc in the lumbar and cervical spine, and sciatica.  They serve patients in the Houston and surrounding areas, including Katy, Galleria, Cinco Ranch, the Woodlands, Sugarland, the Woodlands, Pearland, Westchase, River Oaks, Conroe, Baytown, Beaumont, Port Arthur, Humble, Kingwood, Atascocita, as well as other regions of Texas and the United States.

~ New Patients Welcome ~
Call Today: 281-446-3876 (281-44 NEURO)

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