Low-Cost Back Pain Treatments

For some people who deal with back pain, the thought of taking on surgery may bring on as much discomfort and concern as the pain itself! Though the kind of minimally invasive spine surgery practiced by physicians like Solomon Kamson is less invasive, with a smaller incision and a briefer recovery period, it’s important to know that back surgery is still reserved for cases where more conservative treatments have failed. Unless it is a case of acute injury, there are other forms of treatment that can be tried first. Some can even be done with minimal cost. These kinds of treatments should still be undertaken under the guidance of a doctor. It’s important that you keep track of what works — and what doesn’t — and that your physician is aware of any changes in the nature of your pain.

Eat Right
Altering your diet to ensure you are getting the nutrients that will be most beneficial to your spine is one low-cost way to support your back health. While it’s always important to have a balanced diet, if you are experiencing pain you may benefit from eating foods that compliment a specific kind of healing. Certain foods like pepper are known to have minor painkilling properties (and in fact, capsaisin is often used in topical painkillers). Make sure you are getting enough calcium and vitamin D in order to support your bone health.

OTC Medications
For some people, limited use of supplements or over-the-counter medications can help ease pain. However, for others this may not be a good option. Depending on your liver and heart health, you doctor may or may not want to prescribe you a regular dose of OTC medications like NSAIDs. For these patients, selective use of supplements may provide some relief.

Heat or Cold Therapy
Heat and cold are best used for different kinds of injuries (heat for muscle soreness, cold for swelling). Some people benefit from alternating between the two. Cold packs that you put in the freezer and hot packs that you warm in the microwave are inexpensive and reusable. Keep both on hand, and make note of what works.

Tame Tension
Many people suffer neck, shoulder, and back pain that is exacerbated by physical stress. Whether it comes from overexerting your muscles through keeping a tense posture, sitting in an unhealthy position all day, or performing physically demanding tasks, this tension can have a very real impact on your back health. Trying stress relief measures can reduce the amount of pain you experience as a result of tension, which in some cases can also help prevent further injury. Relaxing by indulging in a favorite hobby, reading a good book, or meditating are all inexpensive ways to reduce your physical tension at the end of the day.

When it comes to treating back pain, more isn’t always more — sometimes simple and inexpensive changes like these can help relieve your pain. If you are experiencing persistent, intense pain, it’s important that you see a specialist like Dr. Kamson to get a proper diagnosis and treatment plan.

Alternatives to the Spinal Pump

Spinal pain pumps are one option for people who are dealing with intractable chronic back pain. These devices, which are implanted into the back, work by delivering a pain medicine in regular doses over a specified period of time. A doctor will “refill” the pump each month, and the pump will then administer the medicine over the course of the month to help control your pain. Solomon Kamson notes that it is important to know that spinal pumps ease your pain, but do not treat underlying disorders or conditions. It is critical that you have an accurate diagnosis in order to have a pain pump be effective: You don’t want to mask symptoms of a problem that could become worse, so it is important to understand the causes of the pain. There are numerous methods that can be used to manage chronic back pain; a treatment like the spinal pain pump should only be used when more conservative treatments have failed to decrease your pain.

Physical Therapy and Medication
Physical therapy is one of the least invasive means of treating back pain, and so it should generally be your first option in situations where you are experiencing minor to moderate back pain that has not been specifically diagnosed. Prescription or over the counter oral medications can be used to supplement physical therapy as your doctor considers appropriate.

Other Forms of Medication
In some patients, medications that are not indicated for back pain (like antidepressants and anticonvulsants) can help with chronic pain. These medications have been linked to a decrease in neuropathic pain experiences. Of course, this course of treatment can only be attempted with a physician’s guidance.

Massage and Yoga
While the relief from massage and yoga may seem temporary, for some people regular use of these therapies can lead to a long-term decrease in back pain. With regular use, the muscles supporting your spine can become stronger, more flexible, and more relaxed, helping to relieve pain.

Spinal Injections
Spinal injections treat pain through much the same mechanism as a spinal pump, injecting pain medication at the site, but are of course less permanent. Doctors will frequently use spinal injections not only to treat localized back pain, but also to try to identify the underlying causes of the pain. The extent to which injections help ease pain can give your physician valuable information on the nature of your condition. Injections are preferred to treatment with oral medications as these work more quickly.

Treating Other Areas of the Body
Many people are shocked to discover that a pain they have been experiencing as back pain is actually being caused by a problem in another part of their body, such as the hips or feet. Identifying and treating the source of this pain can provide the best source of pain relief in these cases. This is another instance that underscores the importance of an accurate diagnosis from a physician like Dr. Kamson.

Regenerative Therapy
If you discover that your back problem is related to natural wear and tear that results from everyday use or from an old injury, you may be a candidate for regenerative therapy. These are not pain treatments. Instead, regenerative treatments like platelet-rich plasma therapy help encourage new cell growth and healing. The immediate result is not necessarily pain relief, but relief from pain can be the net result as your body repairs and replaces worn-out tissue.

If these kinds of therapies do not provide enough relief or a lasting solution, a spinal pain pump may be one option that you can pursue. Back pain that is related to structural damage to your spine, however, like vertebral compression fractures or a herniated disc, is better suited to intervention with minimally invasive spine surgery. When a physical issue like one of these is the source of your pain, it’s important to treat the problem, not only the symptom.

The Impact of Really Hard Jobs on the Back

Due to increasingly sedentary lifestyles, the average American is now more likely than ever to experience back pain at some point in his or her life. But what about people who do not have sedentary lifestyles? There is research to support the claim that people are more active tend to have far fewer complaints of back trouble. But on the flip side, people who have jobs that require lots of repetitive motions or lots of standing for long hours are at high risk to develop back pains. Beyond that, there are some jobs that put strain on the back in very particular ways. Here are a few careers that go along with some very particular kinds of stresses for the spine and its supporting muscles.

Doctors and Nurses
Medical professionals are very likely to spend a lot of time on their feet in the average workday. Exacerbating the problem, most surgeons and nurses will have to spend at least some of their time holding odd and uncomfortable positions. Even when the surgeon is able to sit down during a procedure, they still have to hold their neck and back in a particular way for a long period of time. For nurses, there is the additional stress of having to often lift patients of all sizes on to and off of their beds or out of their wheel chairs. Especially with very large patients, this can actually lead to severe back problems for nurses if even the slightest misstep occurs in the process of lifting a patient.

While for most of us tend to think of the pain we feel after exercising in a “no pain, no gain” way, for professional athletes that kind of pain can have serious repercussions. This is an especially big problem for professional athletes like football players who regularly collide with each other, leading to injuries of the head, neck, and back. In fact, recent studies have shown that a disturbingly large number of professional football players have experienced a concussion or other injury to the nervous system that can lead to long-term pain as well as problems with cognition and physical functionality.

Space travel is an experience that is so outside our normal frames of reference that it seems filled with excitement and wonder. But for those who have actually experienced it, the hard truth is that being an astronaut is a physically demanding profession. Recently, Gennady Padalka set the new record for the longest time spent in outer space with a 168-day stay on the International Space Station. In all, Padalka has spent 879 days in space. Researchers are hoping to study Padalka to better understand the long-term effects of space life on the human body. According to an article by NPR, extended periods in outer space can lead to atrophy of the muscles, a decrease in bone density, and spinal extension, which may lead to health issues even after returning to Earth.

Dr. Kamson notes that almost no one goes without experiencing some kind of difficult pain at some point in their lives. Regardless of the nature of your job, you have the chance of developing a back problem. It’s important to know what your risk factors are, and what preventative measures you can take to prevent work-related back injuries.

Key Exercises for Back Health

To prevent or alleviate back pain, one of the most important things that patients can do is increase their exercise routine in ways that specifically focus on back health. But, if you’re new to the concept of exercising for a specific muscle group or body part, how do you know which exercises will be most beneficial? Here’s a quick guide to the core relevant muscle groups to help you get started:

The Back Itself
You might be surprised to discover that many times when patients experience back pain, it is not from overuse but actually from underworking the muscles surrounding and supporting the spine. People who experience back pain will sometimes avoid strain and exercise, which actually ends up making matters worse.

Here’s a quick set of moves that helps strengthen your back by stretching muscles while using mild resistance: Using dumbbells (pick a weight that’s comfortable for you), spend five to ten seconds in each of the following poses with one weight in each hand. First, hold your arms directly in front of you parallel to the ground. Then, slowly bring your arms straight up above your head. Last, extend your arms straight out to your side.
The Core
The muscles in the core—the long muscles that wrap around your torso, supporting your spine—are extremely important for back health. The following exercises are just some of the ways you can work on strengthening your core:
• Yoga poses including cat/cow, sunbird, and the boat pose
• Traditional floor mat exercises like crunches, bicycles, leg lifts, or jackknives
• Taking a vigorous walk for ten to twenty minutes. Though it might not seem like it helps your core, this kind of cardio both engages your muscles and can potentially release endorphins, which in itself can reduce the perception of pain.

The Thighs and Glutes
In many people, a flat backside is a good indication of poor spinal strength and health. Your hips and tailbone are critical for spinal functionality; so don’t neglect training the muscles in those groups.
• Squats and lunges are extremely good for working out your thighs and glutes. You don’t need to use weights, though you can add free weights to these exercises. What’s most important to focus on is and positioning, as poor form in squats and lunges (especially when using weights) can lead to injury.
• Use a treadmill or elliptical trainer set to an uphill incline. This will exercise your core and back, as well as strengthening your glutes and thighs.

Plus the Brain!
Though your brain isn’t a muscle, you can still give it a workout. It’s important you don’t neglect mental health and stimulation when addressing back pain. Boredom, depression, and fatigue can all exacerbate chronic pain, so keeping yourself happily engaged with hobbies, work, reading, or conversation, can all help you lessen your experience of pain.

Don’t forget: Before you begin any exercise program, it’s important to consult with a physician first. You need to ensure that the exercises that you are doing will not cause injury, as well as that they are properly supporting your back health. If you are experiencing chronic back or neck pain, contact a specialist like Solomon Kamson of the Spine Institute Northwest.

How Can I Appeal a Rejection By My Insurance Provider?

Even if you have a completely successful minimally invasive spine surgery, all too often if you can’t provide evidence that your insurer feels is sufficient to deem the procedure medically necessary your claim will be rejected. Unfortunately, there can be a wide gap between what your insurance provider considers necessary and what feels necessary to you, especially when you’ve been suffering from chronic pain. What are your options?

Medical Tourism
For some people, the best option is to explore options elsewhere. In fact, insurance rejection is one of the biggest motivators for people to research getting a specific procedure in another state or another country. If you don’t want to fight your insurer or deal with miles of red tape and medical bureaucracy, exploring your options in other locations can be ideal. For example, many patients who come to see Dr. Solomon Kamson at the Spine Institute Northwest in Washington travel from states like Alaska, North Dakota, Idaho, and Hawaii.
Your Rights to Appeal
Regardless of the type of healthcare you have (including Medicare and Medicaid), you always have the right to appeal a coverage decision at least once. If your appeal is rejected, you may be barred from appealing again, so it’s important that you make your case as strong as possible. Your primary responsibility is to provide evidence that your spinal procedure is medically necessary. If you do decide to appeal, here are some helpful tips:

• Read the guidelines for making an appeal by the North American Spine Society. In cases where a mistake can lead to days of bureaucratic delay, it’s always smart to be sure you’ve thoroughly understood the directions.

• Make sure you have your physician on your side. Your surgeon knows more than you do about what makes this procedure medically necessary, and is basically your “expert witness.” Talk with your doctor about the possible complications of waiting to have the procedure or of failing to get the procedure altogether. If this could be an issue, it can motivate an insurer to cover a procedure, particularly when left untreated the problem will be more expensive in the long term.

• Keep a folder of all of the paperwork that you think might help you prove your case. This could be documentation that confirms your doctor’s recommendation, the confirmation of a second opinion if you have one, proof of the undue financial burden of the out-of-pocket cost, proof of your attempts to undertake alternative and preventative practices, and proof of your long-term attempts at treatment as well as the progression of your disease or injury.

• You should also be keeping a record of your communications with your insurance provider. This will help you prove that you have followed all directions, submitted the proper paperwork, and so on.

• Even when you’re struggling with pain, keep your cool and remain courteous but firm. If you become angry, people may write you off or even refuse to help you any further. You want every encounter you have with your insurer—whether in person, over the phone, or via email—to be good and productive, while making it clear that you don’t intend to relent anytime soon.

Common Medications for Treating Back Pain

When it comes to treating back pain through medicinal means, your course of treatment of course depends on the nature of your back pain. Factors to consider include the severity of your back pain, the degree to which it is interfering with your normal daily life, and the root cause of your pain. But if you have been prescribed a course of treatment for your back pain, you may have some questions about the nature of your prescribed drug and its side effects. Here is a brief overview of some of the most commonly prescribed types of drugs for managing back pain.

Over the Counter Pain Relief
Over the counter (OTC) options for pain relief include NSAIDs like Ibuprofen and Aleve. Medicines like these are handy for treating mild pain problems that may occur regularly, but not chronically. NSAIDs are easy to take because they are non-habit forming and carry a relatively low risk of complication. Even so, you will need to take these pills with some caution. NSAIDs can contribute to stomach and kidney problems like ulcers, and should not be taken every day for a long period of time, especially if you have a history of stomach or kidney problems. You should also be cautious using them if you have any problems with blood thinning. Similarly, acetaminophen (the active ingredient in Tylenol) can aggravate liver problems and should be used with caution. If you find you are taking OTC pain medications daily, it’s time to reassess your pain management program. Dr. Solomon Kamson of the Spine Institute Northwest can help determine an accurate diagnosis and an appropriate intervention for your condition.

Prescription NSAIDs
Some common OTC pain relief drugs (Tylenol, for example) come in stronger doses that are only available by prescription. However, these carry the same risks as over the counter NSAIDs and should only be taken in accordance with a doctor’s instructions. These tend to contain not just larger doses of the active ingredient in the OTC version, but also secondary active ingredients that have the potential to interact with other medications you may be taking.

Muscle Relaxers
If your back pain problem stems from a muscular issue, you may be prescribed muscle relaxers. Though only taken over short, controlled periods, muscle relaxers can help break a cycle of spasms that occur in muscles following an injury. This will give you time to heal naturally in such a way that you can continue on with your normal life functions. Muscle relaxers come with a few side effects, most commonly drowsiness, and so are not usually meant to be used for extended periods of time.

Opioids are a stronger form of painkiller and are only accessible with a prescription from a doctor. They may be used for a brief period of time to help you deal with pain while recovering from surgery or an injury, or they may be used over a longer period of time to help you cope with a chronic pain issue. Opioids can provide significantly more relief than typical OTC medications, but they also have a higher likelihood of side effects and many carry a major risk of dependency. Common opioids available by prescription include codeine and Vicodin. These drugs are controlled substances and you may not be prescribed these drugs if you are considered at risk of addiction.

There is evidence to suggest that many cases of chronic pain are related to or symptomatic of depression or depression-related complications. In some chronic pain cases, patients will find a great amount of release via antidepressants. Others may not want to pursue this option because of side effects, interactions with other medications, and/or potential complication of other psychological issues. Many antidepressants also require a long period of adjustment before the user experiences their effects, meaning that no matter what, this is not a “quick fix” for issues related to chronic pain. It is worthwhile though to talk to your physician about the mental symptoms as well as the physical symptoms of your back pain. Chronic pain can lead to feelings of sadness, hopelessness, and despair, and you should not have to struggle with these alone.

Whichever course of treatment, it’s important that you follow your doctor’s instructions carefully and quickly report any side effects you experience. While rare, side effects can be serious, so make sure you are paying attention to your experience with any medications.

Taking Care of Your Back at Work

Do you ever find that your back pain is exacerbated by long days at work? It can be so easy to fall into bad posture habits, especially if you have a desk job. For most of us, sitting at a computer all day isn’t exactly conducive to staying upright and alert! Fortunately, there are steps you can take to decrease your back pain and mitigate your chances of developing a more serious problem. If you are experiencing chronic back pain, Dr. Sol Kamson of the Spine Institute Northwest can help you with an accurate diagnosis and a personalized plan for intervention.

Here are a few things you can do to interrupt the patterns that may be causing you work-related back pain:

First, make sure you are demonstrating good ergonomics. This means that your feet should be flat on the floor as you work, you are not bent over in your chair, your neck and shoulders are straight and relaxed, and that your wrists are not arched over your keyboard. If you need to make adjustments to the height of your chair or your computer monitor to achieve better posture, do it!

If you are unable to get comfortable because of your chair, desk, or computer arrangement, don’t be afraid to ask for new office supplies. If your company can’t accommodate you in this regard, see if you can bring in your own supplies so that you can be more comfortable (though generally, human resources professionals are quite in tune to these kinds of issues). If you are short or tall, you shouldn’t have to spend the rest of your working life sitting in chairs that hurt your back!

Another option is a standing desk. People who stand or walk around frequently for their job tend to have significantly improved heart and back health as compared to people who have to sit all day. This is true even when you add regular exercise into the equation. Try to capitalize on this by ordering a standing desk for your office. You don’t have to stay standing all day long; many standing desks come with bar stool-style chairs so you can sit down when you need to. Some are also adjustable so you can raise and lower the computer as you want to sit and stand. Being able to stand up when you need to without interrupting your work flow can be hugely beneficial for your back.

A less expensive option is sitting on a yoga ball instead of a chair at work. They may make you feel a bit silly, but this kind of constant core strengthening and having to maintain balance is great for your back. Don’t toss that desk chair, though — especially as you are getting used to balancing on an exercise ball, you should probably only swap the ball in for maybe an hour at a time each day, and work up to spending more time using it.

Tips to Prevent Back Pain Caused by a Heavy Backpack

Every year, millions of children put on backpacks filled with books and other materials as they walk to, from, and even around school. Unfortunately, the large quantity of items that may be required at home and at school can place a large strain on a developing back. Over the course of time, this stress can cause back pain and injury. Luckily, there are several steps you can take as a parent to help protect your child’s spine.


The Effects of a Heavy Backpack
When heavy weight is placed on the back for an extended period of time, the body will naturally compensate. This can have several effects. First, it distorts the natural curve of the lower and mid-back. This can cause muscle irritation and strain, as well as irritation of the spine joints and rib cage. Over time, this can even lead to rounding of the shoulders and poor posture. This can reduce your child’s balance, making them more susceptible to falls and other injuries.

Additionally, strain on the neck muscles can lead to pain in the neck, arm, shoulders, and even cause headaches. If your child is suffering from severe back pain that is not alleviated with rest or a lighter backpack load, speak with their primary care physician. The physician will likely perform an exam, and determine if a visit to a spinal specialist such as Dr. Solomon Kamson of the Spine Institute Northwest is needed.

Distribute the Load Evenly
Sometimes, children will switch weight between shoulders to alleviate pain. While this is effective in the short-term, the long-term effects of this can be quite damaging. The uneven weight causes the spine to lean toward the opposite side. This places stress on the mid- and lower back, as well as the ribs. This can cause muscle spasm, muscle strain, and back pain. As an adolescent and adult, your child may also develop back conditions faster than they would otherwise. It’s important to make sure your child always uses both straps when wearing his or her backpack.

Choose a Quality Backpack
If your child does not have to regularly walk up and down stairs, it can be beneficial to purchase a backpack that rolls. While rolling backpacks are more expensive, they alleviate a lot of the weight that can cause your child’s pain. You should also be careful to avoid backpacks that have a single shoulder strap. This forces your child to carry the backpack on one side or the other, causing a number of back problems. Another option is to look for a backpack with a chest stabilizer. This will help to ensure your child is evenly distributing the weight of their backpack.

Lighten Your Child’s Load
If your child must carry heavy books to and from school, consider making copies of the text. You may also be able to find used textbooks, or digital textbooks online. This allows your child to keep the heavy books at school and still complete homework at home. If your child has to carry a laptop to and from school, make sure they are carrying it in a separate bag. Finally, if your child plays a musical instrument, consider buying a second new or used instrument. Then, they will not have to transport their instrument to and from school.

Cervical Spinal Stenosis: What It is and How Surgery May Help

One of the most critical functions of the spinal canal is to protect the collection of nerves known as the spinal cord, which runs from the lower back to the base of the brain. When an individual is afflicted with cervical spinal stenosis, the spinal canal begins to narrow in the neck. This narrowing can cause a variety of symptoms, including pain in the neck, legs, and arms, deterioration of fine motor skills, a slower gait, and more. After exhausting other treatment options, spinal specialists such as Dr. Solomon Kamson of the Spine Institute Northwest often recommend minimally invasive cervical laminectomy surgery to relieve the pressure and pain of spinal stenosis.

cervical vertebrae

Causes, Symptoms, and Treatment
In many cases, aging is the cause of cervical spinal stenosis. However, this disease may also be caused by disc herniation, degeneration of the spinal column, spinal instability, constriction of critical blood flow to the spinal cord, and congenital stenosis. Regardless of the cause, cervical spinal stenosis can result in a change in your walking pattern, numbness or tingling in the hands, shoulder weakness, urinary difficulties, and pain. A specialist will use your symptoms, a physical exam, your medical history, and diagnostic tests such as an MRI to diagnose the condition.

Once the condition has been diagnosed, your back doctor will begin treating your pain with conservative measures. Some alternative treatments include immobilizing the neck, wearing a neck collar, electrical stimulation, steroid injections, and physical therapy. In some cases, however—for example, if the patient has already lived with the symptoms for years—the condition is so severe that surgery is the first course of action. If these treatments do not work, or if the cervical spinal stenosis has progressed significantly, a minimally invasive cervical laminectomy surgery is often recommended.

How Minimally Invasive Spine Surgery May Help
The symptoms of cervical spinal stenosis are caused by the compression of the nerves in the spinal cord by the spinal column. When the surgeon removes the troublesome area — which can be bone, a bulging disc, or other tissue causing the spinal canal to narrow — it relieves this pressure. Cervical laminectomy also works because the removed areas leave extra space along the spinal column. This excess space allows other parts of the spinal cord to move more freely, preventing compression of nerves in the spine. The prognosis for minimally invasive cervical laminectomy is very good. It is considered to be a very safe procedure, and is often effective at alleviating the symptoms associated with cervical spinal stenosis.

Image: Anatomography [CC BY-SA 2.1 jp], via Wikimedia Commons

How Getting Back into Shape after Pregnancy Affects Your Spinal Health

The postpartum period following the birth of your baby is one that can be challenging for many women. Some experience depression, others face stress from raising a child, and even more have difficulty getting back to their pre-pregnancy weight. While eating right and exercising may be the last thing on your mind after giving birth, it is critical to your health to get back to your pre-pregnancy weight as soon as you are cleared by your doctor. Even before you are cleared, you may be able to speak to your primary care physician about small steps you can take to return to your pre-pregnancy level of health.


Healthy Weight
Many people fail to realize the implications that your weight can have on back health. The spinal column has the ability to support a healthy level of weight. When you gain weight, the spine often compensates by bending itself to support the extra weight. This can cause lower back pain and other problems. If you experienced back pain during your pregnancy, as many women do, then it is important to return to a healthy weight and take the strain off of your spine.

Strengthening the Spine
As you exercise to return to your pre-pregnancy weight, the exercises you do can also strengthen your spine. Remember that your little bundle of joy isn’t going to stay under ten pounds forever! To prepare yourself for carrying around your little one the next few years, you should be sure that your spine is strong. As you exercise, the muscles in your back that surround the spinal column grow stronger. This provides additional support, preparing you for the next few years of your child’s life.

The back pain that many women experience following pregnancy can often be combated with a stronger spine. If your exercises seem to be making your pain worse, consider low-impact alternatives such as water aerobics. For additional tips on low-impact exercises to strengthen the spine, consider consulting with a specialist such as Dr. Solomon Kamson of the Spine Institute Northwest.

Maintaining the Spine’s Flexibility
Once you become a mother, it is likely that your next few years will include plenty of time bending down to pick up the baby, as well as his or her toys. With all of this bending, it is important that the spine remains flexible, as well as strong. When you do stretching exercises, yoga, and similar activities, you encourage the spine to lengthen. These activities can help to maintain spinal flexibility, and prepare you for the years still to come.

Improving Overall Mood
Another common cause of back pain is stress. Fortunately, you can combat this with exercise. When you exercise, you release endorphins. Endorphins are a natural pain reliever, as well as a mood lifter. Whether you are experiencing post-baby blues, or are just stressed out from being a new mother, regular exercise can improve your mood and your health. Additionally, endorphins can give you the boost that you need to get through a challenging workout pain-free.

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