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Q & A with Joseph Condon, M.D., Spaulding Rehabilitation Newtork

Your spine is an amazing, complex, and dynamic structure that needs a little TLC to function well. Too often, our daily routines don’t support a strong and healthy back. While it’s true that the spine is subject to wear and tear as we age, we can reduce our risk for back pain – and the rate at which our spine ages – by decisions we make every day.

Q. What are common types of back pain?

Back pain will affect an estimated 80% of adults at some point in their lives. Muscles are one structure in our backs that can cause pain after a strain or sprain. The pain of ten resolves with conservative treatment. Other common diagnoses are: bulging, herniated, or thinning discs; spinal stenosis, or narrowing of the spinal canal; sciatica, or pinching of the lumbar nerve roots which then form the sciatic nerve. Sciatica can cause pain from the but- tocks to the feet. A more acute type of back pain can be caused by compression fractures, fractures of the bones which make up the spinal column called vertebrae. These fractures can be due to osteoporosis or thinning of the bone due to leaching of calcium out of the bone.

Q. If it’s so common, can back pain really be prevented?

Many of our treatment strategies are prophylactic in nature, that is, they reduce the chance of getting severe back pain. A life- style that includes core-strengthening exercise, a healthy diet, and plenty of sleep reduces your risk for many debilitating conditions, including chronic back pain. Likewise, addressing lifestyle factors should be part of any treatment plan for chronic back pain.

Q. Why is exercise important?

There is extensive evidence that exercise is both a powerful preventative strategy and an important medicine in treating chronic pain. Exercise naturally stimulates the body’s healing process. An ideal exercise program will in- clude both strengthening and aerobic components.

Your 29 core muscles of the abdominal wall, back, pelvis, hips and diaphragm all work to- gether to stabilize your trunk. Exercises to strengthen your core will help support and pro- tect your spine and avoid cumulative damage due to poor posture.

Yoga, tai chi, and Pilates are great for strengthening the core, improving posture, and developing flexibility. They also improve breathing, reduce stress, and encourage a mind- ful approach to living. The wellness programs at Spaulding Cape Cod include yoga for back pain, gentle chair yoga, and tai chi, all of which promote a healthy spine.

Swimming, walking, or using a stationary bike or elliptical are low-impact aerobic exercis- es that build endurance and support cardiovas- cular health. If you’re not exercising, check with your doctor before getting started.

Exercising for a few minutes at a time may be easier to work into your day. For example, you can stretch your leg muscles while sitting by extending one leg in front of you, flexing the foot, holding for 10 seconds, then repeating on the other side.

step ladders, and icy walkways.
• Eliminate fall hazards at home. Scatter rugs, clutter, poorly lit hallways and entrances, steps/ stairs without handrails, and pet toys, etc. are all potential fall hazards.

Q. How is chronic back pain treated?

Pain is a natural process that signals injury, but chronic pain can be a disease process in itself, which we are trying to under- stand better through research. Though we have many treatments for back pain, we can’t always eliminate it. But we can reduce pain, minimize its impact, empower the patient to function effectively, and reduce the risk for future episodes.

A comprehensive approach may include a combination of treatments noted below plus psychological treatment to address any ongoing issues and integrative medicine strategies, such as stress reduction, yoga, meditation, or other wellness programs, which can complement and enhance traditional interventions.

Medications, injections, physical and occupational therapy, acupuncture, and chiropractic may be appropriate for acute or chronic back pain depending on the diagnosis and severity of pain. Physical therapy, for pain relief and for strengthening muscles that support the spine, may be prescribed in conjunction with medica- tion and injections.

Other non-surgical interventions, including epidural, steroid, trigger point and Botox injec- tions, and radiofrequency ablation, can reduce or eliminate pain and inflammation and improve function. Plasma rich protein (PRP) injections and implanted neurostimulators may be effective for certain patients. Surgery may be considered if these conservative treatments don’t bring relief. However, it’s important to note that a per- son experiencing sudden or rapidly worsening neurologic symptoms, such as numbness, weak- ness, or loss of bowel or bladder function, should be evaluated as surgery may be necessary.

In my experience, patients who do well have a partnership with a physician who takes a wholistic approach to relieving pain and re- storing function. Treatment includes a plan to reduce contributing risk factors, often incorpo- rating lifestyle changes and wellness strategies.

Dr. Joseph CondonAbout the Author: Dr. Joseph Condon is board-certified in Physical Medicine and Rehabilitation (PM&R) and Pain Medicine. He has extensive experience in orthopedic rehabilitation, particularly chronic back and joint pain, and in- terventional (non-operative) pain management. A graduate of New York Medical College, he completed his PM&R residency at New York Hospital-Cornell Medical Center and his Pain Medicine fellowship at University of California at Davis. Dr. Condon sees patients at Spaulding’s outpatient centers in Plymouth, Sandwich and Orleans. ∞

 

Dr. Condon recently spoke about current treatments for chronic back pain at Laurelwood at the Pinehills, Plymouth, MA.

This article is reprinted from the March 2019 edition of the South Shore Senior News.

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