W

hy do so many people nowadays suffer from back and neck pain?

There does appear to be a silent epidemic of spinal pain that is related to modern life and poor posture. The use of computers at work and at home has contributed to this. Even children are experiencing back and neck pain. The widespread use of laptop computers, iPads and gaming consoles is also linked to the increased number of sufferers.

What are the common causes of back and neck pain?

A common cause of mild cases is muscle strain. Another common cause is spine disc degeneration. The disc is the soft gel-like material that is in between the spinal bones (vertebrae). Poor posture, prolonged sitting and certain impacts or physical sports activities can accelerate wear and tear in the spinal discs. In older people, spinal stenosis, facet degeneration and osteoporosis can cause back pain. Spine tumors and spine infections can also cause back and neck pain.

How is back and neck pain diagnosed?

If the problem is mild it can be treated by a family doctor with medication, muscle relaxants and ointments. Simple physiotherapy may also be helpful. If the problem is recurrent, prolonged or increasing in severity then a specialist consultation is warranted. A spine specialist will perform a spine examination and most likely X-rays. Quite often an MRI of the spine may be needed, for example, to confirm the diagnosis of a slipped disc or herniated disc.

What are the treatment options?

Treatment is determined by the nature of the spine problem and its severity. Mild slipped problems can be treated by pain medications and physiotherapy together with lifestyle adjustments. More severe problems that cause persistent pain despite these treatments may need a spine procedure. Modern spine procedures include spine injection treatments that do not require open surgery. These newer treatments include discoplasty, annuloplasty, nucleoplasty, biacuplasty, neuroplasty and others that can be done as day procedures under local anesthetic using fine needles.

However, these treatments may not be suitable for all patients. In addition, these procedures may only give medium-term relief from pain as they are not long-term cures. Many of these spine injections are for pain relief and do not treat the root of the problem such as disc herniations that cause nerve pressure.

When would a person require spinal surgery?

If there is severe and persistent pain and an MRI shows that there is a large spinal disc herniation causing severe nerve compression, then surgery may be the best choice. Those that have recurrent problems despite adequate physiotherapy, pain medication or pain procedures are also candidates for spine surgery. It is understandable that most people do not want surgery.

However under some of these circumstances, waiting may cause the problem to worsen and result in permanent nerve damage. The spinal nerves are responsible for feeling and control of movement in the body and limbs. They currently cannot be replaced.

Are there safer and more modern forms of spinal surgery?

Yes, certainly, with new technologies including microsurgery and endoscopy the openings needed are smaller than before. There is less need to cut normal tissue and bone to get to a herniated or slipped disc. Finer instruments can be used to remove the damaged parts of the disc that cause the nerve pressure. There are also alternatives to spinal fusion such as artificial disc replacement and dynamic spinal implants that allow preservation of the spine’s motion. Nerve monitoring during spinal surgery can also be helpful in reducing the risks of nerve injury. All of these methods have allowed spinal surgery to become more successful in returning people quickly to normal life.