hello everyone and welcome to bestie as
you all know we have this new series
More than half of working Americans experience some form of pain in their lower back. And today we have with us neurosurgeon, Dr. Joseph Aferzon to discuss the causes and treatments for lower back pain.
Other Articles recommended for you:Read: 5 Shocking Surgical Procedures To Be Ever Done Read: Drink Chamomile Tea Once A Day, See What Happens
The Causes Of Lower Back Pain & How To Treat It - Dr. Joseph Aferzon.My name is Bestie,back with a new Article, do you wanna know The Causes Of Lower Back Pain & How To Treat It - Dr. Joseph Aferzon.
The Causes Of Lower Back Pain & How To Treat It - Dr. Joseph Aferzon!
where we are interviewing doctors
surgeons specialists in their field to
tackle today's most pressing medical and
wellness questions and today we have dr
joseph apherson with us who is a
specialist in spinal surgery and a
neurosurgeon at hartford healthcare dr
aphrazon thank you for joining us today
uh let's just jump in with the uh the
first question i have and that is
what are the different types of back pain
well
the most common problem we see
is
pain
back pain related spine pain and muscle
pain
[Music]
it's estimated that 80 of people will at
one point in their lives have
significant episode of back pain
and eight percent of all americans which
is uh about 16 million people have um
what we call chronic
disabling back pain and by disabling it
means it interferes with their daily
activity
it's common for somebody to what we call
pull their back maybe lift something
twist certain way
uh it's certainly more common
in people when they get in their 40s and
50s but it can happen as a gianna's 20s
and 30s so we break
the uh back pain into three categories
what we call acute
subacute and chronic and acute back pain
is usually
less than six weeks from the onset of
injury
to a period of six weeks we consider
that to be acute problem and then the
second group of people will have
subacute pain which lasts from six uh to
12 weeks
and after 12 weeks the pain is
considered to be chronic
which means it's not likely to gonna get
better and the rationale here is you
expect very good outcome in acute period
you expect 90 of people to get better
uh in that acute and subacute period but
once people get into chronic period then
you start
getting a little more sophisticated in a
treatment of the pain i it's actually
coincidental that we're on this uh you
know we're on this call because i
recently hurt my back
uh lifting weights so i'm i'm 49 years
old and i've been lifting heavy weights
now for a couple of years and recently
um i injured my back i was in
at the time that it happened i didn'
feel anything but afterwards i was just
an excruciating pain in my lower back
and i had an mri done and i had uh which
i'm sure you know what it is are bulging
discs l4 l5 l6 and when that happened to
me
because i didn't have the knowledge of
uh
you know
whether it's acute or chronic
i was concerned that this would now turn
into a you know a chronic condition
where i would no longer be able to do
the you know my fitness routine and i
was really concerned that it took it
took probably about three or four weeks
it's much better now but even though now
when i do weights i still like i'll feel
a little bit of pressure and i try to be
careful not to re-injure that so yeah it's good to hear from you that there
there are
some forms of back of back pain that are
chronic some that are acute
but
how do you like
what determines if it's
going to be forever or if it's gonna
heal in a few weeks
uh so let let me just frame this so
different ages have different types of
back problems so you expect a disc
problem to be in a younger
more active ages because the disc is
very elastic
so usually requires elasticity to the
body to hurt the disc
once we age once we get into our 60s and
70s that this becomes very stiff it
loses a lot of its elasticity and it's
much less likely you're going to hurt
the disc you're more likely to hurt
other parts of the bat i want to bring
up
another concept called inflammation
and when you hurt your disc inflammation
is a very big component
and inflammation is defined as redness
hoeness swelling
and a good analogy if you take a
splinter if you were working on your
deck
and you got splinter in your hand
and you don't quite realize it the first
day but by the third day you feel like
there is very very sensitive area to
touch it feels red and hot
similar process happens in your disk so
initially when you injure your disc
it takes a little bit of time for
inflammation to set in
and it usually by second and third day
you get this very very severe very
sensitive type of
pain
and then it usually takes about six
weeks for that to settle down
and by three to six months majority of
people will
resolve that
there's another issue which i think is
important and it's called secondary
injury and it's common not just in a bag
but you could have it in a head trauma i
mean people who play sports aware of uh
sensitive period after injury where you
are restricted not to reinjure it
a lot of times repetitive injuries in
this sensitive period is what leads to
chronicity or to things not healing
so how do you
because
back pain of all types
um are so common and it's such a
you know i feel it's such a reoccurring
problem that i hear you know with people
at all ages
more so with people who are older
what is a
kind of a good
path to
having a healthy back and to not injure
how do we prevent injury
uh especially as we age
um we believe that uh there are certain
uh
risk factors that contribute to bac
pain
now these could be
environmental factors for example
there is evidence that smoking
increases uh risk for back pain and
moreover uh impedes healing
from from from injury
so we feel that smoking is a risk factor
uh people who are overweight
also um there's evidence that the risk
factors
there is a data that people who are
depressed there is a data people are
generally unhappy with their
cinumstances
people who are unhappy with their job
there is evidence that these people they
focus on their pain much more
they get very anxious about pain they
basically have pain pain avoidance
behavior these are the people who will
feel something is absolutely wrong with
my back and be afraid to walk or
so so your attitude toward
you know toward uh your back matters the
activity level obviously is a
factor there's plenty of evidence that
people who exercise regularly people who
engage in cardiovascular type of
activities running walking swimming you
know tend to do much better have lower
incidence of back pain
so
the back health probably has multiple
components to it
and it relates to one
keeping your back in a good shape
and that would relate to exercise
activity in general the core of your
back is a passive element
uh and muscles are actually uh levers
that work on the core of your back
and the if your muscles are not balanced
and you have a lot of segmental musele
weakness you're probably going to be
pulling on the weak spots of the back
and developing poor will help stabilize
the entire spine
so when you are active when you do all
these things
you have a much better support
for your spine if that makes sense
it does make sense so
so
when i have people who come to me and
they have a bad disc that's failing to
heal like typically a lot of my patients
for example have like golfing
there's a lot of twisting involved in
golfing for bowling i have people who
really want to go back to bowling
so
those kind of things that involve
twisting in the same direction with
weights are probably not ideal for your
back obviously activities that
low gravity activities
for example
swimming
usually spares you back is a very good
exercise for your back
certainly walking brisk walking is a
good exercise
running
there is a lot of
bounce and load on running and people
people who run
within reason
will be fine but i think people who take
it to extreme will have a lot of wear
and tear in the joints knees hips and
back
obviously weight lifting
i usually find that people in the
younger ages 20 30s 40s
can get away with weightlifting but once
you get into your 50s and 60s and starts
having degenerative disc disease i find
people start injuring their back you
have to be very careful you have to be
careful about your form so you have to
be very balanced when youyou know you can't kind of load the
weight and
create uh uneven lever in your back so
it's typically
uh lifting the weight enough when you
bend forward or moving the weight with
your hand and twisting and but i find
that once you get into 40s and 50s
you have to be a little more
a little more careful about lifting
well that that makes sense that makes
sense um what other types of symptoms
are associated with specifically lower
back pain
yeah so this gets us uh to do an
important thing so
it's like the back is like a snake it's
made of multiple segments
and you move at each particular segment
and usually when we treat the back we
look at the disease of each particular
segment so for example in your case when
they did an mri they told you that you
have a disc at 4 5.
so typically when we damage something we
damage a specific segment of the spine
so and that's because we move
individually at each particular segment
and in fact different
parts of the spine very differently
and subserve different movement function
and lastly the back
has nerves in it so if you think about
cables computer cables running through
the building
and on each floor you have cables
exiting through and feeding information
in and out
of
you know whatever electronics you have
on that particular floor and they fit it
to the central unit
so once you have mechanical problems you
can start pinching those cables
now you can pinch the wires as they come
out or you can pinch the central cable
that runs through entire core of the
building
in general
the symptoms you're gonna have
associated with back pain will be
related to those cables so uh one thing
you're gonna have is numbness
you could have weakness depending upon
what part of the cable you are tension
is there is there an early
point in time when you start
experiencing back pain
that
you should go see a doctor like what
should you be feeling that would prompt
you to go see a doctor
right so development of uh bladder
symptoms so incontinence
or
loss of sexual function in males
that would be a concern
if you have a weight loss
or if you feel generally sick you have
fever you have chills
um so what we call systemic
manifestations not just your back but
there are other parts of your body just
not functioning normally
you kind of back pain in older age so if
say you are 75 years old right and you
have some back pain you kind of work in
the yard you pay the price and you okay
and then suddenly you develop the pain
that's out of character you can move
very different
that's a concern you got to be concerned
about fracture particularly in ladies
who have weak bone and they can get
osteoporotic fracture
so that is a red flag
so again we're trying to recognizing
that ninety percent of people
it's just a pool maybe you know disc
there maybe ligament pool maybe they
pull their joint and they'll be better
we have to pay attention to things that
put them at higher risk of having things
that require medical attention and the
red flags is blue way
in the body
i see let me ask you doctor what are
some of the kind of lifestyle factors
and specifically because i know most
people are at desks from you know 8 to
12 hours a day
what is your opinion on
long periods of time
sitting
and the effect it has on your back
health
so there are two points to be made here
there's actually some data to that
effect and people have looked at
specifically posture
and they also looked at among the time
you sit in the same position at the time
it's probably best to think about
frequently changing what you do
so frequent change in position
is probably more important than
specifically kind of posture
i have patients for example who have um
who'd have sedatory jobs they sit and
they have dyskogenic pain
and they do better in extension they do
better when the back is straight they'll
put a pillow behind the back some of
them will do chairs where they put
pressure on the knee and try to kind of
straighten the back and bring it kind of
push the disc forward if you will
it's a good idea to not sit for four or
five hours but kind of take a walk move
around and then in general being in the
same position for a long time is not
good for your lower back
okay doctor efferson just to wrap things
up i have one final question what is the
the most important thing
we can do to
prevent
back injury and the resulting
dehabilitating back pain what is that if
you could name one thing that you would
tell your your closest friends to do
what what would that do to prevent
so there's two points to that first
there are certain genetics
that some of us has that makes us better
and certain bags are built better than
other bags it just happens to be so
the other point to be made is that
the things that we do at different ages
are very different
so what a
30 year old should be doing about their
back is different than what a 50 year
old and is different what an 80 year old
should be doing
so
that is a moving target
but in general
healthy lifestyle
is absolutely a significant factor in
keeping your back health
by that i mean good sleep
while there is significant data that
quality and duration of sleep
has impact on the pack and it can get a
little complicated why but
the exercise concept is if it's too much
it's probably not good for you there is
there there's usually is a golden golden
metal in this
uh you know
i think taking things to extreme on
either end
you either wear your body if you do too
much
or you become deconditioned and you do
not provide enough support for your back
if you do too little and you realize
when you get into your 40s and 50s that
you can't just do
in your 50s what you did in your 20s
so one has to be realistic and our brain
has to catch up with our body because
sometimes we feel
our brain feels younger than our body
and that's how we get to injure
ourselves
so uh i think being realistic about what
you can do and as you get older you
really have to spend a lot of time on
support activities
so if you can get away in your 20s and
30s of jumping and doing something in
your 50s and 60s you have to spend much
more time stretching you have to think
about the form you have to think about
the balance you have to balance both
sides you can't just keep twisting one
way
so you have to be a little more
a little more strategic about your
activities and sometimes you have to
abort certain activities you did before
and take on
something that is better for your body
as you get older
that sounds like a good idea i think i i
think i'm going to probably do a little
less weight lifting and a little more
swimming
women is a very good activity for the
best amazing swimming is very um
yeah so so again um i think uh a healthy
lifestyle
good sleep
uh
minimizing things that involve uh heavy
loads or lifting heavy loads
obviously you know will help will help
you back
yeah dr aphrazon thank you very much for
joining us today and thank you for all
of this information this is definitely a
topic that needs to be discussed more
uh
and again wanted to thank you very much
for your time today and for um all of
those watching uh we will have a link to
dr aphrazon's information and you can
you can check that out and thank you
again and please leave your questions in
the comments and we'll do our best to to
answer those questions thank you very
much again for your time
0 Comments