Frequently Asked Questions to "Dr. Steven Valentino"

 

What is back pain?

Back pain is very common issue, especially for active people. The spine is a complex structure composed of bones, muscles, nerves, and joints. When pain in the back gradually increases, most likely the patient has something defective in their musculoskeletal spine. With that said, back and neck pain can be misdiagnosed as there can be great variation among spine doctors and their training. Dr. Steven Valentino is a fellowship-trained orthopedic surgeon who specializes in spine care. Dr. Valentino has had an active spine specialty practice in the Philadelphia area for more than 25 years. Fellowship-training is the highest level of medical education possible in the United States.

What causes back pain?

Most often back pain develops from a disruption to the normal functioning of muscles, ligaments, cartilage or a pinched nerve. Back pain caused by damage or disease to your spine will most likely require surgical intervention to cure the problem. Those who work in labor intensive jobs in Michigan can be at higher risk of back pain.

What are the symptoms of a back pain?

Back pain is most common in the lumbar (lower back) region, although it can be felt anywhere along your spine, from your neck down to your hips. The lower back (lumbar spine) area is the most frequently reported area of pain. The neck (cervical spine) is another common pain area. The middle (thoracic spine) area is least reported due to the rib cage and sternum providing structural support of the spine, usually resulting in less problems and pain in the middle region. Back pain symptoms can include pain that runs down your legs or arms, muscle ache and spasms, and limited range of motion.

What are some conditions that are often linked to back pain?

Some of the common back problems include bulging or herniated disc, spinal stenosis, scoliosis, spondylolisthesis, and degenerative disc disease. The only way to correctly diagnose the cause of your back or neck pain is with specialized diagnostic tests. Dr. Steven Valentino uses X-rays and MRI diagnostic tests to reveal disc herniations. Dr. Valentino also uses spinal injections as both a therapeutic and diagnostic procedure. Spinal injections can not only relieve pain symptoms from a herniated disc, but more importantly, confirm the exact disc level that is responding to pain medication, or NOT responding. By confirming the exact disc level, this ensures Dr. Valentino that he has identified the pain generator. This also ensures a successful surgery by Dr. Valentino if surgery is indeed necessary.

What’s the difference between a slipped disc, a bulging disc, a ruptured disc and a herniated disc?

All four cases occur when discs become weakened over time and part of a disc is sticking out between the bony parts of the vertebra.

What’s the difference between a back sprain and a back strain?

While someone may argue that the two words are different, that a sprain is a more serious injury than a strain, in reality, sprain and strain have evolved to mean essentially the same things to doctors and lawyers. Both words relate to an overworked muscle, ligament or tendon that is overstretched. Some may argue that strain relates to stretching or tearing of muscles or tendons, while sprain relates to tearing of ligaments or tissues in a joint area. For example, if bones in a joint are forced beyond a comfortable range of motion, the joint may be sprained. Another word that you may hear is “muscle spasm,” where a muscle locks up in an excruciating, hard lump.

What’s the difference between a simple strain or a more serious herniated disc?

Most people erroneously think that the more excruciating the pain, the more likely that you herniated a disc. That is not the case at all. In some cases a back spasm can knock you down to your knees. A person can have excruciating pain, but if it is mostly in the low back, it’s probably not a herniated disc. Typically, a herniated disc in your back will radiate pain down into your leg, or pain will radiate down your arm if you have a blown disc in your neck. In this sense, Dr. Valentino emphasizes to patients that pain is not a good indicator of when it’s crucial to see a spine surgeon. Dr. Valentino notes that weakness and numbness in a foot or hand are the real emergency symptoms that need to be seen within a couple days to prevent permanent paralysis of those nerves.

What are the spine diagnostic tests that may be done in Dr. Valentino’s spine practice?

Types of diagnostics include:
• X-rays show bones and the space between bones. Although X-rays are of limited value to muscle-related back pain cases, the spine surgeon at Ann Arbor Spine Care may conduct X-rays to detect possible fractured vertebrae or narrowing of disc space.
• MRIs (Magnetic Resonance Imaging) and CT scans provide images of soft tissues and nerves in the spine, including discs and joints. This is valuable information to your physician in determining the cause of your pain. These tests provide a medical photograph of your body and are painless.
• Myelograms can reveal the amount of damage in the spine. They are used to determine if surgery is necessary. If it is, myelograms provide a surgeon with key information to ensure the success of surgery.

What is degenerative disc disease?

A natural byproduct of aging is the loss of resiliency in spinal discs and a greater tendency for them to herniate, especially when placed under a weighty load, like when we lift heavy objects. Additionally, some people have a family history of degenerative disc disease, which increases their own risk of developing it. When a natural disc herniates or becomes badly degenerated, it loses its shock-absorbing ability, which can narrow the space between vertebrae.

When should someone get a second opinion for spine surgery?

There is a tremendous amount of spine surgery in the United States. Consequently, Dr. Valentino believes it can be a good idea to get a second opinion for spine surgery from a physician who is fellowship-trained in spine surgery. During a second opinion, the fellowship-trained spine surgeon will look at your previous diagnostic studies and your medical history to make sure non-surgical treatment options have been exhausted. Also a second opinion can reveal if you really need a spinal fusion or if you qualify for a less invasive minimally invasive spine surgery. Ann Arbor Spine Care does a large number of second opinions related to back surgery.

How can osteoporosis impact the spine?

Osteoporosis can have extremely serious consequences on the spine. Because osteoporosis often progresses undetected, the first indication could be as disastrous as a bone fracture. These fractures typically strike an area of the body that carries the most stress, such as the spine, wrists or hips. Spinal fractures can occur without notice, as vertebrae simply compress. Compression fractures can be very painful and may lead to stooped posture, loss of height and risk of serious neurological damage to spinal nerves.

What non-surgical options are available?

Non-surgical treatments for chronic back pain can include physical therapy, acupuncture, spinal injections, nerve blocks, and specialized spine therapy. Dr. Steven Valentino emphasizes non-surgical treatment options in advance of spine surgery.

How can I avoid back pain?

Prevention is the best strategy for coping with back pain and can save a great deal of time and agony. Become an educated health care consumer by learning about effective prevention methods.

Home remedies for back pain include:

• Stretch before and after strenuous activity.
• Use good posture at all times, and do not slouch.
• When standing, keep your weight balanced on both feet rather than shifting it back and forth.
• Sleep on a firm mattress.
• When sitting for long periods of time, take frequent breaks.
• Maintain a healthy weight and try to avoid weight gain, especially around the mid-section, which can take a toll on the low back.
• Don’t try to lift objects that are too heavy for you. When lifting, use the strength in your legs more than the back.
• Avoid smoking, which accelerates degeneration in the spine.

Why do so many people suffer from back pain?

With age, our bones and muscles lose tone and elasticity. They become less able to properly cushion the vertebrae and more likely to spasm or break. When a spinal disc ruptures or bulges, it places pressure on the surrounding nerves and results in pain signals traveling to the brain. Other factors such as smoking, obesity, poor posture and lack of sleep can also contribute to back pain.

How can I incorporate ergonomics into my everyday lifestyle?

• Applying ergonomics can help prevent repetitive motion injuries such as carpal tunnel syndrome, particularly if you are constantly working at a computer. Use a headset for lengthy or frequent telephone work.
• A footrest should be used if, after adjusting the height of the chair, feet do not rest flat on the floor.
• When performing daily tasks, alternate between sitting and standing or take small walking breaks throughout the day.
• Position the computer monitor directly in front to avoid excessive twisting of the neck. When typing, press the keys gently; do not bang them or hold them down for long periods. Keep your shoulders, arms, hands, and fingers relaxed.

 

 

Notes:

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