Lumbar Herniated Disc Surgery a Must for Some Patients

Lumbar Herniated Disc Surgery

Most patients with herniated discs prefer to travel the non-surgical road when it comes to treatment for their condition. It’s natural to want to avoid “going under the knife”, so to speak. For these patients, most chiropractors and other spine specialists will suggest NSAIDs and rest for at least four to six weeks and, often, that’ll do the trick. But when a regular course of non-surgical treatment doesn’t seem to be getting the job done, surgical intervention may become necessary to relieve pain and set the patient on the road to recovery.

So, when is it time to talk to your patient about surgery? Generally, the problems listed below are a good indication that something more drastic must be considered.

  • Medication has not significantly reduced the symptoms of the herniated disc
  • Physical therapy has not aided in reducing the symptoms
  • The individual is having severe pain that interferes with the tasks that must do daily, including walking and standing as well as tasks related to their specific job or duties
  • Neurological symptoms appear or worsen, including numbness or weakness in the legs

Any or all of these could even occur before the normal course of non-surgical treatment is completed. In other words, if progressive neurological symptoms happen at 3 weeks, then it may be time to recommend surgery for this particular patient.

Surgery. That’s a scary word, especially for individuals who have never spent any time in the hospital. It’s likely your patient will have an adverse reaction to the word when you mention it as an option, but they should know that lumbar herniated disc surgery has an excellent rate of success and is actually quite minimally-invasive. You’ll want to explain that both the microdiscectomy and the endoscopic discectomy are usually performed on an outpatient basis, with patients coming home – in most cases – on the same day as the procedure. You can also talk to your patients about the specifics of the procedure and explain what’s happening now that they have a herniated disc and what will change once the surgery is complete.

Just about everything about their surgery and about the lumbar spine in general can be demonstrated via the use of a detailed spine model like the ones made by Dynamic Disc Designs (ddd). These models were designed with spine specialists in mind, but were also created to help the lay person understand the complicated workings of the spine. Doctors who use ddd models to educate their patients about their conditions and about upcoming procedures create patients who are less frightened and more confident about their doctor’s recommendations. That confidence generates patients that will stay with your practice and recommend you to others.

For more information on the right ddd model(s) for your spine surgery or chiropractic practice, browse the website and watch the videos for a detailed explanation of how each model works.

“The LxH disc model is the most realistic patient education tool I’ve seen in 27 years of practice. When patients see the model, they immediately “get it”. If you treat herniated discs in your practice, this is a must have. I commend Dr. Fryer on his painstaking efforts to produce such a finely crafted and well thought out model.”
–Dean M. Greenwood, DC

Lumbar Extension Exercises Help Your Patients Heal

Lumbar Extension Exercises

There are so many reasons for experiencing back pain. Sometimes it’s a result of the work our patients do, including heavy lifting and repetitive movement that taxes our lower back. Sometimes we merely overdo it in everyday life while, other times, an accident or fall causes our lower back pain.

Whichever the reason, it’s important to find ways to combat the pain, so recommending lumbar extension exercises for back pain is often a wise idea, where appropriate. Such exercises are often a “no-brainer” because they are easy to do at home and require no equipment. The only thing necessary is motivation and the desire to feel better.

Chances are that if you prescribe lumbar extension exercises for your patients, you’ll want to take the time to demonstrate how to do them properly or, at least, provide the patient with illustrations or videos that assist them in doing these in the proper manner so as not to cause further harm. You’ll likely do that in your office or some other space where physical therapy takes place. Hopefully, you’ll supervise the patient and correct anything they may be doing wrong.

Patients need careful instruction from their doctor or physical therapist, so communication is essential. You wouldn’t send them home with the suggestion to “look up lumbar extension exercises on the internet and do some of those”, would you?

But will you take the time to explain to them WHY you’re suggesting these lumbar extension exercises? Truly, it’s not enough just to give your patients or clients an assignment. They should know why you’ve made this suggestion and what kinds of benefits they will reap from doing the exercises daily.

For this kind of spine education, you need the right tools. These tools will demonstrate the workings of the spine and help explain why these exercises will be advantageous to the patient’s recovery. From these tools, your patient will learn how they injured themselves or what’s affected due to their condition, why they hurt, and how their spine will positively respond to the exercises.

The only way to do that accurately is to use a spine model, and the only spine models that are realistic enough to get the job done are those manufactured by Dynamic Disc Designs (ddd). These models are amazingly accurate and they move just like a real spine. So, if you want your client/patient to do prone press-ups or a standing extension, you can show them exactly what will happen to their spine as they do those exercises and why their back pain may cease with the stretching.

There are numerous lumbar models available from ddd and you can browse their website or consult with the company’s expert creator, Dr. Jerome Fryer, to determine which are best for your practice. Because Dr. Fryer designed these models for his patients, who were plagued with various problems, he can easily assist you in choosing the one (or more) that will address the issues and conditions you most often encounter in your practice.

I use the spinal disc model daily to educate my patients. The dynamic nature of this model conveys the importance of proper movement patterns and disc mechanics.”
Dr. Douglas J. Taber, DC,

A Lumbar Injection May Be the Answer for Low Back Pain

Lumbar injection

Anyone suffering low back pain likely prefers a non-surgical way to combat that pain…and a lumbar injection may be the answer for many patients. This is a practice that’s been in use for more than a half-century and one that proves to be helpful for a number of conditions, like sciatica.

Specifically, a lumbar epidural steroid injection (ESI) aims at pain relief and can be quite successful on its own. For many, it seems an easy way to reduce discomfort and, as such, return to normal activities that may have been curtailed due to lower back pain.

Of course, if you’re able to convince a patient that the injections, when paired with a well-crafted rehabilitation program, can provide an even better chance of eliminating lower back pain, you’re certainly headed in the right direction.

While a lumbar injection isn’t necessarily a long-term fix – some patients only achieve relief for a few weeks – it can indeed provide enough relief to allow a patient to begin or continue with stretching and other exercises that will result in more lasting results. It’s important to note that it is preferable not to allow the patient to begin to rely on lumbar epidural steroid injections alone; these should only be a step towards self-motivation and the desire to do what it takes to make oneself well again.

It’s hard to convince someone to take time for exercise and stretching, especially if it’s a patient that works a long day, tends to a family, and has a long list of other responsibilities that occupy their time. But it’s your job as a spine specialist to educate them as to the advantages of giving their lower back a little extra attention, even if just for 10-15 minutes per day.

To accomplish this task, try using the very realistic models offered by Dynamic Disc Designs (ddd). These lumbar models are ideal for demonstrating why the patient’s back hurts, what the lumbar injection did to relieve the pain, and how they can continue to live pain-free by doing a little extra work on their own.

The ddd models look like the real thing! That’s because Dr. Jerome Fryer, the designer of the many models offered by the company, made them after being frustrated with the unrealistic models that were available for patient education. He wanted his patients to “see” the spine, feel how it moves, and understand their role in spine health. As such, models like the Professional LxH lumbar model are the most realistic on the market and spine specialists of all types – chiropractors, osteopaths, surgeons, physiotherapists, massage therapists – are singing their praises, noticing that these models provide such a clear picture of the spine’s workings that patients walk away confident about their diagnosis, their treatment, and their responsibility to themselves as a patient who wants to feel better.

“You can use a poster or a tablet to educate your patients, but they will see an image on a poster or a tablet. If you use a 3d model, they will have a spine in their hands. There is not a minute to lose in a clinic and a ddd model is simply the best way to demonstrate back pain. Quick, visual, concrete, straight to the point.”
– Louis Riendeau, DC

Explaining the Risks and Successes of Lumbar Discectomy Surgery

Lumbar Discectomy Surgery

“You need surgery.”

That’s never a phrase that patients want to hear. Use the word “surgery” and most individuals go into panic mode. And rightfully so. While no responsible doctor recommends surgery without expecting there will be an upside and positive results, any kind of surgery carries a fair number of risks. As doctors, it’s all about letting the patient know that the successes outweigh those scary risks.

A lumbar discectomy, of course, is used to treat a herniated disc. In the case of a microdiscectomy, the surgery can be performed on an outpatient basis, usually with no extended hospital stay at all or perhaps an overnight stay in some cases. Happily, most patients can return to a fairly normal level of activity in no time at all, so – as surgeries go – it’s quite routine.

The success rate in regards to lumbar discectomy surgery is quite high. Around 90 percent of patients report no further discomfort or other issues, though statistics show that somewhere between 5% and 10% may suffer a recurrent disc herniation, either within a few months or many years later. It’s difficult to tell who may be a candidate for recurrence. When multiple disc herniation recurrences happen, the patient may be a candidate for more-complicated spinal fusion surgery.

Of course, risks are present and complications can indeed happen. A dural tear may occur, resulting in a slightly more complicated recovery period. Nerve root damage is a rare complication as is bowel or bladder incontinence due to surgical error. And there’s always the risk of infection. But these are rare.

Nonetheless, when a lumbar discectomy is recommended it is necessary to explain both the positives and negatives of such a surgery. It’s essential for your patient to understand everything about their impending surgery, including the scary stuff, though chances are you’ve learned how to emphasize the positive over the not-so-positive.

Your nervous patient will benefit from the most comprehensive explanation you can provide them about their surgery. So, it’s time to put away the poster and laser pointer and trade these tools for a lumbar model from Dynamic Disc Designs (ddd), an innovative company that offers the best in spine education products. The company’s lumbar models, such as the Professional LxH, easily demonstrate the particulars of disc herniation and are an ideal way to teach a layperson about the spine.

Models manufactured by ddd are fully-dynamic and lifelike, providing spine surgeons with a tool that allows patients to hold and manipulate the spine and, therefore, grasp how it works and what occurs during a herniation. With these models, the doctor can also demonstrate how the discectomy will solve the problem and what is necessary to maintain good disc health.

Those who use ddd’s models will tell you that they are ideal in putting patients’ minds at ease before and after surgery and are the perfect tool for explaining other spine issues as well.

Dynamic Disc Designs offers a variety of both lumbar and cervical models for your surgical spine practice. They may be ordered individually or in bundles at a reduced price. Browse ddd’s website for photos and informative videos.

ChiroHub calls ddd models: “…beautifully designed, accurate, user-friendly, and professional grade.” They add: “The quality is impressive to patients, and the ability to demonstrate and describe flexion and extension loads on a disc herniation makes a huge impact on patient compliance.  Sure, you could go get a Mr. Thrifty skeleton for less, but you’ll find yourself wishing you could actually show what happens to a patient’s disc when they lift improperly.”

Lumbar Compression Fracture

Lumbar Compression Fracture

The spine contains some of the strongest bones in our body, but even our spines are prone to injury for a number of reasons. Just like all the other bones in the human anatomy, a vertebra in the spine can fracture and, when it does, it will need prompt attention.

A lumbar compression fracture is defined as a vertebral bone in the spine that, due to fracture, has decreased in height by at least 15% to 20%. These fractures tend to occur in the upper back – or thoracic spine – and are quite often the result of osteoporosis. As such, older individuals – often women – are the victims of lumbar compression fractures.

Some lumbar compression fractures are referred to as “wedge” fractures because the front of the vertebra collapses and the back is unchanged, forming a wedge-shaped vertebra. However, individuals can also suffer from a “crush” fracture, which indicates that the entire bone has broken; or a “burst” fracture, which involves loss of height in both the front and back walls of the vertebral body.

So how does someone know they’re suffering from a lumbar compression fracture?

Though there are many conditions that cause similar back pain, a compression fracture is usually characterized by sudden onset pain. Patients achieve some degree of relief when lying on their back but walking and standing is generally painful. Mobility is generally impaired, sometimes to quite an extent, and disability and deformity may eventually occur.

Those who treat the spine know that a lumbar compression fracture is quite often the culprit when a patient arrives with back pain that has seemingly come from nowhere. This is especially true with osteoporosis patients, who are plagued with a condition that’s normally silent, though debilitating. That’s why spine specialists are likely to suspect a compression fracture when patients over the age of 50 come to their office complaining of sudden pain. (Though on rare occasions, pain does not accompany a compression fracture at all.)

When a patient arrives complaining of severe pain that seems unexplainable, they will naturally be anxious to receive a diagnosis. They can probably tell you that the pain happened perhaps after a fall that jarred their spine or maybe after lifting or bending. Sometimes, however, when osteoporosis is really advanced, fractures can occur with relative ease and could be caused by the slightest movement, like turning over in bed or perhaps coughing.

Once you’ve determined that you are indeed dealing with a lumbar compression fracture, which may demand a CT scan or MRI, it’s time to discuss the findings with the patient. This might be difficult as it’s tough to picture the spinal vertebrae and how they work. But if you present your patient with a detailed model of the spine that they can observe, touch, and manipulate, chances are that their understanding of compression fractures will be more complete once you’ve finished your explanation.

The best tool for this kind of education is a spine model manufactured by Dynamic Disc Designs, manufactured with exactly this type of scenario in mind. Dr. Jerome Fryer designed these lumbar models specifically so that patients could get a good grasp on a variety of spine-related conditions such as compression fractures, and doctors who use them report that patients do indeed understand once they “see” the spine. Once the patient understands, you can use ddd models to explain treatment, which may or may not be surgical, and what happens afterwards.

“While I have used many models for patient teaching over the years, [Dynamic Disc Design] models are so much more accurate and realistic. The dynamic design allows the patients to understand the pathology of disc herniation very clearly. I strongly recommend these models for patient education and surgical consent discussions.”
– Ali Moshirfar, MD, Orthopaedic and Spine Surgery Institute, Virginia, USA

Spine Upper Back Pain Common in Today’s Population

Spine Upper Back Pain

While lower back pain still remains the major cause of missed days in workplaces around the world, spine upper back pain has become more and more common among individuals who spend much of their day hunched over a computer.

Individuals of all ages are prone to spine upper back pain but, these days, college and high school students are amongst those who most often complain of this type of discomfort. And it’s no wonder they hurt! Many millennials spend upwards of 8 hours or more at their desktop PC or on their laptop. In many cases, their desk chair may not provide proper support. In other cases, those who chose to work on their computer while in bed or while sitting in another spot that provides no support at all will likely wind up with upper back pain. Often, they’ll experience neck and shoulder pain as well.

Most cases of spine upper back pain are attributed to some sort of muscular irritation. Joint dysfunction may be the culprit as well. Just as with lower back pain, participating in a task that involves repetitive motions could cause upper back discomfort as could a lack of strength in that part of the body. In addition, car accidents, falls, sports-related issues, and other injuries may result in muscular irritation that prompts this type of pain.

Unfortunately, those who are used to spending their days at a desk, staring at a computer, have come to accept this upper back pain as merely part of the load they must bear as workers of the 21st century. Chances are that there are tens of thousands of individuals who suffer with this pain who simply “grin and bear it”, figuring it’s a job-related hazard and there’s nothing they can do about it.

Fortunately, they’re wrong. No one need suffer from any kind of back pain as there’s always a solution to either lessen it or to help it go away altogether. In regards to spine upper back pain, sufferers should consider turning to a non-surgical spine specialist who will likely be able to treat their pain and make them comfortable again.

Options for treating this kind of pain include:

  • Stretching exercises
  • Manual manipulation
  • Trigger point injections
  • Acupuncture
  • Massage therapy
  • Pain medication

Any number of professionals, from chiropractors and osteopaths to massage therapists and Chinese medicine experts, can address upper back pain with their patients, and part of that discussion can be a demonstration of how the spine works and what exactly is causing their pain. When a 3-dimensional, fully-dynamic upper back model from Dynamic Disc Designs (ddd) is used for education purposes, patients will “get” what’s going on with their back and will be inclined to follow doctor’s orders.

According to specialists who already use ddd’s models, these finely-crafted educational tools turn on that proverbial light bulb in a patient’s head, prompting them to understand why their upper back hurts and how lifestyle changes can help make that pain disappear. As a result of that knowledge, they set themselves on the road to recovery and, as mentioned, are more likely to follow the recommendations provided to them.

My clinic relies heavily on the patient education process, as I believe all clinics should. I have not come across any anatomical model that depicts spinal mechanics as well as this one does. It saves me time, makes detailed explanation easy, increases patient compliance and ultimately, produces better results. I recommend it highly to any clinician who works with the spine.”
–Dan Kelly, physiotherapist

Lumbar Injury and Your Athletic Patient

Lumbar Injury

It’s safe to say, no doubt, that as a spine specialist you’ve viewed a lumbar injury or two…or two hundred…or two thousand, if you’ve been in practice for a long time. Maybe you specialize in treating athletes or perhaps dancers or gymnasts. All those categories of individuals are prone to lumbar injuries, from strains and sprains to – unfortunately – much more serious injuries that could be life-changing.

Though the lumbar spine is sturdy and offers great support to the human body, the things we do to our body often make us prone to injury. Athletes, especially, tax their body to its limit in many instances. And as adults remain more and more active through their later years, it’s likely that you’ll continue to see more lumbar injury due to participation in sports. Whether your patient is a pro, a recreational athlete, a workout fanatic, a so-called “weekend warrior”, or just someone who enjoys a little competition now and then, they can get themselves into trouble when putting extra strain on their spine, especially as they age.

Low back injuries are quite common among professional and amateur athletes and are the reason most people miss work. These problems often include bruising, overstretching, or mild tissue tears. Minor fractures may also occur, or the patient may be burdened with something a bit more serious such as disc herniation or spondylolysis.

Thankfully, lumbar spine injuries usually do not affect the spinal cord itself, so healing is certainly probable and pain may be mild in many cases. Nonetheless, your athletic patient will be seeking relief and looking forward to getting back on the baseball field, the tennis court, the ice rink, the gym, or wherever else they enjoy staying active.

In some instances, cessation of certain activities may be a reality and, chances are, your patient won’t be very happy about that suggestion. However, it’s your job to demonstrate what will occur if they disregard your recommendation. While you’ll likely recommend that they keep moving in some manner, they need to understand how further injury can incur if they do not curb their activity as per your suggestion.

You can do that by demonstrating how the spine works, what caused their injury, how their injury is affecting their lumbar area, and what must be done in order to heal and become active again. For this, you need to have your best tools on hand as avid athletes will need plenty of convincing in regards to that temporary cessation you’ve suggested.

Why not use the ultimate spine model to demonstrate to your patients the important of following your directions? That model is the Professional LxH by Dynamic Disc Designs (ddd). This lumbar model, crafted by a chiropractor and designed specifically for patient education, includes a flexible and totally dynamic herniating (or prolapse) nucleus pulposus. This is achieved through a realistic 2-part intervertebral disc with 6 degrees of freedom. In other words, this amazing lumbar model looks, feels, and operates like the real thing.

patient-engagement

By using this with your athletes – amateur to professional – you’ll create that spark of understanding that convinces them to take your advice seriously. Furthermore, when they understand their problem, they’ll be more likely to follow through with your overall recommended treatment plan and, with their success, they’ll become a dedicated patient and will likely refer you to others like themselves.

Compared to generic ‘static’ models, your ‘dynamic’ models help us explain the intricate details of each client’s condition in an easier to understand concept that can be catered or customized to each individual client’s needs, whether technical or basic. Your models have re-established the vital importance of the doctor / client communication relationship, dramatically bridging the gap for both to have a common understanding of the condition, the process ahead, and the targeted outcomes towards health and wellness for life.”
– Barry Kluner, DC