Spine Wellness

This past December, I served as a faculty member at the 15^th Instructional Course meeting for the Cervical Spine Research Society held in Charlotte, North Carolina. For this continuing medical education meeting, I was a member of the course program committee as well as a moderator and speaker.

The overall continuing medical education objectives for this meeting included:

·                     Review appropriate anatomy and biomechanics of the cervical spine,

·                     Compare the methods for diagnosis of neck disorders,

·                     Evaluate operative and non-operative treatment options for cervical   spine disorders, and

·                     Recognize and respond to complications of surgical treatment, and exchange information on cervical spine research, diagnosis and treatment with both US and international spine surgeons.

At this meeting, in a section on techniques in spine surgery, I lectured on C1 lateral mass/C2 laminar screw fixation for posterior atlantoaxial fusion. In that this was a spine surgical technique section, I described how the procedure was done and then presented a video demonstration.

There was another educational section on cervical myelopathy for which I was a co-moderator. During this section I also presented a talk on myelopathy. A basic definition of myelopathy is a functional or pathological change in the spinal cord.

Mark Your Calendars!

Indiana Spine Group is excited to announce the fifth annual spine symposium, 

Back Talk: A Comprehensive Review and Practical Approach to Spinal Diagnosis and Treatment.

 Mark your calendars, and plan to join us!

Date:  November 11 & 12, 2011

Location: Renaissance Hotel | Carmel, Indiana

Back pain continues to be a major health care issue. Not only is it one of the main reasons for physician visits, but it is also one of the most common reasons for missed work. According to the National Institutes of Health, back pain affects eight out of ten people at some point during their lifetime. This symposium will provide the latest information for the diagnosis and treatment of spinal disorders and abnormalities.

At the conclusion of this conference, attendees will be able to:

• Perform a comprehensive diagnostic examination and evaluation of patients that present with back and neck pain, including the identification and etiology of normal and abnormal spinal anatomy and conditions, and the effects of the degenerative cascade of the spine.
• Identify the diagnostic indicators and treatment options of patients with common and uncommon spinal disorders and abnormalities with a thorough understanding of non-operative, minimally invasive and operative treatment options, and the clinical indications of selected treatments.
• Discuss overall spinal health and wellness with an understanding of the role and importance of lifestyle and other wellness factors, e.g. diet and exercise, and the recommended prevention and screening guidelines. 
• Review case studies of common spinal disorders and abnormalities, and discuss indications of imaging studies and diagnostic  procedures, appropriate treatment protocols, clinical indicators and expected outcomes.
• Highlight the latest research, emerging treatment options and technology in spinal care with its applicability to the patient care model.  

This one and one-half-day continuing medical education symposium will feature general and concurrent educational sessions, and new this year are clinical workshops that will be hosted at the Medical Academic Center (located just north of the Renaissance). 
 

For more information and conference updates call (317) 228-7000. To sign-up for the mailing list send your contact information to info@indianaspinegroup.com.

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This activity has been approved for AMA PRA Category 1 Credit. Additional CME/CE categories will be applied for.

Most likely when you think of osteoporosis, you think of a disease that affects older individuals. But did you know that the health habits of teens can affect their risk for osteoporosis? This spine wellness blog will provide resources for you and your teen(s).

This fall the Health and Human Services launched a new program to influence girls aged 9 – 15 to eat healthy now! This campaign encourages spine wellness and is called The Best Bones Forever!™ Campaign. This program encourages girls to get active and eat more foods with calcium and vitamin.
 

“It is important for teens to pay attention to the amount of calcium and Vitamin D in their diet, as well as develop spine wellness health habits. When you are young, bone is replaced at a more rapid rate. So essentially, when you are a teenager you are building your “bone bank” for later years,” says Kevin Macadaeg, MD, a minimally invasive spine specialist with Indiana Spine Group. “And by 18, an individual has built most of their bone mass,” Macadaeg continues.

The new osteoporosis program for teens and their parents, Best Bones Forever, has a web site with resources and information to get started on bone healthy future. Click here, to visit the web site and resource center.

One essential ingredient to overall spine health and a tool in the fight against osteoporosis is Vitamin D. Vitamin D is essential to the absorption of calcium by your body. This spine wellness tip will provide the latest recommendations.

On November 30, 2010, the Institute of Medicine (ICM) released updated recommendations for Vitamin D and calcium for the prevention of osteoporosis.

The following is now recommended:

• Healthy adults under 71 – 600 IU (international units) of Vitamin D per day
• Healthy adults 71 and older – 800 IU of Vitamin D per day

Additionally, it is recommended that individuals with very little sun exposure, osteoporosis and other conditions/circumstances to intake more Vitamin D per day. Talk to your physician for your specific recommendations. To read the new recommendation, visit this link.

As you plan your menus for the upcoming holiday season and New Year – think of a spine healthy menu. Healthy menus are not only beneficial to maintaining your weight, lowering your cholesterol to just name a few of health benefits - but also for your overall spine wellness and health.

The National Osteoporosis Foundation provides a wealth of spine wellness and health resources to aid in the prevention of osteoporosis. Visit this link, to learn more about healthy eating tips and your spine.

Chances of a "white Christmas" are high, with snow on the ground and in the forecast. With snow, comes the dreaded chore of shoveling. This spine wellness blog entry, will provide a few tips to help you avoid neck and back pain.  

• Stretch - think of snow shoveling as exercise and stretch before you begin!
• Push - move the snow forward, rather than lifting when possible.
• Avoid twisting - do not lift the snow and throw it over your shoulder.
• Proper technique - when lifting the snow, use proper body mechanics, lifting from your legs and do not bend from your waist.

If your holiday plans include traveling. Sometimes that in itself can be a pain in your back! This spine wellness blog entry will provide a few healthful tips for minimizing back pain while traveling.

• Before you travel – remember to stretch! Stretch both your back and neck.
• If you are traveling by car – take frequent breaks to stretch. Also, switch drivers – when you are not driving this allows you to sit in a more relaxed position.
• Support your back, with either a lumbar pillow or place a rolled towel along your lower (lumbar) back.
• Remove your wallet or other items in your back pocket. Sitting on objects, can cause you to misalign your spine.

For more spine wellness tips for traveling by car, click here for a fact sheet.

For more travel tips, visit this page on the Spine Health website. This page provides “29 Best Travel Tips for Your Aching Back.”

It is estimated that 10 million Americans have osteoporosis. Sometimes called the “silent disease”, osteoporosis is a leading cause of fractures in older adults. According to the National Osteoporosis Foundation, approximately 50 percent of women with osteoporosis will break a bone in their life time, and one of four men with osteoporosis will experience a fracture.

Fractures as a result of osteoporosis are most likely to occur in the hip, spine or wrist. It is estimated that there are more than 700,000 vertebral compression fractures each year as a result of osteoporosis.

For more information about osteoporosis tips for prevention, treatment options, visit the National Osteoporosis Foundation’s web site.

Watch for upcoming spine wellness blog entries addressing osteoporosis and your spine’s health.

In addition to patient care and research, physicians with Indiana Spine Group lecture nationally and internationally as well as publish.  A few recent publications include the following:

• A book chapter co-authored by Kevin Macadaeg, MD, and Rick Sasso, MD, et.al. This chapter was on neck pain and was entitled, “Treatment of Axial Neck Pain”. This was published in Arthritis and Arthroplasty: The Spine, edited by Shen and Shaffrey.  To purchase this book, visit this link.  

• A chapter co-written by spine surgeons Rick Sasso, MD, and Paul Kraemer, MD, entitled “Rigid versus Dynamic Cervical Plates: Indications and Efficacy”. This chapter was published in a book entitled Controversies in Spine Surgery: Best Evidence Recommendations, edited by Vaccaro and Eck. This book is available online.

We are all aware of the dangers of smoking. Cancer, increased risk of stroke, coronary heart disease, are only a few of the risks. 

This spine wellness blog entry – will focus on smoking and your spine.

When you think of smoking and your overall spine health:
 

• Smoking contributes to early and more severe degenerative disc disease as a result of the nicotine blocking the transportation of oxygen and other important nutrients to the spinal discs. (This is true for nicotine in any form). When spinal discs are deprived of oxygen, the discs are less able to repair themselves which leads to earlier collapse than what is seen in non-smokers.

• Smoking results in slower healing times for individuals that undergo spine surgery (back surgery).

• Female smokers who are postmenopausal, have lower bone density than women who have never smoked. This lower bone density can increase the risk for osteoporosis and fractures (e.g. hip fractures).

The good news is when you stop smoking, this helps to reduce your health risks. Additionally, there are many resources to help individuals stop smoking and the American Lung Association provides a lot of programs for both adults and teens. For more information about how to stop smoking, visit this link and talk to your physician.

When someone twists their ankle, or pulls a muscle in their back – you know heat and cold are good remedies to help with swelling and pain. Often time though, it is hard to remember which you do first. A spine wellness tip to help you remember – think of the alphabet - c comes before h. So cold and then hot!

So next time you pull a muscle in your back  - for the first 24 to 48 hours after you hurt your back, use ice. This will help reduce the swelling, muscle spasms and back pain. Then after 48 hours, switch to heat, which warms and helps relax sore muscles. (And if the back pain is persistent and does not go away in a timely fashion, see your physician).

This spine wellness blog entry will answer a question from a reader.

Question:  “I am looking at exercise equipment, which would you recommend – a treadmill or elliptical machine for back health?”

Answer:  The bottom-line answer is that one piece of equipment is not necessarily better than the other – it all depends on the individual’s needs and preferences. The following highlights considerations for each:

Elliptical Machines:  Elliptical machines provide exercise with little or no impact. This is a very good option for people with knee or back pain. When shopping for an elliptical machine, it is important to purchase one that allows you to adjust the stride length. If the stride length is too long, it can cause you to hyper-extend your lower back. (This is similar to taking to very big steps).

Treadmills: Walking is a great exercise for your back, and no equipment is needed for this! Walking helps increase blood flow, which brings nutrient-rich blood to the spine.  Additionally, it promotes strength and flexibility. HOWEVER, for individuals with spinal stenosis or spondyloslisthesis walking can increase the stress on the spine.

Recumbent Bikes:  These can be an excellent option for individuals with spinal stenosis or spondyloslithesis. When using recumbent bikes, you are sitting and your spine is in a more flexed posture, this decreases stress and pressure on the spine. 

This spine wellness blog entry was answered by Adam Ebbert, PT.  Adam is the physical therapy coordinator with Indiana Spine Group.

Depending on where you live – texting and cell phone laws vary. For instance, in Indiana only drivers under the age of 18 are banned from using cell phones or texting while driving. While in Kentucky, texting is banned for all drivers regardless of age.

Spinal injuries and trauma caused from accidents caused by drivers not paying attention is increasing, as sadly so are deaths from texting and driving. To help combat this issue, a great spine wellness (and life wellness) tip is not to text and drive.

The American Academy of Orthopaedic Surgeons (AAOS) has partnered with the Orthopaedic Trauma Association and has created a public service announcement and tip sheet to help eliminate texting and driving. Simply put, don’t text and drive!

Spine Wellness Tip #8 – Relax!

This spine wellness tip for a healthy back is easier said than done – relax! Prolonged stress can become chronic, and lead to muscle tension that causes neck or back pain. Common ways to help manage stress include exercise, yoga, meditation, hobbies, massage therapy, counseling – and learning to say “no”.

This spine wellness tip is something you have probably heard time and time again – drink plenty of fluids. Not only does drinking liquids help to keep you body hydrated, but it also flushes out the toxins that can create inflammation in your body. And a great deal of back pain is caused by inflammation. The general rule is a minimum of 64 ounces of water per day. This Mayo Clinic link, addresses how much water you should drink a day – using a simple calculation.

Spine Wellness Tip # 7 – Stay Hydrated

This blog entry will continue a series on spine wellness and spine wellness tips. 
 
 

Spine Wellness Tip #6 – Eat Well

Did you know that proper nutrition can help prevent or decrease spinal pain? It is important to incorporate healthy eating habits into your life style. This includes eating the right kind of foods, in the right amounts. In your menu planning include lean proteins, plenty of fruits and vegetables, and low-fat dairy products. Proper nutrition can decrease inflammation, keep your weight down and thereby help to decrease or prevent spinal pain, This link on Spine Universe provides some spine wellness helpful tips for healthy eating.

Fall is a great time of the year! Cooler temperatures, football, changing leaves and . . .  It is also the time of the year, you begin thinking of cleaning up outside, raking leaves , putting away planters and lawn furniture. A list of chores,  if not done properly can lead to back injury or back pain.

This spine wellness blog entry, will provide a few suggestions for avoiding back pain as you tackle your “outside” chore list. 

·     Stretch first! Few the work as exercise, and stretch as you would prior to beginning to exercise.

·         Use proper body mechanics when lifting.

·         Use your legs to move from side to side, rather than your arms – step side to side.

For a complete spine wellness tip sheet for preventing back pain /injuries while working out side, visit this link.

• Select a backpack with two wide - padded straps that go over both shoulders.
• Try to carry heavier items closer to the body - and bulkier items away from the body.
• When picking up the back pack, bend at the knees and use both hands. (Use leg muscles not your back to pick up the backpack). 
• If your child arches their back or leans forward, the backpack is most likely too heavy.