News and Updates

Enjoy a Romantic Weekend – Even With Sciatica

Valentine Tips Sciatica

Take it easy Fellas—it’s just date night!  It’s not like you have to prepare for battle.  Well, then again… you know you better be prepared.  Not to detract from the importance of romance but you are preoccupied with back pain from sciatica, or perhaps you are still recovering from a minimally invasive spine surgery procedure.  Here are some suggestions to help you get through your romantic evening, and even enjoy it!

Stay local: The last thing you want to do when you have a painful spine condition is sit in your car for hours, hunched over the steering wheel with your head tilted forward and straining your neck.

  • Try some new positions: In YOGA! Instead of stressing and rushing through dinner in an overcrowded restaurant, making ‘relationship’ conversation, and then racing to a movie or show, Chill!  Put on matching Zen-sweats and head over to a Yoga and meditation class.  Gentle yoga is recommended for many back pain conditions, from muscle strain to sciatica.
  • Continue the calm with healthy cuisine: Whether you are combating pain, or recovering from a minimally invasive spine surgery procedure, nourishing your body (and soul) with healthy veggies and lean protein will go a long way to making you feel great.  Keeping with your date night theme, and yet flirting with danger—try a vegetarian restaurant!  (She will love it and don’t worry, you will survive this.)
  • Choose red: if you pop open some wine for the evening, make it red.  According to a research study from the University of Zurich, published in 2011 in the journal Spine, the compound resveratrol found in red wine may have an anti-inflammatory and analgesic effect on vertebral disc conditions that cause sciatica and other forms of back pain.

From exercise, to meditation, and some red wine…your endorphins should be dancing for joy by evening’s end.  Endorphins, the feel-good hormones released by your body, are nature’s best answer to pain.  So don’t let sciatica, or recovery from a minimally invasive spine surgery procedure stop you from having a wonderful date night with your ‘sweetie.’  And remember, don’t underestimate the healing powers of love and romance!

Physiatry May Help Prevent Unneeded Spinal Surgery

Physiatry For Sciatica

For those of you who follow professional golf, the good news is that Retief Goosen is making a nice comeback from recent spine surgery for a herniated disc.  He reported on his website that he recently finished his first week back on the PGA Tour.  Prior to his procedure, he was undergoing treatment that included physiotherapy in hopes of averting surgery for a herniated disc.

Last year he told reporters from ASAP Sports at the WGC-Bridgestone Invitational in Akron, “My physio is doing a good job keeping me on the course at the moment and I am in discussions with a number of doctors to see what options there are with the back.” He indicated that he was receiving epidural injections and doing physiotherapy core strengthening exercises.

Physiatry is a field of rehabilitative medicine that isn’t as well known as other specialties.  Practitioners focus on optimizing functionality for people who have injuries to bone, tissue, muscle or nerves.  According to the American Academy of Physical Medicine and Rehabilitation, a physiatrist is a medical doctor or osteopathic doctor, who may direct a team of rehabilitative specialists including neurologists, orthopedic surgeons and physical therapists.  They commonly treat chronic conditions such as low back pain due to various causes including herniated discs and degenerative disc disease.  Following procedures like spinal surgery, a physiatrist might care for the patient in various areas such as psychological, pain management and functional rehabilitation.

The outcome from a recent study published in the February 1, 2013 edition of the journal Spine, found that when an insurer required individuals to consult with a physiatrist prior to seeking non-urgent surgical consultation, the rate of spinal surgery procedures decreased.   This finding seems to support the importance of exhausting conservative treatment and interventional procedures for conditions like herniated discs before moving toward surgical solutions.   No doubt, having a strong core thanks to physical therapy exercises prior to receiving his surgery, will help Goosen recover and regain his strength soon.

SpinePath is now in Phoenix!

Phoenix is one of our favorite cities, and now we have even more reason to appreciate the home of the Heard Museum and Chase Field, not to mention the mouth-watering pizza at Pizzeria Bianco.  Here’s the great news: Abram Burgher, M.D. and John Ehteshami, M.D. have combined to offer the SpinePath procedure, bringing the best and latest in minimally invasive spine surgery to Phoenix and Scottsdale.

If you live near Phoenix or know someone who does, it’s time to get on the phone and give one of our patient coordinators a call at (855) 831-4153.  We are offering a free MRI review for individuals with chronic neck and back pain who are considering minimally invasive spine surgery.

The SpinePath procedure provides neck and back pain sufferers relief in a short outpatient procedure, requiring only an adhesive bandage or single stitch. It will be performed at Freedom Pain Hospital – the nation’s first pain hospital.

Double board-certified in interventional pain management and anesthesiology, Dr. Abram Burgher is devoted to helping people overcome pain. After earning honors at the University of Minnesota’s School of Medicine, Dr. Burgher completed his internship, residency, and fellowship in pain management at the world-renowned Mayo Clinic. He is actively involved in clinical research to improve the safety and quality of care for patients with chronic pain.

As a board-certified orthopedic spine and scoliosis surgeon, Dr. John Ehteshami works closely with each patient to maximize their quality of life while minimizing the negative impact of chronic pain. His training has centered on the top institutions of his field: he earned his medical degree from Thomas Jefferson University Medical School in Philadelphia, completed his residency at the Hospital for Special Surgery in New York City, and completed a fellowship at Rush University Medical Center.

Whether you live in Phoenix – or are nearby in California or New Mexico – you now have even closer access to the best in minimally invasive spine care through Spine Treatment Centers of America and the SpinePath procedure. (You may want to grab some pizza while you are there.)

Managing Sciatica with Cognitive Behavior Therapy

Cognitive Behavior Therapy

We can learn a lot about coping with chronic pain from watching injured professional athletes who continue playing despite enduring tremendous discomfort.  While adrenaline and endorphins no doubt have something to do with their increased tolerance for pain during game time, sports psychology may also come into play.  These therapists help athletes develop their emotional and mental toughness when facing challenges like coping with injuries or even performance setbacks.  So how can psychology help regular folks cope with sciatica nerve pain or herniated discs?

Cognitive behavior therapy (CBT) is a form of psychotherapy that explores and improves the connection between our thoughts, emotions and behaviors.  The idea is that through this form of talk therapy, an individual can improve their coping skills with challenging circumstances such as chronic pain.  CBT teaches people to change the way they think for the better.  People suffering with chronic low back pain from conditions like sciatica and herniated discs can become depressed when they are less active and over time develop feelings of hopelessness, anxiety and despair. Sadly, this may worsen rather than help the recovery process.  It’s important to maintain as active of a lifestyle as is possible, and an optimistic attitude toward managing your pain and treatment process.

The steps involved with CBT for chronic pain management include:

  • Identifying Negative Behaviors: A therapist can help you examine negative thought patterns and assumptions. People struggling with pain over time start to believe they cannot do things, so why even bother.
  • Improving Thinking: By challenging these negative assumptions and beliefs, the therapist helps you to develop an awareness of ‘bad thoughts’ so you can begin to replace them with more rational and positive ones. For example, thinking that you can’t be an active person while coping with chronic pain, can be challenged by realizing that you are able to perform gentle rehabilitation exercises.
  • Improving Behavior:  By overcoming negative thought patterns, you may be able to overcome inactivity due to anxiety, fear and depression from chronic pain.  Becoming more active with a positive and proactive attitude could go a long way in reducing pain and stiffness. If you have to undergo surgical procedures, a positive outlook will also help you improve the recovery experience.

According to the Mayo Clinic website, research has shown that CBT helps to relieve chronic low back pain.  While this therapy alone will not treat your underlying injury or condition, changing how you perceive your circumstance could help you improve your emotional state so that you are better able to cope with the challenges of chronic back pain.  The American Psychological Association website states that sports psychologists help athletes cope with pain during injury recovery which also helps the physical therapy process.  If you suffer with sciatic nerve pain or a herniated disc, you may want to speak with your physician about including a mental health professional and some CBT to your pain management treatment plan.

The Benefits of Tai Chi for Spinal Stenosis

Tai Chi Spine

So was that 2 parts milk and one part spiced cardamom tea, steamed with a dollop of froth on top? Noooo. We aren’t talking about Chai Tea here, but rather Tai Chi. This is the ancient Chinese martial art practiced for self-defense and for its many healthy perks.  Although there are many forms of the art, modern practice in the west is most commonly associated with the gentle slow poses, executed with fluid motion, concentration and controlled breathing.  The philosophy emphasizes harmony by unifying body and mind. The concept is that Tai chi affects proper flow of ‘qi’ or life force.  The practice has been recommended for individuals suffering with chronic low back pain from conditions such as spinal stenosis, sciatic nerve pain, muscular strain and arthritis.

According to the Mayo Clinic, early research indicates that Tai Chi is beneficial for various reasons including, reducing chronic pain, improving balance, flexibility, and muscle strength and reducing falls among older adults.  All of these gains help to develop and maintain a strong back and core; increase flexibility; protect the spine from further injury and enhance the healing process.  When an individual is diagnosed with a condition such as spinal stenosis or sciatic nerve pain, it’s important to determine the specific cause of the pain.  If surgery isn’t required, a brief period of rest may be prescribed before beginning physical therapy and low impact exercise such as yoga, swimming or Tai Chi.

Harvard University Health Publications newsletter differentiates Tai Chi from other forms of exercise in that the movements are circular and never forced, that muscles remain relaxed, and that connective tissues aren’t stressed because joints aren’t fully extended or bent.  The practice can be adapted for anyone across all levels of mobility.

The exercises are generally considered to be gentle and safe for older individuals with various chronic pain conditions such as spinal stenosis and sciatic nerve pain, but you need to check with your physician before beginning any exercise program, including tai chi. Lessons are usually taught in groups and it’s also very important to make sure that you have a qualified teacher to guide you in learning these movements with proper technique to avoid any falls or further injury.

Why not consider adding this delightful and therapeutic ancient martial art and exercise form to your weekly routine.  You may improve your ‘Qi’ flow, flexibility and health at the same time!


Prevent Sciatica Setting in from Icy Slip-and-Falls

Icy Slip Injury

What is it about winter?  We can’t wait for it to arrive.  Crisp air, cuddly sweaters, hot cocoa and glistening white snow blanketing our world.  And yet how quickly the dream turns into the flu, chills, and endless sodium-laden microwaveable noodle soups.  Oh yes, even the snow is nothing but a disappointing grey mess making our daily commutes treacherous.

This part of the season ushers in yet one more joy: something sinister and stealthy that lurks beneath the frozen slush and soot.  In southern towns, less accustomed to frozen precipitation, it masquerades as shiny asphalt.  Don’t feel bad if you can’t see it yet…you’re not the only one who has been caught off guard by the dreaded arrival of ICE!  This enemy-to-all (well maybe not to hockey players, skaters and bobsledders) is the cause for countless serious injuries like herniated discs and lingering sciatica, arising from wipeouts.  Most injuries aren’t serious, including many a bruised ego from public falls.  However some falls result in serious or long-lasting injury and chronic pain.

Preventing slip and falls on icy sidewalks with some planning and preparation is your best strategy for avoiding serious harm from the trauma, such as muscle strain, bruising, herniated discs and symptoms of sciatica from pinched nerves.  Here are some suggestions for navigating icy terrain when you simply cannot avoid it at all:

  • Footwear is Key – not only should you choose supportive and proper fitting boots with rubber soles with great traction, but also make sure the footwear is flexible and not so stiff that you are unable to ‘feel’ the ground beneath you and flex your feet while walking.
  • Stock up on Sand – stock up on small bags of sand or salt at home improvement stores.  Small bags are safer to carry and you can keep individual bags in your car and at each door to your home.  Make sure to sand your walkways before a storm arrives to prevent it from icing up, and make sure to treat any icy surfaces again after the precipitation stops.
  • Morning Caution – when stepping out early in the morning be extra careful, as parking lot surfaces may have frozen over throughout the night.
  • Avoid Shiny Spots – even if you think a shiny sidewalk is simply wet, don’t take the chance as it could be ‘black ice’.  Tread cautiously by testing the area with the tip of your shoe to see if it’s slippery.
  • Handrails – Forget pride, just use them.
  • Focus – Simply paying attention to where you walk and staying on shoveled walkways can prevent a mishap.  This isn’t the time to be zoning off  while chatting on your cell phone.

Often when people slip and fall on the ice, they land with tremendous force in a seated position.  This can result in severe vertebral compression and possibly herniated discs that lead to sciatica symptoms.  When disc material presses or leaks onto nearby nerve roots, painful sciatica symptoms can develop.  A 1998 study published on the National Institutes of Health website PubMed analyzed emergency room data following an ice storm and found that back injuries comprised 19.3% of all injuries and were the most common type.  So, with some care and these ice safety tips you can protect yourself.  Be patient, and remember  that spring is not too far away.


Prevent Strain and Herniated Disk When Reading in Bed

Bed Reading Pain

Don’t remember the last time you worked out at the gym? Not much of a weekend warrior sports nut? So WHAT on earth is happening in your neck and shoulders? Nothing seems to explain the incessant pain radiating into your shoulder and down your arm.

That radiating pain is referred to as radiculopathy.  You may have a muscle strain or worse, a herniated disc in your cervical spine, or the neck portion of your spine.

So what did you do to yourself now?  It could be nothing.  If direct trauma or injury isn’t the cause, aging or wear and tear is often the explanation. You’ve heard about the great results people are getting with minimally invasive spine surgery.  Perhaps that’s your answer to finally put an end to your chronic battle with pain and medication.

Before taking this treatment route, there is something else you should ask yourself: Do you read in bed?

Correct postural alignment is essential for spine health.  Reading in bed throws off this alignment.  When undue stress is placed on the lower cervical spine, just above the shoulders, the cervical vertebrae may slide from the prolonged forward pull of gravity on the head.

The results are irritation of the facet joints, which over time may lead to degenerative disc disease, predisposing you to herniated discs.  Reading in bed, with your head pulled forward and chin pulled downward toward your chest is a particularly stressful position to your neck.

If you are a dedicated bedtime reader, here are some tips to protect your neck and enjoy a good read:

  • Purchase a wedge shaped pillow to prop your book up so that you can extend your neck up into a neutral position.
  • Avoid propping your head up on stacked pillows
  • Use armrests or pillows to prop up your arms so that you can raise your book or e-reader to eye-level.
  • Sit straight up with your back and head supported, and place your book or reader upright on a bookstand that is raised to eye level.

With a little planning, and some inconvenience, you may save yourself the pain of a herniated disc… and the trip to a minimally invasive spine surgery procedure.  Think of it this way: you are being kind to your neck and still enjoying a great read before bedtime.  Your neck will thank you by purging your pain.  Now THAT is great bedtime story worth reading!


Degenerative Disc Disease A Genetic Matter: So Say Twins

Genetic Degenerative Disc

Blame it on the genes!  Now we can add another condition to this ever-growing list of attributes, good and bad, that we credit to our DNA.  For years, medical researchers and clinical practitioners have said that degenerative disc disease, usually associated with aging, is often in fact, an inherited condition.  Recently, a research study has identified a genetic component to back pain and degenerative disc disease.

This scientific advance will bring the medical community closer to tailoring specific treatments to patients depending on the underlying cause of their condition.  From conservative therapies to interventional procedures, including spinal surgery, and potentially gene therapy, more effective treatment options are growing.

A sample population of 2500 identical and non-identical female twins was tested for several risk factors, including degenerative disc disease and genetic predisposition.  The study was a collaborative effort led by a medical researcher at Tel Aviv University’s Department of Anatomy and Anthropology at the Sackler Faculty of Medicine, in Israel together with scientists at Kings College in London, U.K.   Researchers analyzed data from spine MRIs, radiographic body composition assessments, and blood samples for DNA extraction in search of possible biomarkers indicating joint disease.

The findings indicated a strong correlation between genetics and degenerative disc disease.  With a shared genetic makeup, both identical twins were six times more likely to have the joint disease.  Among the non-identical twins, who share half their DNA, a twin was almost 3 times as likely to suffer the condition if her twin had the disease.

The study from Tel Aviv University was published last year in the journal Annals of the Rheumatic Diseases.  The study’s lead researcher says that genetic factors are second only to age and that the findings have the possibility to revolutionize the study and treatment of back pain.

As the medical community and patients alike welcome innovative and cutting edge treatments for degenerative disc disease, it is certain that the treatment strategy you and your health care team choose is unique to your condition.  Regardless if you are a twin, your treatment strategy must be as unique to your medical condition as your genetic makeup, and may include lifestyle therapies, interventional pain management, spinal surgery or a combination of all of them.

Degenerative Disc Disease Therapies More Effective Without Smoking

Smoking Back Pain

Did you derail your new year’s resolutions already?  Are you back to overeating simple carbs and (intentionally) ‘misplacing’ your gym clothes?  Now that your pre-paid personal trainer has given up leaving you voice-mails, you’re free and clear!   Not so fast… This year, we all get a free ‘restart’ to our resolutions! Did you really need another convincing reason to quit smoking this year?  Well, here it is:  medical researchers from the University of Rochester Medical Center conducted a study finding that the cessation of smoking is positively related to reduced pain among back pain sufferers with conditions including degenerative disc disease.  In previous articles, we learned about medical research that proved smoking is harmful to the successful outcomes of spine surgery.  It would seem very clear that, whether you are being treated with medication, physical therapy or interventional treatment for back pain from degenerative disc disease or facing a surgical procedure you should not delay your resolution to quit smoking.

The study analyzed data from 5300 spine disorder patients who were treated with medicine, exercise, physical therapy, injections and spine surgery for back pain, over an 8-month period.  At the start of treatment, the patients who never smoked or quit long ago reported less pain than the smoking group and recently-quit group.  By the end of the treatment period, those patients who quit smoking just prior to or during treatment experienced improved symptoms while those who continued smoking did not benefit from similar results.

Since nicotine has some analgesic attributes, people may reach for a cigarette when they are experiencing pain, but over time nicotine actually increases pain for various reasons.  It has been linked with inflammatory properties leading to pain.  Nicotine also impedes healthy oxygen circulation, which prevents affected areas from healing.  It has also been proven to increase the likelihood for developing early onset of bone and joint problems such as osteoporosis.

One of the researchers from the study, published in Journal of Bone and Joint Surgery, noted that young people who were current smokers or recent quitters in the program, experienced pain along with the older patients who quit a long time ago.  He suggested this confirms earlier studies indicating smoking accelerates the onset of degenerative disc disease. So now that you have another reason to quit smoking, and you can restart those resolutions, there is NOTHING standing in the way of your ‘Restarting’ your New Year’s resolutions.  You can get excited about improving your spine health in 2013!

Prevent Herniated Discs From Pilates

Pilates Herniated Disc

It’s trendy and requires using cool gizmos and nifty apparatus.  Not to mention the gorgeous exercise outfits! Like yoga, Pilates may be prescribed for people with low back pain due to muscle strain, herniated discs or other non-specific mild pain.  The technique was developed by Joseph Pilates, who used it to help rehabilitate wounded World War I soldiers. The idea behind this practice is that strengthening the ‘power house’ or core muscle group is key toward developing better posture, endurance, strength and balance.

A story in the British news source Mail Online about a 38 year old mother of three, will remind us that while many therapeutic remedies may be helpful for low back pain and may even help prevent spinal surgery, it’s critical to get a proper diagnosis together with a prescribed treatment plan specifying any exercises, from a physician.

The woman hoped to get back into shape after giving birth by taking up Pilates.  She heard it was good for strengthening the spine supporting muscles, and improving overall fitness.  As a young girl she had been diagnosed with scoliosis, so she was particularly concerned with taking care of her spine health.  Three months into her new Pilate’s class, she woke up one morning with numbness in her leg. Her instructor wasn’t concerned and told her to take it easy, but when her symptoms worsened she went to the doctor and received an MRI, which confirmed a herniated disc.  She said at that point everyone thought she would require spinal surgery to remove the disc material pressing on her nerve.  Five years later she has been managing her pain and inflammation with epidural injections, and physiotherapy.

The exercises in Pilates are performed on specialized apparatus and on a mat.  Pilates is in fact excellent for developing core strength but when a person has a spinal condition it is important to use caution.  Many moves require placing a lot of stress and force on the spine, which can further damage a pre-existing condition or cause a new injury in an already weakened back.

For individuals with low back pain, the Mail Online article suggests choosing Pilates instructors who are experienced with spinal conditions, and who teach gentle therapy based Pilates exercises.  Avoid group classes in favor of private sessions, where the instructor is familiar with your medical history and can work with you to keep you safe and healthy. Although they cost more than group classes, the investment in your spine health will be well worth it.