Most people have had an episode of low back or neck pain, or both. Spine pain is the number one reason people miss work. One of the highest healthcare expenses in this country is the diagnosis, treatment, and rehabilitation of back pain. What most people may not understand is when to get help and who to seek help from. A small temporary flare up may just be a muscle strain…or it may represent something more serious. If your pain persists, radiates into the arms or legs, or if you have weakness, numbness/tingling, difficulty walking, bowel/bladder problems, or sexual problems, this may be an indicator of possible nerve injury. (Image by Michael Dorausch)
“It may not just be a pain in your neck or a pain in your buttocks”
Do not feel bad or “freak out” when the usual questions pop in your mind: “Will I need surgery? What kind of surgery and will it be complicated? Isn’t that dangerous? Can I be paralyzed?” I hear these questions quite often, including from my own family. The best approach is to openly discuss your concerns; as cliché as it sounds: knowledge is power, but nothing is more dangerous than partial knowledge. When it comes to neck and back pain, it is important to understand that the spinal cord and nerves are the main output and input to the brain.
We all remember when we were kids (mom stop laughing), “don’t touch that, you will burn yourself.” That reflex so well learned by all of us was a simple yet intricate process of our nervous system. The hand sensed the heat via nerves, transmitted to the spinal cord and then to the brain for comprehension and at the spinal cord level an instantaneous reflex withdrawal of the hand from the heat was initiated.
Where do you get answers? Who should you see? As a board certified and spine fellowship trained neurosurgeon, I emphasize the importance of a multidisciplinary approach of close communication between specialists and primary doctors. Having a team of highly skilled experts of surgical and nonsurgical approaches on your side is key. Excellent communication between the patient, surgeon, pain physician, rehabilitation team, and primary physician is a must! The answer to your pain issue may be as simple as changing your posture or ergonomic station at work. Patients often come to discuss Minimally Invasive Spine Surgery, but surprisingly find out there are other surgical options in my tool bag. The million dollar question is what is the true cause of the pain and how best to treat it. For example, two patients may present with very similar looking MRI images, but, in reality, may require two entirely different surgeries or no operation at all. Surgically speaking, the most important consideration is risks versus benefits of no procedure versus a certain procedure versus a different procedure.
In short, if you have pain or other symptoms, contact your doctor and ask for help. Answers can be found with a logical and grounded approach; ignoring an issue rarely makes it go away. Your doctors care about you and are there to help. Make sure you get a second opinion if you have questions about what procedure is right for you and, most importantly, get your questions answered
Daniel S. Yanni, MD, FAANS