Low Back

What You Need to Know About Back Pain After Surgery

By Last updated on December 16, 2020 Last updated on December 16, 2020 No Comments

DO YOU HAVE LOW BACK PAIN?

Back pain is one of the most common types of chronic pain in the United States. Almost everyone who is capable will experience some form of back pain in their lifetime.

Some forms of pain will go away on their own with time and the body’s natural healing processes. When pain persists, however, it can impact almost all aspects of life. People who are experiencing back pain often have trouble completing tasks that they have done effortlessly before.

General enjoyment of life can be greatly impacted. Finding the right treatment option depends on a proper diagnosis. The complex nature of the back and spine impacts every aspect of treatment as it is happening. Surgery becomes an option when minimally invasive treatment options fail to provide relief.

The option to undergo surgery is most often voluntary, so for patients to make the decision that is best for them it is important to be well-informed.

This article will discuss the anatomy of the back in a general sense and how it relates to certain conditions which may be causing pain, how back pain is typically diagnosed, treatment plans, surgical intervention, and a new form of alternative therapy which offers hope to patients who make the decision to undergo surgery.

Anatomy of the Back

Spinal issues are most commonly associated with back pain. The spine is made up of vertebrae, bony segments of varying sizes that are stacked on top of one another. Located between each vertebrae are vertebral discs. These act as a cushion between the bony parts of the spine, preventing them from rubbing against one another. Vertebral discs also play an important role in spinal support and stability.

Outside of the spine itself are an intricate network of muscles, tendons, and ligaments which protect the spine. They also provide support, stability, and mobility.

The bony part of the spine serves as a protection for the spinal cord. The spinal cord contains nerve tissue and is an integral part of all movement as it sends signals from the brain to the rest of the body. The spinal cord is connected to nerves, meaning that it is particularly important to be aware of them during the treatment of back pain. Nerve damage can lead to significant issues long- and short-term.

Any of the aforementioned aspects of the spine can become damaged or injured. In some cases, it is more than one specific part of the spine which is damaged and causing pain. The causes of pain or discomfort in the back can be varied, but generally the causes stem from:

  • Degeneration: tissues degrade naturally over time. This can apply to vertebral discs, tendons and ligaments, muscles, and many more.
  • Injury: a sudden traumatic injury can result in misalignment of this intricate network, as well as cause trauma and stress to the spine.
  • Overuse: certain motions that have been repeated regularly over time can lead to more rapid degeneration.

Most of the conditions associated with back pain can be traced back to these general causes. The diagnosis of back pain leads to receiving proper treatment.

Common conditions related to back pain can include:

  • Bulging/Ruptured/Herniated discs
  • Arthritis
  • Osteoporosis
  • Vertebral Fracture
  • Ligament or Muscle Tears
  • Bone Spurs
  • Nerve Damage or Pinched Nerves

It is crucial that a patient seeking medical advice for back pain receive a proper diagnosis of what is causing discomfort. Each diagnosis comes with a different treatment plan, which is tailored even further to match each patient’s specific needs. The first step to treating or managing pain is finding out the root cause of it.

Diagnosis of Back Pain

It is generally recommended that an individual visit the doctor once pain begins to impact daily life. This can surface as an interruption of sleep, inability to perform certain tasks, and general discomfort which impacts enjoyment.

Once this pain reaches the point where it is lowering the quality of life, doctors will begin the diagnosis process. Diagnosis typically follows a path that begins with a minimally invasive assessment, but for greater accuracy doctors will often employ the aid of certain imaging techniques. The process of receiving an accurate diagnosis generally involves:

  • Examination: doctors will look at a patient’s range of motion and test their abilities to perform certain tasks. During this, they will ask the patient to describe the pain they are feeling and inquire about the location. This form of testing does not typically lead to a diagnosis for back pain, as many conditions could be occurring. This is typically done to narrow down further diagnostic testing to move forward most efficiently.
  • MRI Imaging: Magnetic Resonance Imaging (MRI) is used to create a picture of the soft tissues. This includes muscles, ligaments, and tendons, so if the pain is caused by a tear in any of these or deterioration of them, and MRI can paint a more accurate picture of what is going on. CT scans are also used in some cases for a picture of soft tissue.
  • X-Ray: this form of imaging is used to determine the bone structure. If back pain is being caused by a bone spur or herniated disc, this will show up on an X-Ray.

These are the most common diagnostic methods, but there are many more on the market which could make a diagnosis even more accurate.

Treatment of Back Pain

Once diagnostic methods have established the source of pain, doctors will create a treatment plan specific to each patient. Some of the factors which may influence a treatment plan include family history, age, activity level, profession, and the severity of injury or degeneration.

Acute pain is more common than chronic pain. Acute pain refers to pain that occurs for a shorter period of time, under three to six months, but goes away over time. Chronic pain refers to pain which persists for a long time and does not improve or go away.

Each treatment method varies, but the general format for treating back pain is a sort of timeline which goes as follows:

  • Rest: to begin, doctors will suggest that a patient rest and avoid strenuous activity. In the case of muscle or ligament tears, the injury is often capable of healing itself. Rest is recommended to instigate healing if the cause of pain can be healed on its own.
  • Physical Therapy: the general goals of physical therapy are to strengthen muscles and improve range of motion. In the case of back pain, physical therapy also seeks to correct posture which may be negatively impacting an injury and its ability to heal, among many other uses.
  • Injections: there are many forms of injections that can be used on the spine in an attempt to treat pain. The type of injection a doctor may recommend is dependent on the type of injury and location of it. One of the most popular forms of injection for chronic pain is Corticosteroid Injections, which works by delivering a high dose of anti-inflammatory properties into the source. This helps patients in the short-term with pain management, but has been proven to actually damage tissue over time.

Many more non-surgical treatment options are available, these are the most common, but the list of treatment options is extensive.

When back pain persists even after minimally invasive treatment options have taken place, doctors will often turn to a surgical option.

Surgery for Back Pain

There are many forms of spinal and back surgeries that doctors may consider for treating back pain. Due to the complex nature of the spine, each surgery must be considered along with its risks to provide patients with as much information as possible. Being aware of what will happen during surgery is important for creating a recovery plan. Most surgeries are elective and it is therefore up to the patient to decide if they would like to pursue it.

Some of the most common types of surgery include:

  • Spinal Fusion: this form of surgery involves removing a vertebral disc which could be causing pain and fusing two vertebrae together
  • Discectomy: herniated or bulging discs can contribute to pain. Discectomy is the removal of parts of a vertebral disc that are abnormal and could be causing pain or discomfort.
  • Laminectomy: enlarging the spinal canal by removing vertebral bone (lamina) can relieve some pressure which the spinal column faces.
  • Artificial Discs: replacing discs with artificial substitutes could relieve pain and pressure on the spine. This is generally a less invasive form of surgery which seeks to relieve pain before needing spinal fusion surgery.

Each form of surgery comes with its own set of risks, so it is important that patients discuss these with their surgeon before deciding to undergo the surgery. All surgeries come with a general set of risks:

  • Infection
  • Blood Clots
  • Pneumonia
  • Stroke

The art of performing surgery is well-documented and surgeons will generally be as knowledgeable and efficient as possible. The risk of these side effects is generally low due to safe practices and knowledgeable surgeons and doctors.

What Happens After Surgery?

Some surgeries are minimally invasive and have a short recovery period. Others, like spinal fusion, are highly invasive and can take months to over a year to fully recover from. For this reason, a doctor’s recovery plan will be different for each patient.

Generally, it is recommended that patients rest often and take prescription painkillers to manage pain levels. Surgery can be a life-altering process during the recovery period, and in many cases, it is not certain that surgery will treat pain in the long-term.

The uncertainty that surgery may not improve pain leads to many patients seeking alternative therapies before and after undergoing surgery.

Regenerative Medicine’s Role in Managing Back Pain

The field of regenerative medicine involves taking a patient’s own healing cells, concentrating or amplifying them, and using them to treat injury or degeneration. The two types of regenerative therapy that CELLAXYS offers are:

  • Stem Cell Therapy: this form of therapy takes a patient’s own stem cells, typically harvested from fat cells (adipose tissue), blood cells, or bone marrow. The stem cells are then processed so that they are more concentrated, then reinjected into the area that is causing pain. Injecting stem cells can improve the recovery timeline by healing an injury or degeneration more quickly than it would without the injections.
  • Platelet-Rich Plasma (PRP) Therapy: this form of therapy takes a patient’s own blood via a simple blood draw. The blood is then put into a centrifuge which separates platelets from other properties in the blood. Platelets contain growth factors and proteins which are already used in the body’s natural healing process. Concentrated platelets are then injected into the source of pain. The goal of this form of therapy is to increase the amount of healing properties in an area, which in turn can help an injury to heal faster.

Both these forms of therapy are minimally invasive and have relatively low risk as they are using a patient’s own cells – they have a low risk of rejection.

The process of receiving either form of therapy is an outpatient process and doesn’t last more than two hours to complete. Some patients experience pain relief in a matter of hours, some in a couple of days.

Though regenerative medicine can be used to help back pain, it may be even more important as a treatment aid after back surgery. Most surgeries are changing or rearranging the structure of the spine or surrounding tissue. This disruption of structure means that the body works extra hard to heal. Using these forms of therapy may help this process move a little faster and more efficiently.

Conclusion

The back is made up of an extremely complex system of nerves, tendons, muscles, ligaments, and bones. The sensitivity of the spinal cord inside the spinal column can lead to particularly challenging navigation of treatment.

Treatment of back pain can vary from patient to patient, but if the quality of life is being impacted by back pain, individuals should seek treatment. If minimally invasive treatment options do not relieve back pain, surgery becomes an option. There are many different types of surgery, each with its unique set of risks and potential complications to consider.

When faced with back pain, reviewing all of the options available can be beneficial to patients seeking alternative therapies such as stem cell or PRP therapy.

The human body has an exceptional ability to heal itself, but it could be amplified even further with these forms of therapy. Faster recovery time means getting back to enjoying things you like sooner.

Dr. Pouya Mohajer

Dr. Pouya Mohajer

Director of Regenerative Interventional Spine Medicine
Board certification in Anesthesiology and Interventional Pain Medicine
Fellowship-trained from Harvard University
UCLA Alumni

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