Why does my back hurt? A spine surgeon’s analysis

Why does my back hurt? A spine surgeon’s analysis

Dr. James Califf is an orthopaedic surgeon at AppOrtho, a member of Appalachian Regional Healthcare System. Over his more than 25 years in practice, he has further refined his treatment of spinal disorders, offering non-surgical as well as minimally invasive surgical techniques. His clinical focus includes spine, shoulder, hip, hand, joint replacement and arthroscopic surgery. Learn more about Dr. Califf >

Back pain will affect 80 percent of humans at some point in their lives. It is the most common cause of job-related disability and a leading contributor to missed work days.¹ Sometimes leg pain and weakness can originate in the back. Fortunately, the majority of back pain will resolve itself in 6 to 8 weeks, but it’s important to determine if the pain is coming from a severe underlying condition. An orthopedist can evaluate the cause and recommend the best treatment for your particular condition. Your treatment plan should also include preventing a recurrence of your injury. Surgery is recommended only if other measures fail or the issue is severe enough. If you are suffering from back pain, please contact AppOrtho online or call (828) 386-2663.

Muscle/soft tissue injury or strain

One of the most common causes of pain, this injury is commonly associated with poor physical conditioning. Muscle strain can affect people of any age or activity level.

Symptoms: The pain is usually a grabbing, localized pain that can radiate to the knees and down the back of the legs

Treatment options: Exercises, minimal medication, or physical therapy.

Degenerative arthritis

Also called Osteoarthritis (OA), or “wear and tear” arthritis, this condition can be part of the aging process which begins around age 30. With OA, the cartilage within a joint begins to break down and the underlying bone begins to change.²

Symptoms: Degenerative arthritis usually causes back pain that does not radiate down the legs past the knees unless the spurs from arthritis compress the spinal cord or a nerve. The pain is usually worse with activity and when getting up from a sitting position.

Treatment: Exercises, physical therapy, medication, activity modification and injections, or fusion surgery (rare).

2. Osteoarthritis (OA). (2017, September 6). Centers for Disease Control. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

 

Spine Fracture

Injury or osteoporosis can cause spine fracture.

Symptoms: Pain can be moderate or severe. If the fracture is displaced it can compress the spinal cord or nerves and cause radiating pain or nerve damage.

Treatment: Bracing, physical therapy, medication, possible kyphoplasty for osteoporotic fracture

Bulging or herniated disc

The lower back, where most back pain occurs, includes the five vertebrae (bones) in the lumbar region and supports much of the upper body’s weight. The spaces between the vertebrae are maintained by round, rubbery pads called discs that act like shock absorbers in the spine to cushion the bones as the body moves. Most people have a bulging disc, and usually they do not cause a problem.

Symptoms: When the disc compresses the spinal cord or nerve, radiating leg pain and or weakness can occur. Most disk herniation symptoms resolve without surgery. To diagnose herniated discs, an orthopedist uses an MRI or CT scan. Progressive weakness and bowel or bladder problems can be signs of a dangerous condition.

Treatment options: Exercises, medication (steroids, NSAIDs), epidural injections, physical therapy, or surgery.

Spinal stenosis

Arthritis and disc problems sometimes cause narrowing of the spinal cord. This can occur if the bone spurs are large enough to compress the nerves or spinal cord.

Symptoms: Numbness and weakness in the legs, usually with activity, that improves with sitting or bending forward.

Treatment: Exercises, physical therapy, medication, activity modification, injections, or surgical decompression

Sacroiliac Joint Damage

Pain in these joints on each side of your pelvis can be caused by arthritis, wear and tear or injury.

Symptoms: Produces pinpoint pain in the low back that occurs with sitting and activity. It can be severe.

Treatment: medication, physical therapy, injections, or possible minimally invasive fusion surgery

Treatment options

 

Anti-Inflammatory Medication– Taking a medication such as Naproxen that reduces inflammation just like you would take a vitamin – twice a day with food and water – is a great way to help the body calm down and allow itself to heal, though this may cause stomach issues as a side effect.

Physical Therapy – Physical therapy is a crucial part in recovery of a tendon tear or rupture. In order to regain motion and strength in the shoulder, one must perform exercises specifically tailored for their injury. Regaining strength takes time, and positive results should start after 4-6 weeks of physical therapy.

Injections – A steroid injection done in-office can help reduce inflammation and calm down the injured joint. Usually, these injections can only be performed every 3-4 months in order to avoid any further damage to the joint. Relief can last anywhere from weeks to months.

Arthroscopy – If you have a large or a small injury and it is not getting better with treatment, minimally invasive arthroscopic surgery might be an option for treatment and repair.

Surgery – Chronic issues such as arthritis might result in the need for surgery. X-Rays, CT scans or MRI should always be performed before moving to surgery.

Do you have joint and muscle pain?

AppOrtho can help. Schedule an appointment with one of our highly skilled providers today.

Navio Robotic-Assisted Knee Surgery

Navio Robotic-Assisted Knee Surgery

Are you ready to address your knee pain?

Call us at (828) 386-2663 or request an appointment here 

Are you ready to address your knee pain?

Call us at (828) 386-2663

AppOrtho is the first and only orthopedics practice in western NC to offer robotics-assisted partial and total knee replacement using the NAVIO® surgical system, only at Watauga Medical Center.

How do I know if I am a candidate for robotics-assisted partial or total knee replacement using the NAVIO® system?

Although each patient must consult with a physician individually, typical partial knee replacement candidates share the following characteristics:

  • Knee pain that limits your activities regularly
  • Knee pain due to osteoarthritis
  • Non-surgical treatments are no longer effective

Meet with a NAVIO® trained orthopedic surgeon at AppOrtho today to see if robotics-assisted surgery is right for you. 

Partial Knee Replacement

Total Knee Replacement

NAVIO®-Trained Surgeons

Patient Testimonials

Individual results may vary. There are risks associated with any surgical procedure including NAVIO-enabled Knee Replacement. NAVIO is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, morbidly obese patients, or any other patients contraindicated for UKR, PFA, or TKA should not undergo a NAVIO procedure. Consult your physician for details to determine if NAVIO is right for you.

Why does my shoulder hurt? An orthopedic surgeon weighs in

Why does my shoulder hurt? An orthopedic surgeon weighs in

Dr. Benjamin Parker is an orthopedic surgeon at AppOrtho and orthopedic medical director for App State Athletics. AppOrtho is the official sports medicine provider for App State Athletics, Watauga High School, and the High Country Soccer Association. Learn more about Dr. Parker >

Many people experience shoulder discomfort or pain at some point in their lives. Why does your shoulder hurt? The shoulder is a complex joint, made up of multiple muscles, tendons, and bones that work together to allow us to perform everyday activities – from playing basketball, to working in the garden.  When just one of these components is disrupted by overuse or injury, the shoulder can become painful. Pain in the shoulder can present itself in many different ways, which can be overwhelming and confusing. Do you need shoulder surgery? Maybe, but there are some non-surgical options to consider first. This article’s purpose is to provide information and possible treatment options for common causes of shoulder pain. If you are suffering from shoulder pain, please contact AppOrtho online or call (828) 386-2663.

Arthritis

As we age, our bodies go through some wear and tear, which can result in an arthritic shoulder. This is a normal process that middle-aged to elderly individuals begin to experience.

Symptoms: Shooting and catching pain that originates in the shoulder and stops at the elbow is a common sign of an arthritic shoulder. Overuse of an arthritic shoulder can cause inflammation to enter the shoulder resulting in stiffness and worsening pain.

Treatment Options: anti-inflammatory medication, injection, possible arthroscopy or replacement

Subacromial Bursitis

Bursa are fluid filled sacs that reside inside joints all over the body, including the shoulder below a bone called the acromion. These sacs help reduce friction between muscles sliding over bones and can sometimes become inflamed and irritated due to day-to-day use.

Symptoms: The arm may feel weak or painful, especially when it is lifted to the side.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible arthroscopy or cleanup

Rotator Cuff Tendons/Muscles

The rotator cuff is made of four main muscles and associated tendons. These muscles and tendons can tear or avulse (pop off the bone) during physical activity or a traumatic event such as a fall. Chronic wear and overuse can also cause a tear.

Symptoms: Stiffness, pain and weakness of the shoulder are common symptoms as well as feeling a ripping or popping sound during the time of the injury.

Treatment Options: anti-inflammatory medication, physical therapy injection, possible arthroscopy and repair

Biceps Tenosynovitis

The biceps tendon lies within a groove in the front of your shoulder and sweeps in a “windshield wiper” motion across this groove during day-to-day activities. This repetitive motion can irritate the tendon and cause inflammation in the shoulder.

Symptoms: A biceps tendon problem can be associated with pain in the front part of the shoulder. If rubbing or massaging the front shoulder is sensitive or painful, this might be an indication of biceps tenosynovitis.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible tendon reattachment arthroscopically

Treatment options

 

Anti-Inflammatory Medication– Taking a medication such as Naproxen that reduces inflammation just like you would take a vitamin – twice a day with food and water – is a great way to help the body calm down and allow itself to heal, though this may cause stomach issues as a side effect.

Physical Therapy – Physical therapy is a crucial part in recovery of a tendon tear or rupture. In order to regain motion and strength in the shoulder, one must perform exercises specifically tailored for their injury. Regaining strength takes time, and positive results should start after 4-6 weeks of physical therapy.

Injections – A steroid injection done in-office can help reduce inflammation and calm down the injured joint. Usually, these injections can only be performed every 3-4 months in order to avoid any further damage to the joint. Relief can last anywhere from weeks to months.

Arthroscopy – If you have a large or a small injury and it is not getting better with treatment, minimally invasive arthroscopic surgery might be an option for treatment and repair.

Replacement – Chronic issues such as arthritis might result in the need for replacement. X-Rays, CT scans or MRI should always be performed before moving to surgery.

Do you have joint and muscle pain?

AppOrtho can help. Schedule an appointment with one of our highly skilled providers today.

Our joint replacement program

Our joint replacement program

The Joint Replacement Program educates patients on what to expect before, during and after a joint replacement surgery at Watauga Medical Center. Patients meet with their recovery period primary caregiver for approximately one hour. Classes focus on those patients who are having hip and knee replacement surgery and provide an opportunity for patients and their coaches to ask questions.

It is important that the coach, as well as the patient, know what to expect before, during and after surgery. Knowing what the patient will be experiencing after surgery and during physical and occupational therapy will allow the coach to provide support and encouragement to the patient.

Patients are scheduled for a class a few days (up to 10 days) prior to their scheduled surgery date. Staff representing nursing, anesthesia, physical and occupational therapy and discharge planning teach the class. Preparing for surgery is key to a smooth recovery process.

If you are scheduled for joint replacement surgery at Watauga Medical Center, please download the Joint Replacement Guide.

Is a non-surgical treatment approach right for you?

Is a non-surgical treatment approach right for you?

Depending on your needs, your non-operative treatment approach might include injections, rehabilitation (Physical, Occupational, Speech Therapy) or a combination of both. The Rehabilitation Center at ARHS offers a comprehensive array of services from highly trained orthopaedic physical therapists whose patients’ functional outcomes rank in the top 5% in the nation. For more information on joint specific outcomes at The Rehabilitation Center click here.

Our orthopedic surgery services

Our orthopedic surgery services

At Appalachian Regional Healthcare System (ARHS), we offer an extensive variety of treatment approaches including surgical and non-surgical treatments to your orthopedic injuries and conditions. Our providers are committed to a conservative and non-operative treatment approach first, as they recognize that many injuries and conditions do not require surgery. Nonetheless, non-operative approaches are not always successful or sometimes even indicated. If you must have surgery, you can trust the surgical team at AppOrtho! 

 

General Orthopedics & Fracture Care (all lower and upper extremity) >

Cartilage Restoration and Preservation (Adults and Pediatrics)

Exertional Compartment Syndrome

Orthopedic Trauma Surgery

Pediatric Sports Medicine Surgery

Sports Medicine Surgery

Tendon Repair & Surgery

Ankle Surgeries >

Arthroscopy

ORIF

Tendon repair (Achilles’ tendon)

Wrist Surgeries >

Arthroscopy

Arthrotomy

Carpal Tunnel Release (Arthroscopy & Endoscopy)

Fracture ORIF

Ligament repair and reconstruction

Hip Surgeries >

Arthroplasty (Joint replacements)

Arthroscopic Abductor/Gluteal Tear Repairs

Arthroscopy

Fracture pinning and rodding

Labrum repair

ORIF

Revision Surgery for Hips & Knees

Total Hip Replacement Surgery

Spine Surgeries >

Anterior Cervical Discectomy and Fusion (ACDF)

Lumbar decompression

Lumbar fusion with cage

Lumbar laminectomies

Lumbar microdiscectomy

Minimally invasive options

Sacro-iliac fusion (minimally invasive)

Elbow Surgeries >

Arthroscopy

Arthroplasty

Arthrotomy

Bicep tendon repair

Cubital tunnel release

Elbow Ligament Reconstruction

Excisions

Ligament and tendon repairs

ORIF

Nerve decompression

Nerve transposition

Pinning

Tennis elbow and Golfers elbow

Knee Surgeries >

ACL, PCL, MCL repair and reconstruction

Arthroplasty (Joint replacement: full, uni-compartmental, and customized

Arthroscopic Meniscus Surgery

Arthroscopy

Arthrotomy

Chondroplasty

Complex Knee Ligament and Tendon Reconstructions

Fracture repair

Medial patellofemoral ligament repair

Meniscetomy

ORIF

Partial Knee Replacements (Robotic Assisted)

Patellar Instability Surgery

Removal of loose body

Revision Surgery for Hips & Knees

Synovectomy

Tendon rupture repairs

Total & Partial Knee Replacement Surgery

Shoulder Surgeries >

Acromioplasty

Arthroplasty (Joint replacement)

Arthroscopic Shoulder Rotator Cuff Surgery

Arthroscopy

Bursectomy

Bankart, SLAP repairs

Claviculectomy

Decompressions

Labrum repair

ORIF

Removal of loose body

Revision Surgery for Shoulder

Shoulder Instability Surgery

Shoulder manipulation

Shoulder Replacement/Reconstruction

Foot and Toe Surgeries >

Ankle/Foot Fracture Surgery

Bone spur removal

Fusion

Hammer toe

Ligament repair and reconstruction

ORIF

Osteotomy

Pinning

Tendon releases (trigger finger) transfers and repairs, tendon sheath reconstruction

Hand and Finger Surgeries >

Arthroplasty

Complex laceration repair

Contracture release (Dupuytren’s)

Digital nerve repair

Excision

External fixators

Fasciectomy

Fasciotomy

Fracture closed reductions

Fracture open reductions

Hand Arthritis Surgery

Hand/Wrist Fracture Surgery

Ligament, nerve tendon repair

Scar contracture release (Burns and post traumatic conditions)

Tenosynovectomy

Tendon releases (trigger finger) transfers and repairs, tendon sheath reconstruction

Wrist Surgery (Scaphoid/Radius)