Preventing Back Surgery

Dear Dr. Caraotta,

My Dad just had low back disc surgery. I am built like him and was wondering if there are things that I could do to prevent having a serious back /disc injury and or surgery.

John

---

Dr. Caraotta's Response

As we mature in life, our body transitions through several different physical attributes. In our youth, we are can fall off bikes, roller skates, skate boards, swing sets and have little to no consequence because of the flexibility in the skeletal system.

As we transition to adolescence, we are more prone to sprains and strains. As we transition to the twenties and thirties we are more susceptible to having injuries that require more attention such as injuries from repetitive activities and lifting, such as disc injuries. Disc injuries or discs that bulge, swell or slip are very common in our society but could be minimized if a person takes certain precautionary measures.

From a preventative standpoint, lets quickly review the basics:

1. Resist the temptation of lifting more than you are conditioned for.

2. Only lift with good biomechanics, having good footing, using the three point lift, (your right and left foot and a knee) when lifting.

3. If you strain when lifting, do not stretch afterwards, adding stretch to a stretch injury can add to the injury.

4. Apply Ice after a sprain/strain instead of heat. Heat can cause more swelling.

5. Avoid prolonged sitting after a back strain. Sitting will put more pounds of pressure on the low back.

6. NEVER lift an object when twisting at the waist.

7. ALWAYS keep the objects that you are lifting close to your body.

8. MAKE SURE that you are never bending at the waist when performing a lift.

9. DO NOT sleep on your stomach.

If a person develops low back pain, from a conservative rehabilitation standpoint there are several things that could be done to avoid surgery. The first priority is to decrease the inflammation or swelling in the disc and around the nerve. This is usually done in our office with physical therapy modalities such as ultrasound, electrical muscle stimulation and pulsed diathermy. Another goal is to relieve the nerve pressure via various forms of

chiropractic techniques, traction and extension exercises to re-position the disc away from the spinal cord. As a non-surgical Orthopedist, my specialty and training is to rehabilitate, and avoid unnecessary surgical intervention, but when surgery is necessary, we advise patients accordingly. The ONLY indication for low back surgery is intractable pain, loss in bladder or bowel function, or progressive leg weakness.