Posts Tagged ‘andrew peretz’

Back Pain Relief from a Herniated Disc

Back pain is second only to the common cold as a cause of lost days at work and it is one of the most common reasons to visit a doctor’s office or a hospital’s emergency department.

The good news is that most back pain will go away in a few weeks with some basic self-care.

But if pain is severe or lasts more than a couple of weeks, medical evaluation is called for.

“Back pain is not a disease but a symptom with many possible underlying causes,” says Dr. Andrew M. Peretz, a leading specialist in spine surgery with Somers Orthopaedic Surgery and Sports Medicine Group based in Westchester County, NY.

After strains and sprains, one of the most common causes of back pain is a herniated disc.

A herniated, or ruptured, disc is generally precipitated by years of wear and tear.

This occurs when a tear in the tough outer layer of cartilage allows some of the soft inner material to protrude out of the disk.

This is more likely to happen as you age and the discs weaken and become more prone to tearing, says Dr. Peretz.

The lower back (lumbar region) of the spine is the most common location of a herniated disc.

If the disc presses on the main nerve that travels down the leg, it can cause sciatica – sharp, shooting pain through the buttock and back of the leg – as well as tingling or numbness in the legs or feet and muscle weakness.

Most herniated discs resolve on their own or with conservative treatment, which includes rest, anti-inflammatory medication, and physical therapy.

Some people find that ice packs or moist heat applied to the affected area provide some relief.

“A day or two of rest is recommended,” says Dr. Peretz, “but no more unless you have severe pain.

Staying in bed too long can weaken the muscles and make the problem worse.”

Moderate walking and light activity may help, as well as exercises recommended by a physician or physical therapist that help keep your back muscles strong.

Exercises to maintain and develop your back muscles may include toe touches (with and without rotation), hurdler stretch, pelvic tilt, back extension, and hip extension.

If you do not respond to conservative treatment, an injection of a cortisone-like medicine into the lower back might help reduce swelling and inflammation of the nerve roots, relieving symptoms and improving mobility.

These injections are referred to as epidurals or nerve blocks and their effects sometimes last months.

Surgery is generally advised only for those who do not respond to other treatments, whose symptoms get progressively worse, or who experience progressive neurological decline.

It isn’t always possible to prevent the degeneration that induces a herniated disc but there are steps you can take to reduce your risk.

These include general best practices for good health: weight control, regular exercise and not smoking.

There are also some specific things you can do to promote back health:

Use proper lifting techniques.

Do not bend at the waist.

Bend your knees while keeping your back straight and use your strong leg muscles to help you support the load.

Practice good posture when walking, sitting, standing, and sleeping.

For example, stand up straight with your shoulders back, abdomen in, and the small of your back flat.

Sit with your feet flat on the floor or elevated.

Sleep on a firm mattress and sleep on your side, not your stomach.

Stretch often when sitting for long periods of time.

Do not wear high-heeled shoes.

High heel shoes cause you to lean forward and the body’s response to that is to decrease the forward curve of your lower back to help keep you in line.

Poor alignment may lead to muscle overuse and back pain.

“Most back and leg pain will get better gradually – usually within six weeks — by taking simple measures,” Dr. Peretz says.

“People with herniated discs generally respond well to conservative treatment and are able to return to their normal activities.”