Back pain treatment: surgery or not? Dr. Anton Titov, MD. Back pain is the most common complaint in medicine. How to determine when conservative treatment can help a patient with back pain? Dr. Anton Titov, MD. How to decide when back pain requires spinal surgery to treat the cause of pain? Dr. Anton Titov, MD. How to treat back pain without surgery? Dr. Anton Titov, MD. What are three main indications for back pain surgical treatment? Dr. Anton Titov, MD. Leading spine surgeon shares his experience in choosing the best treatment method for different causes of back pain. Back pain treatment surgery or not? Dr. Anton Titov, MD. How to Decide if Surgery Can Solve Your back pain problem. Video interview with leading expert in spine surgery. Deciding on surgery for degenerative disc disease is a complicated matter. The truth about back surgery is that often it requires more surgery because scar forms and spine degenerated further. Should you have back pain treatment surgery or not? Dr. Anton Titov, MD. decision to pursue surgery is based on three main factors. First, progressive neurological deficit is developing because of slipped disk or spinal stenosis or spinal tumor. Second, bowel and bladder dysfunction occurs. This is emergency situation for spinal surgery. The most common indication for spine surgery is severe chronic ongoing pain. Medical second opinion confirms that degenerative disc disease diagnosis is correct and complete. Patients choose back pain treatment surgery or not, depending on duration of pain. Medical second opinion also helps to choose the best treatment for slipped disk problem and spinal stenosis. Seek medical second opinion on back pain and be confident that your treatment is the best. When is it a good idea to have back surgery? Dr. Anton Titov, MD. Get medical second opinion for step-by-step instruction on making a good decision about back surgery. There are several back pain surgery alternatives. Conservative therapy should be tried first. Bed rest should happen for only few days. Ibuprofen and other NSAID medications should be tried before deciding on back surgery options. Because back pain surgery success rate is not 100%. Back pain treatment should start from non-surgical options. It is wise to attack back pain first with medical treatment. Getting medical second opinion from independent senior spine surgeon helps to decide if surgery might help to treat spinal stenosis and back pain. Should you have back pain treatment surgery or not? Dr. Anton Titov, MD. It depends on causes and severity of back pain. Back pain treatment medical second opinion. Dr. Anton Titov, MD. Dr. Eric Woodard, MD. I have a back pain. My back hurts. Dr. Eric Woodard, MD. I have pain in my neck. Should Dr. Eric Woodard, MD. I have surgery for my spinal problem? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. I have a slipped disk [slipped disc]. These are the most common complaints in medicine. What should a person who has back pain do? Dr. Anton Titov, MD. What kind of a diagnostic path he or she should follow? Dr. Anton Titov, MD. How to make sure that the treatment for back and neck pain is appropriate and timely? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Sure. Back pain, as you know, is one of the most common ailments that afflict patients today in modern medicine. In the United States back pain is the most common reason why patients come to their primary doctors. The intensity of treatment, however, depends on many things. Generally, the severity and the duration of the back pain. Treatment methods for back pain also depend on its association with other factors, such as fever or signs of infection, trauma, or history trauma. Other medical co-morbidities that may relate to the etiology of the back pain. Fortunately, the vast majority of patients with back pain have lifestyle-related, benign back pain. Тhat almost universally can be treated with exercise, flexibility and strengthening. Dr. Anton Titov, MD. What are the options for the person who is considering surgery or is advised to have surgery? Dr. Anton Titov, MD. How can a person with back or neck pain ensure that the surgical treatment is indeed appropriate? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Sure. The cause for the recommendation for surgery could be musculoskeletal-related, such as with a slipped disc [slipped disk] or spinal stenosis. Suggestion to have spine surgery could also be due to one of more urgent causes, such as following trauma, such as a fracture, or blood clot, or due to a tumor or due to an infection. Pretty much regardless of the cause for recommendation to have spine surgery, the following decision-making applies. Almost universally the decision to pursue surgery falls into one of three categories: 1. The patient is developing a progressive neurological deficit. As you know, the spine structures that cause back pain are in immediate proximity to the nerves, the spinal cord and spinal nerves. Not infrequently many of the ailments that cause back pain can also cause spinal nerve compression, or spinal nerve irritation. In some cases this can lead to numbness, tingling or even weakness. That is generally one of the primary causes for us recommending something as aggressive as surgery. Secondly, in the cervical area or the thoracic area of the spinal cord compression or irritation can cause progressive weakness that also involves the bowel and the bladder dysfunction. This urgent situation can be due to a variety of factors. That is a very urgent situation. Because if treatment is not initiated quickly enough permanent loss of bowel and bladder control can occur. This is true even with the best of treatment and the best of surgery. here is the last, the third reason for spine surgery. This is the most common category for recommending spine surgery. It is patients who have severe chronic ongoing pain. Back pain and neck pain are not responding to the non-surgical treatments, many non surgical treatments. Dr. Anton Titov, MD. The latter category. What kind of conservative treatments do you try in your practice before the patients are indeed suitable for the back spine surgery? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. As Dr. Eric Woodard, MD. I mentioned, the vast majority of musculoskeletal ailments are lifestyle related. Most back and neck pain is caused by the restrain of musculoskeletal spine structures and the pull of person's back. Or back and neck pain are due to over-stressing of a joint or a disc due to general weakness or a lack of physical fitness. One of the first things that we do is, #1: we make sure that back or neck pain is not something more urgent or something more dangerous, such as a tumor or trauma or infection. if it cause of back or neck pain confidently looks due to more benign, lifestyle or musculoskeletal-related problem then we do this thing. First, we ask our patients to have a short period of rest and take some anti-inflammatory medications, such as aspirin, or naproxen or ibuprofen. This suggestion applies to patients with an acute onset of back or neck pain. Thereafter, staying active has been shown to be much superior to prolonged periods of bed rest, such as two to four weeks. In the old days you go to bed for a month and almost invariably you developed another complication from going to bed. Now at most it is maybe one or two days of rest. This short rest period followed by active beginning of flexibility and fitness exercises. Very frequently that is done under the guidance of a physical therapist. This method in the vast majority of cases is beneficial. Dr. Anton Titov, MD. What can a person do to prevent injury to the spine? Dr. Anton Titov, MD. specifically how to prevent damage to vertebral disks? Dr. Anton Titov, MD. How to prevent chronic back pain and problems that might require spine surgery? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Sure. The most common causes of chronic back pain are due to musculoskeletal elements. Certainly general medical fitness and general nutrition are important. But also important is maintaining an ideal body weight, so as to not over stress these structures. It is important to maintain excellent posture and to maintain fitness. Especially core fitness for the lumbar spine, shoulder and upper shoulder girdle fitness for the cervical spine. pelvic and buttock fitness for the the lower lumbar spine is very important. Fitness and flexibility, even into older age, is extremely important to maintaining balance across these structures and prevent repetitive stress injury. Back pain treatment surgery or not? Dr. Anton Titov, MD. Video interview with leading spine surgeon. How to decide if you need surgery for back pain? How to treat back pain medically?