What is Back Pain
Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what back pain is and how it is typically treated.
What Spinal Conditions May Be Helped By Surgery?
hen a patient’s symptoms correlate with the findings on the MRI scan, in that situation surgery actually can be very helpful.
And some of the typical symptoms that respond well to surgery are what is typically known as sciatica. So pain, numbness, tingling, sometimes weakness in the legs if it’s due to a herniated disc, then surgery in fact in those situations can be very helpful.
So this model demonstrates a lumbar disc, and discs are cushions. You can think of them as cushions between the vertebrae. Over time these discs degenerate, wear out, lose their water content, and this is actually a normal aging process, and the MRI reports will reflect that, so that’s not alarming.
And sometimes even with acute traumatic situations a disc can actually bulge out or herniate as we see here. When that happens, a portion of the disc can actually protrude and irritate or squeeze a nerve that’s traveling by the disc.
And these nerves travel down to the legs, and when that occurs, patients will experience pain, numbness, tingling radiating down their leg, and that’s called sciatica.
If that sciatica is not responding to conservative measures or nonsurgical measures, and if the pain is worsening over time, or if there’s significant weakness, that very well may be an indication for surgery.
And the good news is that surgery can be very helpful in those situations. Now there are many different types of surgery available for spinal conditions. Lumbar microdiscectomy is one of the most common surgical procedures done.
It’s associated with a very high success rate as long as it’s done for the right indications. Lumbar laminectomy is another surgical procedure that’s done for spinal stenosis, which is essentially a crowding of the space available for the nerves going down to the legs.
There are also other surgical procedures available, such as endoscopic disc surgery, laser spine surgery. The important thing to recognize is that the exact type of surgery is probably not as important as what the surgery is trying to achieve, which is to relieve the pressure on the nerves. And standard microdiscectomy done for the right reasons is associated with a very high success rate.
Local Practitioners: Neurosurgeon
What Causes Back Pain and How Is It Typically Treated?
Back pain is a very common problem, and in fact, approximately nine out of ten people will at some point in their life experience an episode of back pain, and it’s one of the most common reasons that patients visit their family physician.
The good news is that most causes of back pain are fairly self-limited and benign and do not represent a more serious underlying problem. Causes of back pain include muscle spasm, muscle tension; sometimes back pain can occur because of inflammation of the joints in the back – the facet joints.
So these are generally called soft tissue causes of back pain, and again they’re very common and they’re usually self-limited. There is a misconception that back pain is treated surgically when in fact that’s actually not the case.
Very simple treatments such as rest, anti-inflammatory medications, physiotherapy, hot and cold packs, acupuncture, sometimes traction, these can be very effective and are usually almost always effective in relieving the back pain. It may take weeks or a few months, but again these are the typical and most effective treatments for most cases of back pain.
Presenter: Dr. Ramesh Sahjpaul, Neurosurgeon, Vancouver, BC
Local Practitioners: Neurosurgeon
Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what an MRI can reveal about the back.
Dr. Ramesh Sahjpaul, MD, MSc, FRCSC, Neurosurgeon, discusses what spinal conditions may be helped by surgery.