Help for your aching back
Lumbago. It’s the official name for lower back pain, but for the estimated 80% of Americans who will experience it at some point in their lives, it doesn’t matter what it’s called. What matters is how to relieve the agony.
“Usually, my first recommendation to my patients is to pay attention to their core muscles,” said Gordon Nakata, MD, FAANS, a neurosurgeon with Cape Cod Healthcare Neurosurgery in Hyannis. “Exercising for your core, which includes the back muscles that support our spine, is a staple for anyone, even patients without back pain, so it's a good basic measure to keep you out of trouble.”
Dr. Nakata agreed with a recent New York Times article that details the kinds of exercises that can alleviate chronic back pain, such as planks, squats, and push-ups. Still, he also helps his patients manage expectations about what they can comfortably do. “You need to analyze where you are in life and what you hope to accomplish,” he said. “What is most important is good body mechanics and functional capacity.”
Activities like yoga and Pilates will work better for some people, especially older patients, rather than extreme sports, said Dr. Nakata. “There are great gentle workouts, such as water walking or water aerobics that I would also recommend.” He suggested engaging in low-impact exercises, on an exercise bike or even an elliptical machine, which are the best for the spine.
“What is really key is doing some kind of physical activity that moves your body and supports your spine,” he said.
Dr. Nakata noted that regular group exercise or visiting with a physical therapist could also be psychologically beneficial since it helps get people out of the house and engaged in social fitness activities.
“I have a lot of faith in physical therapists, and I think most of my patients could avoid surgery by working with an excellent PT,” he said. He also counsels patients who want to try alternative treatments such as acupuncture and dry needling or non-surgical medical options, such as steroid injections.
“Some patients benefit from those treatments,” he said, “but I try to warn patients away from fringe therapies that are not supported by data, however. I don’t want patients getting milked for a lot of money for things that aren't proven to help the spine.”
When Surgery is Required
While Dr. Nakata encourages everyone to take steps to strengthen their back muscles, there are times when injury or disease - such as worsening spinal stenosis - requires surgery, if conservative measures haven't worked and pain remains disabling. One of the most common surgeries he performs is a lumbar laminectomy, which relieves pressure on the nerve roots in the spine.
“The most frequent reason we're operating is that someone has calcification and narrowing of the spinal canal that's so progressive that they cannot walk straight,” said Dr. Nakata. “At that point, surgical intervention is merited.”
To help share information on various surgical and non-surgical options for managing chronic back pain, Dr. Nakata’s practice, Cape Cod Healthcare Neurosurgery, is sponsoring a virtual seminar on June 15. One of the procedures that will be discussed is kyphoplasty, a minimally invasive procedure that repairs vertebral compression fractures and helps restore the spine's natural shape.
“We hope to shed some light on how people can take control of their back pain,” said Dr. Nakata.
He and his fellow neurosurgeons want their patients involved and empowered with their own care. "The more engaged they are - whether through beginning an exercise program or seeking more information about advanced treatments - the better the outcomes.”
