Frequently Asked Questions
We know that there are many places posting lots of the same information online, which is why we have created an FAQ system. Browse or search our FAQs and you should find the answer to your question.
Q. An orthopedic surgeon told me I need back surgery and he has suggested using the pedicle screw. What are your thoughts on this type of screw?
Q. An orthopedic surgeon told me I need back surgery and he has suggested using the pedicle screw. What are your thoughts on this type of screw? A. Pedicle screws are the standard screw used in spinal fusion surgery [...]
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Q. Are there any side effects after epidural injections?
Q. Are there any side effects after epidural injections? A. The side effects are usualy those of a cortisone injection. You can have headaches, water retention with weight gain, foot and hand swelling, upset stomach, [...]
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Q. Can a failed lumbar fusion be fixed?
Q. Can a failed lumbar fusion be fixed? A. Possibly. You need to have current plain x-rays (weight bearing with flexion and extension views), a CT scan (thin slice, high resolution with multiplanar reconstructions), [...]
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Q. Can an MRI change from worse to better for a degenerative disc protrusion by doing nothing?
Q. Can an MRI change from worse to better for a degenerative disc protrusion by doing nothing? A. 85% of herniated discs resolve, go away, or improve by themselves naturally over time. Disc degeneration does not go [...]
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Q. Can spinal stenosis make you disabled?
Q. Can spinal stenosis make you disabled? A. If left untreated, severe spinal stenosis can cause neurological problems which can in turn lead to disability.
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Q. Do I need imaging studies for a correct diagnosis?
Q. Do I need imaging studies for a correct diagnosis? A. Imaging studies are helpful to rule out other potential serious problems. Most often, a team approach needs to be employed to optimize the care and recovery of [...]
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Q. Do I need surgery for spinal stenosis?
Q. Do I need surgery for spinal stenosis? A. Most cases of spinal stenosis can be managed without surgery. Further, a comprehensive and multidisciplinary treatment plan that looks at the patient as a whole will produce [...]
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Q. Do I need surgery for spondylolisthesis?
Q. Do I need surgery for spondylolisthesis? A. Non-surgical treatment of spondylolisthesis is usually effective although surgery may occasionally be required if conservative care fails.
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Q. Do I need treatment for a curvature of the spine?
Q. Do I need treatment for a curvature of the spine? A. Scoliosis deformities are common and generally do not require treatment except in severe cases. There are at least four different types of scoliosis depending on [...]
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Q. Do I need treatment for Myelopathy?
Q. Do I need treatment for Myelopathy? A. Myelopathy is a serious condition that needs to be treated aggressively or significant and permanent neurological damage can occur.
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Q. Do most insurance companies cover disk replacement surgery?
Q. Do most insurance companies cover disk replacement surgery? A. No. Most do not at this point.
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Q. Do you have experience with Harrington implants and complications that may arrise after an extended period (more than 30 yrs)?
Q. Do you have experience with Harrington implants and complications that may arrise after an extended period (more than 30 yrs)? A. Yes. Problems that occur are usually referred to as “transition [...]
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Q. Does all degenerative disc disease require treatment?
Q. Does all degenerative disc disease require treatment? A. It really doesn’t matter who you are, over the span of your life, your spinal discs are going to start to break down due to wear and tear. You may never [...]
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Q. Does facet arthritis lead to disc problems?
Q. Does facet arthritis lead to disc problems? A. Typically when degenerative conditions that affect the facet joint are present, the intervertebral disc is usually affected as well. There is uncertainty as to whether [...]
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Q. Does rest mean that I should stay in bed?
Q. Does rest mean that I should stay in bed? A. The concept of rest does not necessarily mean to stay in bed. Sometimes this is necessary. However, rest in this context means to avoid strenuous activities that can [...]
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Q. How common is surgery for facet arthritis?
Q. How common is surgery for facet arthritis? A. Surgery for isolated facet disease is common. There simply is not a consistent and predictable result. Surgery in the form of facet and spinal segment fusion is [...]
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Q. How do I know if I have a herniated disc?
Q. How do I know if I have a herniated disc? A. The predominant complaint of herniated disc symptoms in cases usually involves “pinched nerve pain” in the upper or lower extremities that can be severe and [...]
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Q. How do I know if I have a pulled muscle?
Q. How do I know if I have a pulled muscle? A. A pulled muscle can be a slight tear of the muscle, an incomplete or partial tear, or a complete rupture. These injuries usually involve a large area of the muscle and can [...]
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Q. How do I know if I have a trigger point injury?
Q. How do I know if I have a trigger point injury? A. A localized and well defined bump is usually palpated and is very painful. It general is very mobile. When massaged, a grinding feel and sound is often associated.
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Q. How do I treat a bulging disc?
Q. How do I treat a bulging disc? A. Compressed discs are also known as degenerative discs. Bulging of the disc occurs as the disc collapses. This is normal as we age and generally does not cause pain. Special testing [...]
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Q. How does a physical therapist know what therapy will help you?
Q. How does a physical therapist know what therapy will help you? A. Physical therapists are given directions by the referring physician but are often asked to also evaluate and treat patients as they feel is best. The [...]
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Q. How does acupuncture work?
Q. How does acupuncture work? A. Therapy is provided by placing small needles in certain anatomical locations in the body. A great deal of skill and experience is required to provide effective therapy. Most [...]
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Q. How does an epidural work?
Q. How does an epidural work? A. An epidural attempts to treat the symptoms of an underlying problem but not the problem itself. Typically, a mixture of numbing medicine, cortisone, and sometimes pain medication such [...]
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Q. How does massage and massotherapy help?
Q. How does massage and massotherapy help? A. First it helps to identify sore or injured muscles or muscle groups. It further helps to break spasms in the muscle by passively stretching the muscle. It is also [...]
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Q. How does stretching help me feel less pain?
Q. How does stretching help me feel less pain? A. If an injury to a muscle occurs or if the muscle has not been used vigorously for some time, it has the tendency to shorten or cramp into its shortened form. If left in [...]
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Q. How does the X-Stop procedure alleviate pain from spinal stenosis?
Q. How does the X-Stop procedure alleviate pain from spinal stenosis? A. The technique works by spreading apart the two spinous process bones in the back side of the spine and placing a spacer between them to keep them [...]
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Q. How does traction work?
Q. How does traction work? A. Traction is believed to work by stretching the back muscles to relieve chronic spasm and by pulling degenerative intervertebral discs apart reversing the effects of gravity. Recently, [...]
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Q. How effective is a percutaneous spinal fusion?
Q. How effective is a percutaneous spinal fusion? A. A percutaneous fusion is effective but one criticism is that the screws and rods are what are referred to as “high profile” which means they are [...]
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Q. How is black disc disease diagnosed?
Q. How is black disc disease diagnosed? A. There is a special view on the MRI called a T2 weighted image where a degenerative disc shows up as a dark or black structure. A normal disc appears as white indicating high [...]
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Q. How is facet arthritis diagnosed?
Q. How is facet arthritis diagnosed? A. Since it can be difficult at times to isolate the exact cause of back or neck pain, the use of a procedure called a facet block can be helpful. This involves injecting a local [...]
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Q. How is spinal stenosis diagnosed?
Q. How is spinal stenosis diagnosed? A. The evaluation and diagnosis of spinal stenosis requires a team approach if necessary, to accurately determine the exact cause of the condition. This is critical in outlining the [...]
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Q. How long should I use conservative treatment methods before exploring more invasive options?
Q. How long should I use conservative treatment methods before exploring more invasive options? A. The general consensus is that if the pain worsens or does not improve within 3 months other imaging and/or more [...]
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Q. How many surgeries are performed annually and how many of those fail?
Q. How many surgeries are performed annually and how many of those fail? A. It is estimated that approximately 450,000 or more spine operations are performed annually. Innovative surgical procedures developed recently [...]
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Q. How often can I have a cortisone injection?
Q. How often can I have a cortisone injection? A. Most pain management physicians will not do more than three of these injections in one year due to potential problems and complications associated with too much [...]
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Q. How successful is facet arthritis surgery?
Q. How successful is facet arthritis surgery? A. Surgery for isolated facet disease is common. There simply is not a consistent and predictable result. Surgery in the form of facet and spinal segment fusion is [...]
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Q. I had had a fusion procedure in the past and am now having a lot of pain where my hardware is.
Q. I had had a fusion procedure in the past and am now having a lot of pain where my hardware is. A. Painful hardware can be a problem and there are several reasons for this. The most important is to know if the spinal [...]
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Q. I have a morphine pump to treat my degenerative disc disease, is there any surgery you could recommend?
Q. I have a morphine pump to treat my degenerative disc disease, is there any surgery you could recommend? A. In my opinion, a morphine pump is not a good way to treat degenerative disc disease. If the scans are OK, [...]
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Q. I have constant pain in my back. The doctors I have seen say there is nothing they can do for me.
Q. I have constant pain in my back. The doctors I have seen say there is nothing they can do for me. A. We need to determine the source of pain. The treatment then follows. Testing such as X-Rays, CT Scans, MR scans, [...]
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Q. If I don’t treat a herniated disc could it lead to more serious conditions?
Q. If I don’t treat a herniated disc could it lead to more serious conditions? A. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. This is called sciatica and is the [...]
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Q. If I have a degenerative spine condition should I undergo power plate treatment?
Q. If I have a degenerative spine condition should I undergo power plate treatment? A. Vibration is a known stimulus to help bone and soft tissue form and heal faster. However, it is also recognized that vibration can [...]
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Q. If I have spondylolisthesis do I need surgery?
Q. If I have spondylolisthesis do I need surgery? A. Non-surgical treatment is usually effective. Surgery may occasionally be required if conservative care fails. Surgical options include a minimally invasive primary [...]
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Q. If I need surgery is there minimally invasive surgery available?
Q. If I need surgery is there minimally invasive surgery available? A. An alternative minimally invasive micro decompression laminaplasty procedure for the surgical management of Type III degenerative spondylolisthesis [...]
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Q. If my first surgery failed can I have a second surgery to correct it?
Q. If my first surgery failed can I have a second surgery to correct it? A. Further treatment options are varied and complicate. Most spine surgeons will not take on these difficult cases because the normal anatomy has [...]
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Q. Is artificial disc replacement approved by the FDA?
Q. Is artificial disc replacement approved by the FDA? A. Artificial Disc Replacement implants began to appear around 10 years ago internationally and were finally approved by the FDA in the USA around five years ago.
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Q. Is it more difficult to treat a sprain/strain in the back?
Q. Is it more difficult to treat a sprain/strain in the back? A. When the muscles and associated structures in our back and neck are injured, the symptoms can vary from a mild discomfort to very severe and crippling [...]
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Q. Is it natural to have bone spurs?
Q. Is it natural to have bone spurs? A. Bone spurs are very common as we all age and can be seen in any joint of our body, including the spinal joints. If an excessive amount of bone spurs form, they can occupy and [...]
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Q. Is it normal for the titanium rods used in a lumbar fusion to break?
Q. Is it normal for the titanium rods used in a lumbar fusion to break? A. It is not normal. Broken rods or screws usually mean the a fusion failed, did not take, or is incomplete.
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Q. Is spinal instability the same as spondylolisthesis?
Q. Is spinal instability the same as spondylolisthesis? A. Spinal instability refers to a vertebrae and spinal motion segment that is moving too much: either front to back, side to side, or up and down. It can occur [...]
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Q. Is the xlif spinal fusion surgery as good as taditional fusion surgery?
Q. Is the xlif spinal fusion surgery as good as taditional fusion surgery? A. It should be provided there is no spinal stenosis or pinched nerves in the spinal canal. If so, you would need 2 surgeries.
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Q. Is there a difference between a slipped vertebrae and spondlylolisthesis?
Q. Is there a difference between a slipped vertebrae and spondlylolisthesis? A. A slipped vertebrae is a vertebrae that has shifted out of place relative to the one below or above it. It is another term for a [...]
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Q. My abdominal artery is calcified significantly. What can I have done to eliviate the problem?
Q. My abdominal artery is calcified significantly. What can I have done to eliviate the problem? A. You need to determine if it is symptomatic. A consultation with a vascular surgeon would be helpful.
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Q. My L4 shifts 1mm and 3mm, is this significant? In conjunction with disc degeneration and stenosis limited to L4/5, does it require fusion?
Q. My L4 shifts 1mm and 3mm, is this significant? In conjunction with disc degeneration and stenosis limited to L4/5, does it require fusion? A. You may have a condition called degenerative spondylolisthesis. Surgery [...]
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Q. Should I be seeing a chiropractor for my bulging discs?
Q. Should I be seeing a chiropractor for my bulging discs? A. Compressed discs are also known as degenerative discs. Bulging of the disc occurs as the disc collapses. This is normal as we age and generally does not [...]
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Q. What are considered “core” muscles?
Q. What are considered “core” muscles? A. The “core muscles” involve the pelvis, back, abdomen, and chest. This is also referred to as “core stabilization”. These are the muscles [...]
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Q. What are the benefits to aerobic conditioning & personal training?
Q. What are the benefits to aerobic conditioning & personal training? A. Aerobic conditioning takes the hard work performed in strengthening and improving muscle function and transforms it into enhanced function [...]
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Q. What are the most common symptoms of a pinched nerve?
Q. What are the most common symptoms of a pinched nerve? A. Common symptoms of a pinched nerve include extremity pain, numbness, and in severe cases muscle weakness and even partial paralysis. Pinched nerves outside of [...]
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Q. What are the symptoms of neurogenic claudication?
Q. What are the symptoms of neurogenic claudication? A. Symptoms can include pain, numbness, weakness, balance problems, difficulty walking any distance, and in severe cases bowel and bladder disturbances.
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Q. What can a percutaneous laser discectomy treat?
Q. What can a percutaneous laser discectomy treat? A. Percutaneous discectomy including percutaneous laser discectomy is performed in the lumbar spine for a particular type of herniated disc known as a contained herniation.
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Q. What can I do about cysts in my spine that are pressing on nerves?
Q. What can I do about cysts in my spine that are pressing on nerves? A. It Depends on the type of cyst. Sometimes cysts can be drained or removed. Special testing needs to be done to determine the type of cyst [...]
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Q. What can I do to help keep my back healthy after treating my degenerative disc disease?
Q. What can I do to help keep my back healthy after treating my degenerative disc disease? A. Exercise and diet are the two most basic things you can do to help keep you back healthy. After treatment your doctor should [...]
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Q. What causes a stiff back?
Q. What causes a stiff back? A. The “stiffness” felt with a stiff back is usually due to the bone spurs and arthritis but spinal stenosis may certainly be contributing to the problems as well.
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Q. What causes foraminal stenosis?
Q. What causes foraminal stenosis? A. If an excessive amount of bone spurs from around the facet joint, they can occupy and narrow the foraminal canal that is formed by the facet joint above and below each vertebra.
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Q. What causes spinal stenosis?
Q. What causes spinal stenosis? A. The causes of spinal stenosis are several including arthritis of the spine, degenerative disc disease, disc herniation, enlargement of soft tissue structures inside the spinal canal, [...]
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Q. What condition can a microdecompression laminaplasty treat?
Q. What condition can a microdecompression laminaplasty treat? A. The microdecompression laminaplasty is an operation performed for the treatment of symptomatic central spinal stenosis. It is typically performed in [...]
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Q. What condition is treated with a transforaminal micro decompression?
Q. What condition is treated with a transforaminal micro decompression? A. The transforaminal microscopic or endoscopic foraminotomy is used to treat a condition called foraminal stenosis. The goal of the surgery is to [...]
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Q. What does IDET (intradiscal electrothermic therapy) treat?
Q. What does IDET (intradiscal electrothermic therapy) treat? A. IDET, or Intradiscal Electrothermic Therapy, is a percutaneous procedure that attempts to treat symptomatic degenerative disc disease. It is not [...]
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Q. What does OTC stand for?
Q. What does OTC stand for? A. OTC stands for “Over The Counter”. In other words medicine you do not need a prescription for.
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Q. What factors will affect the possible success of my fusion surgery?
Q. What factors will affect the possible success of my fusion surgery? A. Several factors have been identified that can cause a failed fusion surgery. These include persistent motion at the fusion site, poor health and [...]
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Q. What is a flat back?
Q. What is a flat back? A. A “flat back” is a posture change that is associated with a spondylolisthesis that has shifted backwards (retrolisthesis). This causes the entire lower spine to completely [...]
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Q. What is a gyrotonic procedure?
Q. What is a gyrotonic procedure? A. Gyrotonic is a highly specialized form of restoring normal motion and alignment of our spine and joints. A specially designed apparatus is available that places the patient on a [...]
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Q. What is a joint out of place?
Q. What is a joint out of place? A. A joint out of place is a subluxation, or slight dislocation, of one of the ribs where they attach to the spine. This means that the rib head is slightly disjointed caused by a [...]
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Q. What is a laminotomy?
Q. What is a laminotomy? A. A laminotomy is an open surgical procedure whereby a small opening into the spinal lamina is made and access to the spinal canal is created on the backside of the spine. This allows the [...]
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Q. What is a LIF procedure?
Q. What is a LIF procedure? A. Hollow fusion cages made of various materials are available to act as a shim to mechanically support the disc space allowing the fusion to take place. Bone graft or other bone fusion [...]
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Q. What is a Prolo Injection?
Q. What is a Prolo Injection? A. A prolo facet injection is a procedure where a very irritating chemical is injected around a facet joint to induce the formation of a type of scar tissue.
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Q. What is a selective nerve block used to treat?
Q. What is a selective nerve block used to treat? A. A selective nerve root block is performed both as a treatment for a pinched nerve and/or as a diagnostic test to determine if a particular nerve is the source of pain.
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Q. What is a spinal column stimulator?
Q. What is a spinal column stimulator? A. It is an implantable device composed of two main components including a special catheter and a battery power electric pulse generator. It is commonly called an implantable TENS unit.
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Q. What is a Thrown Back?
Q. What is a Thrown Back? A. A thrown back itself is best described as mechanism of injury rather than a condition itself. It generally occurs while playing sports, a work injury, or a sudden movement.
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Q. What is a transforaminal micro discectomy?
Q. What is a transforaminal micro discectomy? A. A transforaminal micro discectomy is performed if there is a herniated disc located within or on the outside of the foraminal canal – the opening between two [...]
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Q. What is a trigger point injection?
Q. What is a trigger point injection? A. A trigger point injection is a local injection involving some numbing and cortisone type medication delivered into a localized painful area. Helpful for treating trigger point injury.
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Q. What is an implantable morphine pump?
Q. What is an implantable morphine pump? A. The implantable morphine pump is considered by most physicians and surgeons a last resort attempt to control severe chronic pain. It is an implantable device consisting of [...]
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Q. What is an inflamed disc?
Q. What is an inflamed disc? A. An inflamed disc is another term to describe changes seen on an MRI scan. Changes identified in the vertebral bone called the endplates on either side of the intervertebral disc are [...]
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Q. What is disc stabilization arthroplasty?
Q. What is disc stabilization arthroplasty? A. You can think of it as a partial artificial disc replacement. The advantage of this approach is that it can be performed minimally invasively through either a back, [...]
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Q. What is gabopentin therapy?
Q. What is gabopentin therapy? A. Gabopentin is the generic term for Neurotin. It is used with varying degrees of success for threating inflammartory nerve conditions.
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Q. What is Lateral Recess Stenosis?
Q. What is Lateral Recess Stenosis? A. The lateral recess is a space located immediately under the spinal facet joints. As bone spurs accumulate, they can push down and pinch one of the spinal nerves getting ready to [...]
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Q. What is prescription medication used for when treating back pain?
Q. What is prescription medication used for when treating back pain? A. Prescription medications may be required to help in the management of pain, inflammation, muscle spasms, and nerve damage. Perhaps the most common [...]
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Q. What is radio frequency nerve ablation?
Q. What is radio frequency nerve ablation? A. When other attempts at pain control fail, the radio frequency nerve ablation can be performed to destroy, or ablate, the nerve endings around a certain structure [...]
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Q. what is severe spinal stenosis?
Q. what is severe spinal stenosis? A. Compression or squeezing of the spinal cord and/or spinal nerves inside of the spinal canal of the vertebral column. Symptoms arise from restriction of blood flow. We refer to [...]
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Q. What is spinal manipulation?
Q. What is spinal manipulation? A. Spinal manipulation is typically performed by chiropractic physicians and osteopathic physicians specifically trained in these technique. It is a passive form of treatment where [...]
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Q. What is spondylosis?
Q. What is spondylosis? A. Spondylosis is a term that describes the collective changes that occur with facet arthritis. It not only describes changes in the facet joints but the intervertebral disc as well.