Good Morning Spine

Archive for the ‘Sciatica’ Category

In its January 8th, 2015 issue, Becker’s Spine Review identified Dr. Eidelson as a “Spine Surgery Leader to Know“.

The article was part of Beckers ongoing feature series that identifies “surgeons to know” across America.

Beckers Spine Review is the leading publication covering the world of Spine Surgery in the United States.

To learn more about Dr. Eidelson

I try to always give options as no results of surgery are perfect. However, improving quality of life and allowing activity do occur after surgery when I involve the whole team at this Institute. Each physicians adds his or her perspective prior to my offering surgery. I am still amazed that patients accept surgery after one visit lbinder@bindermed.com with some doctors without carefully reviewing all options. There are exceptions that require immediate surgery but not common. Younger patients need to bbe careful and review the fine details. Yet, when properly diagnosed, neck or lumbar surgical decompression does offer a fairly low risk solution. Just review a complete plan of treatment with your doctor.

I wonder how difficult patients must have making clear decisions given all the misconceptions about spinal procedures. I try to let them know that non- surgical choices are good as long as there is real improvement. However, I see a lot of patients using drugs that are just masking symtoms that really do not address the compression of the spinsl nerves. If one has weakness lifting their arms or difficulty walking from leg eakness this is very serious. Most of the time, surgery is to remove compression of nerves by either a disc or bony overgrowth that cannnot be avoided. My best outcomes occur if a decision for surgery occur before there is permanent damage to the spinal nerves from chronic compression in either neck or back. Be very careful with overuse of pain medications or prolong therapy!

I believe patients can be very confused about spinal injections. There are several types that can be safe and very effective to treat back pain as well as leg pain from stenosis or arthritis of the facet joints in either neck or lower back. I usually attempt less invasive medial branch block and facet steroids for senior patient that have pain with standing extention associated with leg pain. If a patient only has leg pain , then a transforaminal nerve block is all that is required. Not all injections are the same and precision is very important. I feel succcess is high and surgery in less then 5 percent.

I believe in patients right to know as much as possible about their surgeon. In this day and age, one can easily look up credentials using the Internet. I demand that my patients look up my particular publications and training including continuing education. I also believe that using adjunct staff to perform procedures has gone too far. I perform all my own nerve blocks and. let patients know that their surgeon is performing the actual. surgery. In addition, their surgeo. needs to give the patient very precise plan how to handle post- procedure difficulties should they. arise. I give every patient my cell and home numbers for added assurance for immediate care should this happen. Unfortunately, spinal surgery is an area of medicine that has signicant degree of post- operative complications that can be easily corrected if caught early. Not to lessen the great advancements and success, a patients deserves a full committment as part of patient- doctor relationship. We practice this philosophy at SPOSI.

I am going to try new version of pain control device from Empi that applies direct pain control thru application of a Tens unit easily apply to the skin.The goal is to lessen the need for drugs that can have so many side effects.We have tried to find best combination of products that may lower the need for surgery.

Sciatica is a very common problem and one should not panic. Greater then 90 percent resolve without surgery. I usually give medication and complete therapy program that works for most patients. If symptoms are severe a nerve block is performed in the office. Acupuncture is also offered as well as decompression using special tables. Surgery only as a last resort after above fails.The first disc surgeries were in 1930’s so this treatment was not even offered years ago and patients did recover.

I have recently begun to ask patients to consider their diet and nutritional preparation prior to surgery. We ask all patients to take vitamins but review specifics if they are taking any herbal products. I also try to get them exercising within their pain limits two weeks prior to surgery as well. We all feel, as a team ,this has clearly improved patients outcomes and ability to handle pain in post- operative phase of their care.

Many patient come to my office with leg and back pain. We called this symptom sciatica or irritation of the large cable-like nerve that goes down the back of your leg. The reason for the pain is usually related to compression above in the lower back. In patients younger then 50,the cause may be from the jelly-like material leaking out from disc space or closure of the window where the nerve exits. The latter condition is called stenosis meaning closure of a space.In most cases, surgery is not necessary rather pain management and physical therapy can lessen the acute pain.