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Back Pain Treatment and Prevention
Back pain sufferers may learn to live with the pain, but there are some lifestyle changes that may reduce that pain. Dr. Sam Overley, orthopaedic spine surgeon, discusses prevention and treatment of back pain.
Featured Speaker:
Dr. Overley provides surgical and nonsurgical treatment for a wide variety of spinal conditions, including cervical, thoracic and lumbar problems as well as spine tumors and trauma. His mentorship from both neurosurgeons and orthopaedic surgeons has given him unique experience in treating adult scoliosis, spinal deformities, and other complex spinal conditions as well as performing minimally invasive spine surgery.
Learn more about Sam Overly, MD
Sam Overley, MD
Dr. Samuel C. Overley is an orthopaedic spine surgeon providing care at University of Arkansas for Medical Sciences (UAMS). He graduated Summa Cum Laude in Honor’s Studies with a Bachelor of Science degree in Animal Science. Dr. Overley graduated with highest honors from the University Of Texas School Of Medicine in San Antonio and then completed his orthopaedic surgery residency at The Mount Sinai Hospital in New York, NY as elected chief resident. His formal training culminated with a spine surgery fellowship at the Cleveland Clinic where he had the fortune of training with mentors from both orthopaedic and neurosurgery backgrounds.Dr. Overley provides surgical and nonsurgical treatment for a wide variety of spinal conditions, including cervical, thoracic and lumbar problems as well as spine tumors and trauma. His mentorship from both neurosurgeons and orthopaedic surgeons has given him unique experience in treating adult scoliosis, spinal deformities, and other complex spinal conditions as well as performing minimally invasive spine surgery.
Learn more about Sam Overly, MD
Transcription:
Back Pain Treatment and Prevention
Prakash Chandran (Host): For a lot of people back pain is just a fact of life, but there are many things that you can do on your own to minimize back pain and most of it boils down to developing healthy lifestyle habits. Let’s talk with Dr. Sam Overley, an orthopedic spine surgeon and Assistant Professor of Orthopedic Surgery and Neurosurgery at the University of Arkansas for Medical Sciences. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Prakash Chandran. So first of all, Dr. Overley, can you talk a little bit about some of the more common causes of back pain?
Dr. Sam Overley (Guest): Hi Prakash, yeah you really hit the nail on the head saying that there are a lot of things that we can do on our own and a lot of it boils down to your question of what are the more common causes of back pain and you can really think of it in three different ways. There’s back pain that can be becoming from compression of nerve roots. There’s back pain that can be coming from general arthritic issues primarily of the joints of the low back, and thirdly there’s back pain that could be coming from disc issues and issues within the intervertebral disc.
Host: You mentioned the different types of back pain but I’m curious to learn about the causes. Is it posture, is it sports injury, is it just wear and tear over time? Talk a little bit about that.
Dr. Overley: Sure so the majority of people that I see I would say is degenerative changes, and what that boils down to, it’s kind of a blanket term for just wear and tear over time and so everyone undergoes degenerative changes just as a fact of life. If you think about the type of arthritic changes let’s say that people have in their knees and their hips and they get older and they start to lose some of the cartilage and that’s all degenerative processes and the same goes on in the low back and it’s pretty common. There’s about 80% of the population at some point or another will have an episode of pretty severe low back pain so that’s something to look forward to. Most of the time the good news is most of the time that resolves without any need for intervention and we’ll talk about some of the ways that you can do that, but basically what the majority of people, whether it’s from a history of a lot of sporting from manual labor, from really a number of different things that you have done in your life, they all kind of compound and a lot of it actually is inherited too. So it’s a little genetically predetermined if you will and what it boils down to though are these changes that the anatomy undergoes that ultimately result in pain.
Host: Yeah it’s really interesting to hear about the genetic components of this, but I was thinking just because back pain is a fact of life, doesn’t mean that we can’t take measures to try to minimize some of the pain that we’re going to experience. So maybe talk a little bit about the exercises that we can do or anything that we can do to help minimize or prevent back pain.
Dr. Overley: Sure, so before I get to things like exercises, I think it’s important to note a couple of things and this is what I tell all my patients, weight loss and smoking cessation. So those are two things – those are probably the two biggest modifiable traits that have been shown in the literature to actually significantly decrease low back pain. So the more you know – people who are overweight, just think about it as more stress, it’s more weight, it’s more that your spine has to support, and it’s more force that the joints and the disc and everything else that has the capability to degenerate see and the smoking cessation was something that was discovered many years ago, and what we had found with that is there is a really high correlation with people with chronic low back pain and smoking, and there’s also a correlation between improvement in back pain with smoking cessation. So that being said, you mentioned exercises and I think the biggest thing for low back health is core strengthening. So oddly enough it’s the abdominal muscles, the obliques, all of these things that are kind of – that serve to support and span the spine and it’s those muscles primarily that help a lot with offloading some of the spine and potentially helping keep your back in good shape and keep you from overloading the disc and potentially having herniations and bulges and that sort of thing.
Host: Most of us unfortunately probably don’t do the amount of core strengthening that we need to prevent the back pain that we get. So when we do experience back pain, whether it be sharp or something that is just ongoing, what are some of the things that you do to help treat your patients?
Dr. Overley: Sure so when you really think about core strengthening, it’s not just doing a bunch of crunches. There are all different types of core strengthening, I mentioned the abdominal muscles and the obliques, and that is certainly part of it and that’s probably the biggest part and there are other aspects in terms of the muscles in the back, the muscles right by the spine, what we call the paraspinal muscles. They are two big muscles basically on each side of the spine and a really good exercise, one thing that I think is underrated a lot of times is the plank, so doing plank exercises. There is a certain amount of core abdominal exercises that you can do in the form of crunches and that sort of thing. Some of the other exercises that you can do actually are more kind of stretches and things like the scorpion pose in yoga for instance, kind of laying flat on your belly and slowly picking yourself up and kind of arching the low back as well as hamstring stretches as well and those tend to help quite a bit with back pain. I will tell for those who want kind of a more in depth look at what’s a good regimen, you can grab this online, just off of – there’s a bunch of different websites that will cite it, but something called the McKenzie method and that’s m-c-k-e-n-z-i-e and it’s named after a physical therapist, Robert McKenzie who kind of wrote about these core strengthening exercises and so there’s a whole regimen, it takes about 10 minutes a day. I usually tell people start with that. Do it in the morning. Just clear your schedule for 10 minutes and do it and you’d be shocked at how many people doing that continuously and doing it daily get a lot of improvement in their pain.
Host: Well I’m going to look that up as soon as we get off the line here, but what I’m really hearing is this focus on mobility and looking at the body as a system. From the core strength that you were mentioning to the hamstring flexibility, everything supports each other, and it certainly helps minimize the onset of that back pain that you’re talking about wouldn’t you say?
Dr. Overley: Absolutely, yeah I mean it’s all a unit and you’ll see that people who have back issues, there’s trickle down effects no doubt. I mean they then begin to have some hip issues and then it goes to the knees and it can go the other way as well. So the body is just such a complex unit of so many things going on and there’s a lot of things that we can do from a muscle strengthening, muscle stretching and overall your limberness that can really impact your low back health.
Host: I’d like to move on to the treatment options for back pain. You know I know not everything requires surgery, so maybe talk a little bit about the more accessible lighter weight treatment options for back pain and then when you feel like it requires surgery.
Dr. Overley: Yeah so people who – like I said 80% of the population is going to have some episode of pretty back pain and it can be very crippling when it happens and people always talk about, oh it locks up and that took me to my knees, and that happens. So the thing that I – first of all I encourage people, what I encourage them is that the vast majority of people who experience these issues get significant relief without anything even close to surgery. So that’s one – peace of mind is a very underutilized treatment and I think it helps a lot of people. Secondly I usually, depending on what the pain sounds like, I usually just recommend that they try some physical therapy. I talk to them about these exercises, the McKenzie method and I talk to them about doing this stuff daily and making it part of their routine. If they’re smokers or if they’re obese, obviously I talk about weight loss and smoking cessation. Times when I begin to think, oh maybe this is something related to the nerves or when people start getting pain that goes down the legs, and so that’s something – if someone’s had ongoing, greater than 3 or 4 weeks of pain going down the legs, I’ll usually get an MRI for that to rule out that they don’t have a herniated disc that’s pushing on a nerve. If it’s just primarily centralized low back pain, we’ll start with some physical therapy and a lot of what they will do in physical therapy is variations and different iterations of this McKenzie method. They can also do some things like light traction, some inversion where you basically hang upside down and get a little bit of relief from gravity on those discs and they can do various different forms of physiotherapy and electronic physiotherapy or electric physiotherapy where they stimulate some of the muscles around the low back and try to work out some of that spasm that’s developed.
Host: Alright Dr. Overley, I really appreciate your time today. I think the one thing that I’ve learned here is that an ounce of prevention is worth that pound of cure. Just as we wrap up, you know is there anything that you wish more people knew, besides the McKenzie method, before they came to see you?
Dr. Overley: So I think it’s valuable for people to know that a lot of times this is going to get better on its own with some minor intervention in terms of exercise, stretching, that sort of thing. Things when – times when I think it may be necessary to go see your surgeon, if you’re having a lot of lower extremity radiating pain, if you’re experiencing weakness in the lower extremities, if you’re having difficulty with bowel or bladder incontinence in addition to the leg pain, and some numbness and tingling. Those are times that it may be time is of the urgency – time is of the essence and it may be something that you could potentially have a serious condition that may need to be treated, but there are a lot of options for treatment. Most people get better with very minimal intervention and got to give one more plug to weight loss and smoking cessation.
Host: Alright well thank you so much Dr. Overley. That’s Dr. Sam Overley, an orthopedic spine surgeon and Assistant Professor of Orthopedic Surgery and Neurosurgery at the University of Arkansas for Medical Sciences. Thanks for checking out this episode of the University of Arkansas for Medical Sciences podcast series and for more information on this topic and to access resources mentioned, call 501-686-8000 or visit doctors.uamshealth.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.
Back Pain Treatment and Prevention
Prakash Chandran (Host): For a lot of people back pain is just a fact of life, but there are many things that you can do on your own to minimize back pain and most of it boils down to developing healthy lifestyle habits. Let’s talk with Dr. Sam Overley, an orthopedic spine surgeon and Assistant Professor of Orthopedic Surgery and Neurosurgery at the University of Arkansas for Medical Sciences. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I’m Prakash Chandran. So first of all, Dr. Overley, can you talk a little bit about some of the more common causes of back pain?
Dr. Sam Overley (Guest): Hi Prakash, yeah you really hit the nail on the head saying that there are a lot of things that we can do on our own and a lot of it boils down to your question of what are the more common causes of back pain and you can really think of it in three different ways. There’s back pain that can be becoming from compression of nerve roots. There’s back pain that can be coming from general arthritic issues primarily of the joints of the low back, and thirdly there’s back pain that could be coming from disc issues and issues within the intervertebral disc.
Host: You mentioned the different types of back pain but I’m curious to learn about the causes. Is it posture, is it sports injury, is it just wear and tear over time? Talk a little bit about that.
Dr. Overley: Sure so the majority of people that I see I would say is degenerative changes, and what that boils down to, it’s kind of a blanket term for just wear and tear over time and so everyone undergoes degenerative changes just as a fact of life. If you think about the type of arthritic changes let’s say that people have in their knees and their hips and they get older and they start to lose some of the cartilage and that’s all degenerative processes and the same goes on in the low back and it’s pretty common. There’s about 80% of the population at some point or another will have an episode of pretty severe low back pain so that’s something to look forward to. Most of the time the good news is most of the time that resolves without any need for intervention and we’ll talk about some of the ways that you can do that, but basically what the majority of people, whether it’s from a history of a lot of sporting from manual labor, from really a number of different things that you have done in your life, they all kind of compound and a lot of it actually is inherited too. So it’s a little genetically predetermined if you will and what it boils down to though are these changes that the anatomy undergoes that ultimately result in pain.
Host: Yeah it’s really interesting to hear about the genetic components of this, but I was thinking just because back pain is a fact of life, doesn’t mean that we can’t take measures to try to minimize some of the pain that we’re going to experience. So maybe talk a little bit about the exercises that we can do or anything that we can do to help minimize or prevent back pain.
Dr. Overley: Sure, so before I get to things like exercises, I think it’s important to note a couple of things and this is what I tell all my patients, weight loss and smoking cessation. So those are two things – those are probably the two biggest modifiable traits that have been shown in the literature to actually significantly decrease low back pain. So the more you know – people who are overweight, just think about it as more stress, it’s more weight, it’s more that your spine has to support, and it’s more force that the joints and the disc and everything else that has the capability to degenerate see and the smoking cessation was something that was discovered many years ago, and what we had found with that is there is a really high correlation with people with chronic low back pain and smoking, and there’s also a correlation between improvement in back pain with smoking cessation. So that being said, you mentioned exercises and I think the biggest thing for low back health is core strengthening. So oddly enough it’s the abdominal muscles, the obliques, all of these things that are kind of – that serve to support and span the spine and it’s those muscles primarily that help a lot with offloading some of the spine and potentially helping keep your back in good shape and keep you from overloading the disc and potentially having herniations and bulges and that sort of thing.
Host: Most of us unfortunately probably don’t do the amount of core strengthening that we need to prevent the back pain that we get. So when we do experience back pain, whether it be sharp or something that is just ongoing, what are some of the things that you do to help treat your patients?
Dr. Overley: Sure so when you really think about core strengthening, it’s not just doing a bunch of crunches. There are all different types of core strengthening, I mentioned the abdominal muscles and the obliques, and that is certainly part of it and that’s probably the biggest part and there are other aspects in terms of the muscles in the back, the muscles right by the spine, what we call the paraspinal muscles. They are two big muscles basically on each side of the spine and a really good exercise, one thing that I think is underrated a lot of times is the plank, so doing plank exercises. There is a certain amount of core abdominal exercises that you can do in the form of crunches and that sort of thing. Some of the other exercises that you can do actually are more kind of stretches and things like the scorpion pose in yoga for instance, kind of laying flat on your belly and slowly picking yourself up and kind of arching the low back as well as hamstring stretches as well and those tend to help quite a bit with back pain. I will tell for those who want kind of a more in depth look at what’s a good regimen, you can grab this online, just off of – there’s a bunch of different websites that will cite it, but something called the McKenzie method and that’s m-c-k-e-n-z-i-e and it’s named after a physical therapist, Robert McKenzie who kind of wrote about these core strengthening exercises and so there’s a whole regimen, it takes about 10 minutes a day. I usually tell people start with that. Do it in the morning. Just clear your schedule for 10 minutes and do it and you’d be shocked at how many people doing that continuously and doing it daily get a lot of improvement in their pain.
Host: Well I’m going to look that up as soon as we get off the line here, but what I’m really hearing is this focus on mobility and looking at the body as a system. From the core strength that you were mentioning to the hamstring flexibility, everything supports each other, and it certainly helps minimize the onset of that back pain that you’re talking about wouldn’t you say?
Dr. Overley: Absolutely, yeah I mean it’s all a unit and you’ll see that people who have back issues, there’s trickle down effects no doubt. I mean they then begin to have some hip issues and then it goes to the knees and it can go the other way as well. So the body is just such a complex unit of so many things going on and there’s a lot of things that we can do from a muscle strengthening, muscle stretching and overall your limberness that can really impact your low back health.
Host: I’d like to move on to the treatment options for back pain. You know I know not everything requires surgery, so maybe talk a little bit about the more accessible lighter weight treatment options for back pain and then when you feel like it requires surgery.
Dr. Overley: Yeah so people who – like I said 80% of the population is going to have some episode of pretty back pain and it can be very crippling when it happens and people always talk about, oh it locks up and that took me to my knees, and that happens. So the thing that I – first of all I encourage people, what I encourage them is that the vast majority of people who experience these issues get significant relief without anything even close to surgery. So that’s one – peace of mind is a very underutilized treatment and I think it helps a lot of people. Secondly I usually, depending on what the pain sounds like, I usually just recommend that they try some physical therapy. I talk to them about these exercises, the McKenzie method and I talk to them about doing this stuff daily and making it part of their routine. If they’re smokers or if they’re obese, obviously I talk about weight loss and smoking cessation. Times when I begin to think, oh maybe this is something related to the nerves or when people start getting pain that goes down the legs, and so that’s something – if someone’s had ongoing, greater than 3 or 4 weeks of pain going down the legs, I’ll usually get an MRI for that to rule out that they don’t have a herniated disc that’s pushing on a nerve. If it’s just primarily centralized low back pain, we’ll start with some physical therapy and a lot of what they will do in physical therapy is variations and different iterations of this McKenzie method. They can also do some things like light traction, some inversion where you basically hang upside down and get a little bit of relief from gravity on those discs and they can do various different forms of physiotherapy and electronic physiotherapy or electric physiotherapy where they stimulate some of the muscles around the low back and try to work out some of that spasm that’s developed.
Host: Alright Dr. Overley, I really appreciate your time today. I think the one thing that I’ve learned here is that an ounce of prevention is worth that pound of cure. Just as we wrap up, you know is there anything that you wish more people knew, besides the McKenzie method, before they came to see you?
Dr. Overley: So I think it’s valuable for people to know that a lot of times this is going to get better on its own with some minor intervention in terms of exercise, stretching, that sort of thing. Things when – times when I think it may be necessary to go see your surgeon, if you’re having a lot of lower extremity radiating pain, if you’re experiencing weakness in the lower extremities, if you’re having difficulty with bowel or bladder incontinence in addition to the leg pain, and some numbness and tingling. Those are times that it may be time is of the urgency – time is of the essence and it may be something that you could potentially have a serious condition that may need to be treated, but there are a lot of options for treatment. Most people get better with very minimal intervention and got to give one more plug to weight loss and smoking cessation.
Host: Alright well thank you so much Dr. Overley. That’s Dr. Sam Overley, an orthopedic spine surgeon and Assistant Professor of Orthopedic Surgery and Neurosurgery at the University of Arkansas for Medical Sciences. Thanks for checking out this episode of the University of Arkansas for Medical Sciences podcast series and for more information on this topic and to access resources mentioned, call 501-686-8000 or visit doctors.uamshealth.com. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.