Dr. Kendall Buraimoh and Dr. Julie Bage share tips for how to relieve low back pain without undergoing surgery.
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How to Relieve Lower Back Pain Without Surgery
Featured Speakers:
Dr. Kendall Buraimoh, MD, is an Assistant Professor of Neurology and Orthopaedics at the University of Maryland School of Medicine and a Spine Physiatrist with the University of Maryland Orthopaedic Associates. She is also a part the UM Spine Network, a group of spine experts who practice across the state and collaborate to create comprehensive, evidence-based care plans for patients.
Learn more about Dr. Buraimoh.
Julie Bage, PT, DPT, OCS | Kendall Buraimoh, MD
Dr. Julie Bage, PT, DPT, OCS is a physical therapist at Towson Sports Medicine, a proud partner of the University of Maryland St. Joseph Medical Center and member of the UM Rehabilitation Network. Bage received her bachelor’s in physical therapy from the University of Maryland, Baltimore and her doctorate of physical therapy from the University of Tennessee Chattanooga. She has extensive experience in outpatient manual physical therapy managing a variety of orthopedic disorders. She also served as adjunct faculty in the physical therapy program at the University of Tennessee at Chattanooga.Dr. Kendall Buraimoh, MD, is an Assistant Professor of Neurology and Orthopaedics at the University of Maryland School of Medicine and a Spine Physiatrist with the University of Maryland Orthopaedic Associates. She is also a part the UM Spine Network, a group of spine experts who practice across the state and collaborate to create comprehensive, evidence-based care plans for patients.
Learn more about Dr. Buraimoh.
Transcription:
How to Relieve Lower Back Pain Without Surgery
Scott Webb (Host): Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by the UM Spine Network connected by the renowned University of Maryland School of Medicine. The UM Spine Network is home to the region’s leading spine experts. With convenient locations throughout the state, UM physicians collaborate to create comprehensive care plans for patients across the full spectrum of care. When you work with UM Spine Network physician, you can expect to receive the high quality, evidence-based care that you deserve.
Today, we are discussing back pain and how to relieve it without surgery. I’m Scott Webb. My guests today are Dr. Kendall Buraimoh and Dr. Julie Bage. Dr. Buraimoh is an Assistant Professor of Neurology and Orthopedics at the University of Maryland School of Medicine and a Spine Physiatrist with the University of Maryland Orthopedic Associates. And Dr. Bage is a Physical Therapist at Towson Sports Medicine, proud partner of the University of Maryland St. Joseph Medical Center. Doctors thanks so much for being on today. Dr. Buraimoh, I will start with you. Why should a patient take nonoperative treatments into consideration over surgery for lower back pain?
Kendall Buraimoh, MD (Guest): Surgery isn’t the answer for all lower back pain. There are a lot of patients who are very successful in reducing or eliminating their pain with less invasive measures. Surgery isn’t right for everyone based on other medical conditions they may have or feeling like they don’t have time to dedicate to their recovery.
Host: What are the most common nonoperative treatments for back pain?
Dr. Buraimoh: We typically start with things that are minimally invasive. I’m going to leave talking about physical therapy to my colleague Dr. Bage. But some of the other noninvasive measures are acupuncture, which is something that many of our UM Spine offices offer as an adjunctive therapy. It’s helpful in kind of releasing chemicals into the body that reduce pain or increase one’s overall sense of well-being. Another modality we use is medications. There are many medications that can be tried for different types of spinal pain. So, I won’t go into them in great detail.
But in general, I would say that the goal is to reduce pain whether it’s coming from a nerve or from another structural issue or the goal may be to decrease the inflammation in the area. Lastly, injections can target specific structures in the back which may be causing someone pain. These procedures are done under x-ray guidance to ensure the medication is directed to a safe and very specific location in the back. Most patients can return to work after such a procedure within one to three days and some may even have pain relief for three and up to six months afterwards.
Julie Bage, PT, DPT, OCS (Guest): Scott, I’d like to add to that, that there are a lot of modalities that we can use in physical therapy as well to manage back pain depending upon how a patient’s presentation. The good news is that about 80% of back pain does resolve favorably without invasive interventions. So, that gives the patient really, really good shot at being successful in physical therapy. Some things that we can use include exercise, joint mobilization, manipulation as well as aquatic therapy. We have other kinds of modalities including electrical stimulation and modalities like that that help calm the nerves down, as well as some of our clinicians in several of our facilities perform trigger point dry needling which although is not acupuncture, works with similar needles to help decrease muscle spasms and pain related to muscle dysfunction.
Host: Obviously, exercise is often recommended to ease lower back pain, [00:03:47 – 00:03:49 overlap] What are some of the exercises that people can do?
Dr. Bage: The specific exercises really are dependent on how a patient may present and that’s where we can come in and help patients determine that. A lot of people think about going into bedrest, but the research is really showing that staying active is one of the best things that people can do in order to help themselves recover from an episode of back pain. Certainly, gentle movements that are within a pain free range can be a nice thing that a patient can start independently. But this is where we can really help guide patients without necessarily an extensive course of therapy, giving them some things they can do to treat themselves with movement and exercise. Gentle range of motion, gentle stretching, even some gentle strengthening or muscle activation can be very helpful and sort of setting them on the path to recovery.
Host: And speaking of the things that people can do for themselves; I know that building core strength is really important. Why is that?
Dr. Bage: Well the core muscles, muscles that sort of control the spine including the abdominal muscles, there are several layers of abdominal muscles that we want to activate and create balance in all those muscles. Just like someone who may have had an ankle sprain would need to go back and strengthen the muscles around the ankle in order to allow that ankle to strengthen effectively and allow them to return to normal activity with good strength and control; we do the same thing with the muscles of the core. These are the muscles that act to move the lumbar spine segments and sometimes can become weakened or perform poorly when there is pain, so there’s a great deal of importance in not only building strength but good control in those muscles through a range of motion to allow people to go back to their normal daily activities.
Host: Yeah, I think that’s really what it is. I’m 51 and my normal daily activities include me sitting in this chair for many, many hours and I know that it effects my back. And what I generally do is I lay on the floor on a hard surface, I lay on the floor and my back just feels better. And then I begin to do some stretches, pull my knees up, but I’m just making it up as I go. How should a patient determine what exercises they should do?
Dr. Bage: Well certainly things that do make your back feel better are a wonderful place to start and that’s one of the key questions I look for when I speak to patients is what are you already doing that seems to help and can give us a good foot in the door to helping them find a path for exercises that are going to really suit them. Speaking about sitting, because that’s a common problem for a lot of people with back problems because so many of us sit so much more than we may have generations ago. Certainly getting in positions that are sort of the antidote to that bent position that we frequently live in when we are sitting, rolling over on your belly when you lay on the floor for a period of time may be helpful in sort of taking your spine into a position that you’re not normally going into. As we sit for long hours, we’re putting our spine in a position where things are really stretched for a long period of time. Not many tissues really enjoy that experience without some displeasure or discomfort. So, we can certainly look at exercises even standing and walking around periodically once an hour or whatever a workday will allow can allow people to manage their symptoms so that they don’t continue to escalate through the course of the day of sitting for eight hours in front of a computer.
Host: So, Dr. Buraimoh, how do members of the UM Spine Network help patients who aren’t ready for surgery? How do they treat their lower back pain nonoperatively?
Dr. Buraimoh: Well we offer a comprehensive array of services throughout the UM Spine Network. And those can mean supervised by a spine physician. There are multiple locations within the UM Spine Network where one can see both a physician and a physical therapist in the same location to arrange for coordinating care.
Host: That’s awesome. It sounds like a lot of coverage, a lot of options for people. So, Dr. Buraimoh, lastly today, when should a patient begin considering surgery, especially if they have gone through everything else that we’ve discussed here today?
Dr. Buraimoh: Considering surgery is something patients should do in conjunction with their doctors. Together, we can review treatments that the patients may have tried, perform detailed physical exams and other assessments, review imaging together. If a patient has tried several nonoperative treatments without pain relief, then depending on the diagnosis; they may be a candidate for spine surgery, and we would be happy to coordinate that care as well.
Host: And Dr. Bage, last word to you.
Dr. Bage: Certainly I think that it’s important for patients to consider and coordinate and explore their options with their physician as well as other medical providers involved in their care. Surgery is certainly something that is available to patients but certainly shouldn’t be considered as in maybe other types of injuries the first line of defense. So, it’s certainly good that we’ve been able to have a few moments to speak about some other opportunities that patients might not know are frequently very successful options for treating low back pain.
Host: Doctors, thanks so much for being on today. That’s Dr. Kendall Buraimoh and Dr. Julie Bage. And thank you for listening to Live Greater a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.
How to Relieve Lower Back Pain Without Surgery
Scott Webb (Host): Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by the UM Spine Network connected by the renowned University of Maryland School of Medicine. The UM Spine Network is home to the region’s leading spine experts. With convenient locations throughout the state, UM physicians collaborate to create comprehensive care plans for patients across the full spectrum of care. When you work with UM Spine Network physician, you can expect to receive the high quality, evidence-based care that you deserve.
Today, we are discussing back pain and how to relieve it without surgery. I’m Scott Webb. My guests today are Dr. Kendall Buraimoh and Dr. Julie Bage. Dr. Buraimoh is an Assistant Professor of Neurology and Orthopedics at the University of Maryland School of Medicine and a Spine Physiatrist with the University of Maryland Orthopedic Associates. And Dr. Bage is a Physical Therapist at Towson Sports Medicine, proud partner of the University of Maryland St. Joseph Medical Center. Doctors thanks so much for being on today. Dr. Buraimoh, I will start with you. Why should a patient take nonoperative treatments into consideration over surgery for lower back pain?
Kendall Buraimoh, MD (Guest): Surgery isn’t the answer for all lower back pain. There are a lot of patients who are very successful in reducing or eliminating their pain with less invasive measures. Surgery isn’t right for everyone based on other medical conditions they may have or feeling like they don’t have time to dedicate to their recovery.
Host: What are the most common nonoperative treatments for back pain?
Dr. Buraimoh: We typically start with things that are minimally invasive. I’m going to leave talking about physical therapy to my colleague Dr. Bage. But some of the other noninvasive measures are acupuncture, which is something that many of our UM Spine offices offer as an adjunctive therapy. It’s helpful in kind of releasing chemicals into the body that reduce pain or increase one’s overall sense of well-being. Another modality we use is medications. There are many medications that can be tried for different types of spinal pain. So, I won’t go into them in great detail.
But in general, I would say that the goal is to reduce pain whether it’s coming from a nerve or from another structural issue or the goal may be to decrease the inflammation in the area. Lastly, injections can target specific structures in the back which may be causing someone pain. These procedures are done under x-ray guidance to ensure the medication is directed to a safe and very specific location in the back. Most patients can return to work after such a procedure within one to three days and some may even have pain relief for three and up to six months afterwards.
Julie Bage, PT, DPT, OCS (Guest): Scott, I’d like to add to that, that there are a lot of modalities that we can use in physical therapy as well to manage back pain depending upon how a patient’s presentation. The good news is that about 80% of back pain does resolve favorably without invasive interventions. So, that gives the patient really, really good shot at being successful in physical therapy. Some things that we can use include exercise, joint mobilization, manipulation as well as aquatic therapy. We have other kinds of modalities including electrical stimulation and modalities like that that help calm the nerves down, as well as some of our clinicians in several of our facilities perform trigger point dry needling which although is not acupuncture, works with similar needles to help decrease muscle spasms and pain related to muscle dysfunction.
Host: Obviously, exercise is often recommended to ease lower back pain, [00:03:47 – 00:03:49 overlap] What are some of the exercises that people can do?
Dr. Bage: The specific exercises really are dependent on how a patient may present and that’s where we can come in and help patients determine that. A lot of people think about going into bedrest, but the research is really showing that staying active is one of the best things that people can do in order to help themselves recover from an episode of back pain. Certainly, gentle movements that are within a pain free range can be a nice thing that a patient can start independently. But this is where we can really help guide patients without necessarily an extensive course of therapy, giving them some things they can do to treat themselves with movement and exercise. Gentle range of motion, gentle stretching, even some gentle strengthening or muscle activation can be very helpful and sort of setting them on the path to recovery.
Host: And speaking of the things that people can do for themselves; I know that building core strength is really important. Why is that?
Dr. Bage: Well the core muscles, muscles that sort of control the spine including the abdominal muscles, there are several layers of abdominal muscles that we want to activate and create balance in all those muscles. Just like someone who may have had an ankle sprain would need to go back and strengthen the muscles around the ankle in order to allow that ankle to strengthen effectively and allow them to return to normal activity with good strength and control; we do the same thing with the muscles of the core. These are the muscles that act to move the lumbar spine segments and sometimes can become weakened or perform poorly when there is pain, so there’s a great deal of importance in not only building strength but good control in those muscles through a range of motion to allow people to go back to their normal daily activities.
Host: Yeah, I think that’s really what it is. I’m 51 and my normal daily activities include me sitting in this chair for many, many hours and I know that it effects my back. And what I generally do is I lay on the floor on a hard surface, I lay on the floor and my back just feels better. And then I begin to do some stretches, pull my knees up, but I’m just making it up as I go. How should a patient determine what exercises they should do?
Dr. Bage: Well certainly things that do make your back feel better are a wonderful place to start and that’s one of the key questions I look for when I speak to patients is what are you already doing that seems to help and can give us a good foot in the door to helping them find a path for exercises that are going to really suit them. Speaking about sitting, because that’s a common problem for a lot of people with back problems because so many of us sit so much more than we may have generations ago. Certainly getting in positions that are sort of the antidote to that bent position that we frequently live in when we are sitting, rolling over on your belly when you lay on the floor for a period of time may be helpful in sort of taking your spine into a position that you’re not normally going into. As we sit for long hours, we’re putting our spine in a position where things are really stretched for a long period of time. Not many tissues really enjoy that experience without some displeasure or discomfort. So, we can certainly look at exercises even standing and walking around periodically once an hour or whatever a workday will allow can allow people to manage their symptoms so that they don’t continue to escalate through the course of the day of sitting for eight hours in front of a computer.
Host: So, Dr. Buraimoh, how do members of the UM Spine Network help patients who aren’t ready for surgery? How do they treat their lower back pain nonoperatively?
Dr. Buraimoh: Well we offer a comprehensive array of services throughout the UM Spine Network. And those can mean supervised by a spine physician. There are multiple locations within the UM Spine Network where one can see both a physician and a physical therapist in the same location to arrange for coordinating care.
Host: That’s awesome. It sounds like a lot of coverage, a lot of options for people. So, Dr. Buraimoh, lastly today, when should a patient begin considering surgery, especially if they have gone through everything else that we’ve discussed here today?
Dr. Buraimoh: Considering surgery is something patients should do in conjunction with their doctors. Together, we can review treatments that the patients may have tried, perform detailed physical exams and other assessments, review imaging together. If a patient has tried several nonoperative treatments without pain relief, then depending on the diagnosis; they may be a candidate for spine surgery, and we would be happy to coordinate that care as well.
Host: And Dr. Bage, last word to you.
Dr. Bage: Certainly I think that it’s important for patients to consider and coordinate and explore their options with their physician as well as other medical providers involved in their care. Surgery is certainly something that is available to patients but certainly shouldn’t be considered as in maybe other types of injuries the first line of defense. So, it’s certainly good that we’ve been able to have a few moments to speak about some other opportunities that patients might not know are frequently very successful options for treating low back pain.
Host: Doctors, thanks so much for being on today. That’s Dr. Kendall Buraimoh and Dr. Julie Bage. And thank you for listening to Live Greater a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.