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Health Information Back Pain

My Aching Back

Back pain can lay you out for days or longer. Simple, everyday actions, such as picking up your child or going to work, may seem — or may be — impossible.

Lower back pain is a common problem. Four out of five adults will experience significant low back pain at some point in their lives. Most back pain will heal on its own with a little rest, an ice pack followed by heat, stretching and exercise, or an over-the-counter medication.

But when your pain stems from a more significant spine problem, it might be a relief to know that one of the best teams of back specialists in the country is right here in Chicago at the Spine and Back Center at Rush University Medical Center.

Team effort
The Spine and Back Center employs a multidisciplinary approach. A group of neurosurgeons, orthopedic surgeons and physical medicine and rehabilitation specialists known as physiatrists collaborate to pinpoint the source of pain and get patients back on their feet again, literally; sometimes with surgery, many times without.

Specialists perform the latest and most innovative treatments, including minimally invasive surgeries and artificial lumbar and cervical disc replacement —  procedures that are available at only a handful of centers nationwide.

The multidisciplinary approach doesn't end with diagnosis and surgery. Physiatrists, physical therapists and other specialists help patients with exercise, stretching and other activities. And nutritionists can help if extra weight is putting a strain on your back.

"We really want to move you beyond just getting rid of your symptoms to get you to take care of your back and not become a repeat customer," says Sheila Dugan, MD, a physiatrist at Rush.

"We not only try to get rid of your pain, but we try to restore your function," Dugan says. "We look beyond the acute problem to the question, how does this person get back to his or her life and not have a recurring problem?"

When to get help
Most lower back problems, such as those caused by an injury or improper lifting, will disappear in a few days or weeks with care that doesn't involve surgery. But some back pain — usually associated with aging and the wear-and-tear of daily living — may call for surgery or other active medical intervention. .

"If your condition doesn't improve within a couple of weeks or it's associated with any kind of numbness or weakness in the legs, bowel problems or trouble sleeping, those are red flags, meaning that you need to see a spine expert," Dugan says.

The most common reason for lower back surgery is to repair a slipped or bulging disc. Discs act as shock absorbers that cushion and stabilize the vertebrae. As discs age, they may begin to protrude or collapse, putting pressure on the nerve root that leads to a leg or foot. This painful condition is called sciatica.

Doctors will try nonsurgical treatments for pain relief first, such as stretching, oral medication or spinal injections. Physicians at the Spine and Back Center at Rush use image-guided technology for spinal injections, which allows them to place the injected medication at the identified source of the patient's pain. The injectables are usually steroids and anesthetic agents. "Under x-ray or fluoroscopy, a live image gives us multiple planes of view — depth as well as right-left orientation," Dugan says.

If such treatments do not stop the pain, surgery may be the next step.

Innovations at Rush
"We offer all of the different types of surgical procedures, from conventional to minimally invasive," says Gunnar Andersson, MD, PhD, orthopedic surgeon and chairperson of the department of orthopedic surgery at Rush.

Minimally invasive surgeries use smaller incisions and image-guided technology to maneuver instruments between muscle tissues, rather than cutting through them. These procedures usually mean less pain, shorter hospital stays and quicker recovery times than with conventional surgery.

"If you're disrupting less muscle, the recovery process is faster," Dugan says. "That's been a pretty exciting development."

Another exciting innovation now offered at the Spine and Back Center is artificial lumbar disc replacement for treating the pain associated with degenerative disc disease, a condition that affects more than 200,000 people in the United States each year.

The U.S. Food and Drug Administration approved lumbar disc replacement in 2004. They found that patients who receive artificial disc replacement surgery maintain flexibility. They experience less pain immediately after surgery and regain function faster. They leave the hospital sooner and are more satisfied than patients who undergo traditional fusion surgery.

Physician researchers at Rush are conducting several studies on disc replacements, including cervical disc replacement, a procedure in the neck area that no one else in the Chicago area offers at this time.

Right doctor, right treatment
As both researchers and physicians, the experts at Rush are known for pioneering treatments for spine disorders. This team of experts, working together in a multi-disciplinary approach, help ensure that you will have the right doctor providing the right treatment.

"With collaboration, first of all, you get the right decision as to whether or not you need surgery," Andersson says. "Then we all work together to make sure that both the treatment and rehabilitation are optimal."

Spine and Back Care at Rush

The Spine and Back Center at Rush University Medical Center in Chicago, Illinois, brings together the expertise of specialists from different disciplines, pinpointing and treating the sources of spine, back and neck pain while offering the latest, most innovative nonsurgical and surgical treatment options.

At Rush, highly trained neurosurgeons, orthopedic spine surgeons and physiatrists (doctors who specialize in physical rehabilitation), nurses and physical therapists, come together for a team approach to spine, back and neck care.

For more information visit the Spine and Back Center home page.

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