Health Update

by Tyrone M. Reyes, M.D.

Is your back bothering you at the moment? Do you have a history of back problems? If you answered “yes” to one or both of these questions, you’ve got lots of company. Low back pain is an extremely common condition: 80 percent of people experience at least a bout of it some time during their lives. Rest, some pain relievers, and perhaps some exercises help it go away.

But for thousands, the pain lingers, and may become severe and debilitating. Depending on the underlying cause and the severity of the condition, surgery may be an option. But deciding to have surgery, especially of the back, is never simple. There’s a popular belief among the general population that back surgery is fraught with more danger than other orthopedic surgical procedures. Popular procedures in treating the back have been questioned, and sometimes new ones get introduced even before we really know how well they’ll work in the long haul. Likewise, physical changes to the spine may cause excruciating pain in one person, but no pain in another, so it’s hard to go by physical findings. There are also variations in practice patterns among surgeons doing surgery on the back. Among laymen. therefore, there’s much confusion and difficulty to figure out whether surgery to the back is necessary or not.

Back Basics

Although we talk about strong-willed people having strong backbones, your spine is actually a flexible, curvaceous stack of 24 vertebrae (33, if you count the fused vertebrae of the sacrum and coccyx). They are held together by tough ligaments, and the spinal cord runs down the space in the middle. The five lumbar vertebrae are the largest, as they should be, because they must support much of your body weight when you’re upright. Most back problems come from this lower, weight-bearing region — thus, the “low” in low back pain. You don’t hear it used much anymore, but lumbago is the old word for low back pain. (more…)