Helping College-Bound Students Deal with Chronic Pain

A recent story from NPR brought attention to the issues faced by teenagers who struggle with mental illness who want to go to college. These bright and motivated students face many complicated questions and concerns that their struggles with mental illness will cause them too much difficulty. In more serious cases, there’s the fear that the stresses of school and being away from home could exacerbate mental illnesses and lead to panic attacks and other problems.

But what about young people who deal with problems like chronic physical pain or injury that limits mobility or can hinder day-to-day activity? For these, students, trying to go to college can present many unknowns. In the case of chronic pain, many of these students also deal with depression or other mental illnesses that tend to coincide with pain disorders. Though we tend to think of chronic pain as an issue faced by older people, Dr. Sol Kamson notes that it can affect people of all ages.

Depending on the nature of the chronic pain, students may find it hard to perform basic tasks like getting up and getting ready for class, walking to and from buildings, carrying heavy books or backpacks, or sitting for long periods of time to do homework. For students dealing with an injury that limits mobility or functionality, college campuses can present all kinds of challenges, even with recent improvements that have been made to most old buildings to improve access for the disabled. While most schools have made appropriate adjustments to be in accordance with legal requirements that protect the rights of disabled students, these students are likely to still face challenges that their peers wouldn’t have to consider. For example, it may take them longer to get across campus, or they may need to have help provided by the school in order to get around. For some students, this can cause social concerns or can make students feel unfairly burdened. It’s hard enough to make the adjustment to attending college. What can parents do to help their children make the adjustment more easily?

• While you are with your son or daughter at orientation or while you are visiting the school in advance, take some time to explore the facilities to make sure your child knows how to get around during their first week. For example, if your teen needs access to a wheelchair ramp or elevators, visit the buildings where classes will be held to make sure they know where everything is. This will help alleviate some of their stress about being ready for the first week.

• Reach out in advance to the school to make sure you and your child have a thorough understanding about the support services available to your child. Know what your insurance will cover and what free supportive services the school offers. You may even ask to make a special appointment with a counselor or coordinator around the time of orientation so you and your child can have a good understanding of where they can turn if they need help.

• Know the emergency options. Make sure you know where the nearest hospital is and how they can get there. Understand what can be covered by your insurance. Know when the student health services office is open, and when your child will need to turn to outside services. If your child needs to come home or if you need to make a visit at short notice, figure out how you can make this happen. If you’re far away but you have family or friends living in the area of their school, make sure your child has all appropriate phone numbers in case they need help at short notice.

Going off to college is a scary time, no matter what your child’s situation. But being prepared for every scenario and understanding the options can take a lot of pressure off for both you and your new college student.

When Is Spine Surgery Considered to be Outpatient?

There are many individuals that have the misconception that having spinal surgery is a major surgery and they must stay in the hospital for an extended visit. With minimally invasive spine surgery, this is no longer the case. You will be recovering and relaxing in your own home, in your own bed.

Lumbar Miscrodiscectomy
Lumbar microdiscectomy is a non-abrasive surgery that provides excellent results to those who must undergo surgical treatment to help recover from their lumbar spinal condition. Those who suffer from foot or leg pain, certain amounts of weakness, or even numbness, may have a lumbar condition and may even need this surgery.

When Surgery is the Final Step
Those who exhibit the symptoms of a lumbar spinal condition may have one or more symptoms. There are pain management plans that Dr. Solomon Kamson will set into place in order to minimize the pain and difficulty for you. If one pain management plan does not seem to be working, then Dr. Kamson will try another method to help.

Performing Lumbar Microdiscectomy
This surgery will take approximately an hour to perform. In order to reduce the time needed for recovery, anesthesia that was designed for outpatient surgery is used. The surgeon will use x-ray technology in order to guide him without having to make a larger incision. The smaller the incision that is made, the less muscle and tissue is cut, and the less time it will take to recover from the surgery. This also makes it possible to be an outpatient surgery.

Once Surgery is Complete
Recovery time is cut in more than half compared to what the typical surgery recovery time used to be. When the surgery is done, you will return to your home. The patient is able to walk and even participate in non-strenuous activities. You will have relief from the pain that you have felt for so long. You will be free of the pain that has put difficulty in performing typically daily activities like grocery shopping and cleaning your home.

After Care
It is important to know that even though this surgery is an outpatient surgery, you will need to make preparations to your home prior to the surgical treatment. Placing daily necessities within reach is important. For example, any clothing that will be needed out of the bottom drawers of your bedroom dresser will need to be placed in a more convenient spot. If this is the case, then it is suggested to place a basket on top of the dresser and add the daily clothing to it so less bending is performed. Dr. Solomon Kamson will provide you with other instruction on how to prepare for an easy recovery time and it is highly suggested you follow the instructions and tips.

Failed Back Surgery Syndrome: Does It Really Exist?

Failed back surgery syndrome (FBSS) may sound like something that is a figment of a patient’s imagination. However, it is actually referring to chronic back or leg pain that continues after having spine surgery. There is no guarantee that any surgery will be 100 percent effective, and spine or back surgery is no exception. Dr. Solomon Kamson is there for his patients through every step of the process and can address continued pain and come up with a solution.

Background
Any back surgery only comes with up to a 95 percent effective rate. There are really only two issues that spine surgery can definitively correct, which are to decompress a pinched nerve root and stabilize a joint that is causing pain due to movement. The doctor can only predict what he or she thinks is causing the pain and perform the surgery on that area.

Lingering pain is often a result of the fact that the pain the patient is feeling was actually the result of another problem and not caused by the area of the spine that was operated on. The focus of the surgery is to work on a lesion or injury on the spine. It is only evident after the surgery if that part of the anatomy was truly the cause of the patient’s pain.

Other Causes
Failed back surgery syndrome can be a result of issues other than operating on the wrong spot. When a patient had a spinal fusion, there might be a failure to fuse or the implant might not work as it should. The pain may also shift to another part of the spine after a fusion. In the case of spinal stenosis, it may be a recurring problem that cannot be remedied permanently. When decompression is performed, the nerve damage might not heal or new nerve damage might occur during spine surgery. Scar tissue may form around the surgical site, which can make pain return. There is also the possibility that a patient may reinjure themselves, causing the pain to come back even worse that it was before. This often happens when patients do not stick to the rehabilitation plan laid out by the physician.

Overcoming Obstacles
Most patients need to realize that spine surgery is not a cure for back pain. It is a common misconception that it is a permanent fix and that there will be no pain after the recovery period has ended. Each patient must carefully follow the rehabilitation plan that is established. This often includes months or years of physical therapy to keep the back in the best shape. It is also important not to push physical activity before the back has had a chance to heal, or this may cause more pain or further injury. Continued visits to Dr. Kamson will allow him to monitor the patient’s progress and see if any new therapies or medications need to be added to the plan. With continued therapy and monitoring, most patients should be able to manage pain with failed back surgery syndrome.

Differences between Herniated and Bulging Discs

One who suffers from herniated or bulging discs not only experience loss of flexibility and motion, he or she will endure intense pain and can fall victim to other conditions and repercussions. For instance, relationships and work will be subject to the effects of the condition. There are certain activities that they are not able to participate in due to the spinal condition. Solomon Kamson understands this issue and works to fix the condition so his patients will get right back out to the active world.

The discs in the spine act as shock absorbers or cushions for the protection of the vertebrae. The discs are composed of a layer on the outside for strength and a center of softer cartilage for the shock absorption. They are round with an opening in the middle, sort of like a doughnut. Each disc is perfectly proportioned to fit within the spine.

What is a herniated disc?
A herniated disc is quite different from a bulging disc. A herniated disc is a fracture to the outer layer of the disc. The fracture allows the cartilage to protrude through the outer layer. This is typically in one area of the disc. Other names for this condition are ruptured discs or slipped discs. Dr. Solomon Kamson will be able to repair the problem and render you pain free. There are pain management systems available for those who suffer from the pain. After the proper diagnosis and consultation about treatment; the next step is decided on by the patient and the doctor.

What is a bulging disc?
A bulging disc is a disc that extends past the limits of where it is supposed to be located. Normally, this issue will affect a large portion of the disc. This is also a condition that is brought on by the average aging process. Other age groups do fall victim of this condition, due to injuries most commonly, so it is not limited to the older generations.

Bulging discs are more widely known among those who have one or the other of these conditions. There are even some lucky individuals who do have one of these conditions and are unaware of it because they do not experience any pain. Although they are lucky to have no pain, these sufferers will go on to develop pain, and the condition may be worse if they wait too long to get the disc corrected.

In order to discover which condition you may have in your spine, you will need to see Dr. Kamson. He will perform testing and ask questions in order to properly diagnose the issue. Once the diagnosis is known, he will educate you on the choice for your pain management. The team at the Spine Institute Northwest will be able to help you return to a healthier state.

Causes and Symptoms of Spinal Stenosis

Those who suffer from spinal stenosis are no strangers to the pain that comes along with this debilitating condition. It is the narrowing of the spaces that are located in the spine. This causes a certain amount of pressure on the spinal cord and the nerves. In approximately 75% of cases, this condition is located in the lumbar section of the spine (the lower back). In most cases, there is a narrowing in the spine that is associated with compression on the nerve root. This will cause pain that shoots down the back of the leg.

There are many causes for this condition. Many individuals fall into more than one of the groups. If you find that you fall into more than one group, this means that the risk for this condition increases, and it is imperative that you speak with a qualified surgeon like Solomon Kamson.

Aging: Over a certain amount of time, the human body will be subject to wear and tear. With greater age comes more damage to the body’s ligaments, which are the tough connective tissues between the bones in the spine. These ligaments will thicken. Bone spurs can and often times will develop. Also, the vertebrae will start to deteriorate over years.

Arthritis: There are two types of arthritis that will affect the spine: osteoarthritis and rheumatoid arthritis. For a proper diagnosis, see Dr. Solomon Kamson at the Spine Institute Northwest.

Heredity: If there are x-rays done at a young age and the spine is considered to be small, this may mean that spinal stenosis will show up at an earlier age. There may be structural deformities that are apparent and will cause narrowing in the child’s spinal canal.

Trauma: Many accidents or other types of injuries can cause an individual to develop spinal stenosis. The injury may cause discs in the spine to dislocate, leading to the disorder. The injury may even result in fractures and cause bone fragments to penetrate the spinal canal.

Tumors: In some cases, those who suffer from spinal stenosis will have another health condition they may be unaware, including tumors on the spine. Any such growth on the spinal canal will cause extra pressure and less space, which results in the spinal stenosis condition. Removal of the tumor should alleviate the pressure that the tumor causes, which will result in the spinal stenosis condition being reversed.

Spinal stenosis can cause different symptoms in certain cases. Typically a spinal stenosis sufferer will endure more than one of the symptoms. The symptoms that are typically reported are frequent falling or clumsiness, pain, difficulty while walking, numbness, hot or cold feelings in the legs, and tingling. Dr. Solomon Kamson and the team at the Spine Institute Northwest can help with a proper diagnosis and a pain management system. Not only will he be able to set a pain management system into place, he will do testing and find a solution to the condition itself.

What Are Pinched Nerves, and How Are They Treated?

A nerve that is pinched can become extremely painful. “Pinched nerve” is a term used for pain or impairment of functions due to a nerve that is under pressure. It does happen to nerves that control moment and send messages to your brain, also known as sensory nerves.

When a Nerve is Pinched
The first symptoms of a pinched nerve begin with tingling, burning sensations; shooting pains down your buttock, neck or legs; and numbness. It can also affect your shoulders, arms, and every one of your fingers. At times, that pain can be located in a different area of the nerve. If you have a pinched nerve in the lower back, it can cause you to feel pain in your calf muscles. Constant pressure can cause permanent damage. A qualified doctor like Dr. Solomon Kamson can relieve this pressure and decrease the risk of damaged nerves.

Nerve Basics
These are extensions from the brain. They reach through the arms and legs and into the muscles and your skin. A nerve is a cell that is microscopic, and the fibers run several feet throughout your body. A nerve cell that resides in your brain or inside your spine is called a central nerve. The nerves that start in your spine and go into the arms and legs are named peripheral nerves. The peripheral nerves are bundles of millions of nerve fibers. They leave the spine and branch out to the target muscles in order to allow you to move following brain signals.

After a Pinched Nerve
Dr. Solomon Kamson can educate you on why you feel the pain from a pinched nerve. Once you have a pinched nerve, the flow inside the “hose” is reduced or blocked. The nutrients will stop flowing. Eventually, the membrane of the nerve will start to lose the ability to transmit the electrical charges it needs to transmit for you to function. In this case, the nerve will die and cannot be revived. After the fibers stop working properly, the skin will feel numb; if the nerve is connected to a muscle, the muscle may no longer be able to be contracted.

The Next Step
Dr. Kamson will diagnose you, and then the healing will begin. The Spine Institute Northwest will provide you with treatment options. Although there are conservative treatments for this condition, they will not treat the nerve itself. A pinched nerve is typically a symptom of an underlying disc condition, which the doctor will be able to correct. He will run a series of tests to diagnose the true issue and start the healing process.

Once you are diagnosed, you may need to stay away from certain activities that cause aggravation to the disc or the nerve. Dr. Kamson will provide you with a list of activities that you need to stay away from as well as activities that you need to engage in for a smoother recovery if surgery is your choice of treatment. Typically, you can have a surgery performed to correct this issue instead of going through intense pain and pain management programs.

Q&A: Injections for Pain Relief

Question: Hi Dr. Kamson! I suffer from lower back pain that often causes muscle spasms and pain in my hip. I’ve been told that injections can help relieve my pain. What kind of injections are there, and how long will they last?

Answer: Spinal injections are a quick and more conservative option for treating lower back pain. Generally injections are performed after medications, or you have finished therapy, they are also given prior to surgery or in conjunction with it. These types of injections are not only useful for relieving pain, but also work as helpful diagnostic tools to determine the source of your pain. Spinal injections are much more effective in relieving pain than with oral medication because this medicine is injected directly into the area where the pain is generating. Generally a steroid is injected, which delivers an anti-inflammatory solution to the area of pain.

There are several different types of injections, and depending on which one you receive, you can experience either long lasting, or temporary relief from pain. The most common types of spinal injections include epidural, selective nerve root block, facet joint block, sacroiliac joint block, and extremity joint block. The Epidural Steroid Injection (ESI) injects steroids directly around the sac that contains the fluid that nerve roots are bathed in. This procedure is able to be performed at the lumbar level, thoracic, cervical, or by per caudal approach. The steroid that is injected can help decrease the inflammation that is associated with conditions like; disc herniation, degenerative disc disease, and spinal stenosis.

The primary use of a Selective Nerve Root Block is to diagnose the exact source of the pain, and then provide relief for lower back pain, and/or leg pain. A nerve root can become compressed and inflamed which is what causes pain in the back or leg, and sometimes image studies are unable to show the nerve that is producing the pain. This injection helps the physician isolate the source of pain so it can be treated. This type of injection is also useful for treating herniated discs.

When the facet joint is known to be generating the pain, the facet injection can be used to provide relief. This injection is similar to the selective nerve root block and is used as a diagnostic tool to isolate the exact source of pain. A facet joint block relieves the pain by numbing the source and soothing the inflammation. These injections can also be performed at the lumbar, thoracic, or cervical regions of the spine.

The Sacroiliac Joint Block is an injection used to diagnose lower back pain that is associated with sacroiliac joint dysfunction. With the use of a live x-ray, a needle is inserted into the joint, and a numbing agent and anti-inflammatory medicine is injected to relieve the pain. The Extremity Joint Injection works the same way but can be performed at the knee, wrist, elbow, shoulder, or other joints.

Talk to your doctor about your options, and which type of injections are best for you. He or she will also help you determine if injections seem like a good solution, or if you may require minimally invasive spine surgery to truly get at the root of your pain.

Q&A: Degenerative Disc Disease

Question: Dr Kamson, I’ve been diagnosed with Degenerative Disc Disease that has affected my L4 and L5 discs in the lower right side of my back. I am constantly in pain and it also radiates down my right leg. Recently it has started hurting my foot and toes. The pain has continued to progress and is now unbearable, and I have to regularly go to the doctor to help control the pain. The doctors at my hospital are aware of my condition and have turned me away several times. What can I do to treat this chronic pain and get my life back?

Answer: This is a great question, and it’s unfortunate that the doctors you depend on have turned you away. They should have presented you with treatment options when you were diagnosed with the problem, instead of just temporarily controlling the pain. Surprisingly this is a common problem, and when it doesn’t get better doctors will turn patients away because they don’t want the liability.

One of the most common causes of lower back pain is degenerative disc disease, and it is also one of the most misunderstood. The lumbar discs in the spine are very strong and can resist a large amount of force, and still be flexible. These discs are made up of bands that create a tough outer layer, and the inside consists of nucleus pulposus, which is a jelly-like material. This acts like a shock absorber to cushion the discs and absorb impact. With severe back injuries or as you get older, these discs can wear and develop small cracks which can cause the “jelly” fluid to leak out. This causes changes with the vertebrae and other components of the spine as the discs compress against nerves, which produces the pain. This can cause inflammation and lead to the pain traveling to the hips, and radiating down the back of the legs and into the feet.

For years now the Spine Institute Northwest has been treating many patients with this same kind of complaint. They’ve had to make repeated trips to the doctor without receiving the treatment they need to treat the problem, but only find solutions for treating the pain. There are several different minimally invasive surgical procedures that the Spine Institute Northwest offers, along with other treatment options and therapies.

Treatments like the Lumbar Interbody Fusion and Facet Fixation is a procedure used for many patients who suffer from lower back and/or leg pain from degenerative discs. This procedure uses a screw system to stabilize the spine to help with the fusion process. By approaching the targeted disc through small incisions, bone fragments or disc material is removed and an implant is inserted. A spacer cage then holds the vertebrae in position and aids in the spine fusing with the bone graft.

For a better assessment you can visit www.spineinstitutenorthwest.com and fill out some information and submit your MRI or CT scan for a free review. You will then be able to receive information regarding treatments that can relieve you of your pain so you are able to get back the pain-free life you’ve been missing out on.

Q&A: Herniated Disc Treatment Options

Question: I’ve been in constant pain from a herniated disc and my doctor says it will require major surgery to correct. Is there anything else that can be done to relieve the pain?”

Answer: So many patients have been told the same thing, or that the only other alternative is medication, which only masks the pain. With the minimally invasive Endoscopically Assisted Spinal Decompression procedure, you can quickly get the relief you need and get back your pain-free life.

The vertebrae in the spine are cushioned by small discs that act as shock absorbers in the spine. This is also what helps keep the spine flexible. When a disc becomes damaged it can break open or bulge. This is also referred to as a ruptured or slipped disc. Most herniated discs are in the lower back, and can sometimes occur in the neck. In more rare cases the upper back can be affected as well.

There are several different causes of a herniated disc that come with age or injuries to the spine. As you get older the discs can experience wear and tear that causes the discs to dry out, making them not as flexible. Injuries to the spine can cause small tears or cracks to the outer hardened layer. If this occurs, the gel inside the vertebrae is able to be forced out. This is what causes the disc to break open, bulge, or even break into pieces. The pain you experience is caused by the herniated disc pressing on the nerve roots. It may also cause a weakness or numbness in the body where the nerve is positioned. If you experience a herniated disc in the lower back, you will usually feel numbness and pain that can be felt in the buttocks, as well as down the leg.

If you’ve had an MRI or CT scan to diagnose your pain, you are able to submit it to the Spine Institute Northwest to have a specialist review and discuss the different options that are available. The benefit of an endoscopic decompression procedure is that it uses a small incision so the muscles and tissues in the area not damaged. This results in a much quicker and less painful recovery with very little soreness.

With the use of lasers, coblation, ultrasound, or radio frequency, the inner or outer areas of the disc that are causing the pain is removed. This will reduce the amount of compression on the spinal cord and nerves. This is a fairly quick procedure that usually takes around 90 minutes for each level. After about an hour in the recovery room you are released from the facilities, but need to follow up with the surgeon in 2 weeks to have the suture removed and the area inspected. If you don’t live in the area, you may visit your primary care provider for removal and inspection of the area.

The pain can quickly or immediately disappear, but it will take several months for everything to fully heal. It’s important not to rush back into work or strenuous activities so the back has time to properly heal. Don’t worry, it won’t be long until you are back to yourself and enjoying your life.

Q&A: Exercise to Prevent Back Pain?

Question: I work at a job that requires manual labor, and often suffer from back pain throughout the day. Are there exercises I can do to relieve this pain, or prevent it from happening?

Answer: This is a great question and a very common complaint from patients around the world. Almost everyone suffers from some kind of back pain from time to time. For some it can occur more often than others, the pain can be more severe, and it may last for longer periods of time. The most common area of back pain is the lower back, and this can have a big impact on your day-to-day life. In fact, back pain and back-related issues are the number one reason why people miss work every year.

There are many different factors that can contribute to back pain, particularly in the lower area. This can vary from pain caused by straining a muscle to pains associated with degenerated discs, which usually comes with age. Back pain can greatly vary from person to person, and in more mild cases of pain it can be either prevented or greatly reduced by properly stretching and exercising. When doing manual labor, if you find a certain movement or particular duty that aggravates your back, pay attention to what you’re doing, and if necessary, discuss with your doctor if there are any underlying issues. In many cases a quick stretch and being aware of your movements can make a big difference. A good habit to get into is starting the day with a stretching routine. The stretches can be very basic like just trying to touch your toes in a standing or seated position. The goal is to keep the muscles and tissues flexible, to be less prone to injuring yourself. It is also good to stretch before lifting heavy objects. The most important thing to remember when lifting is to lift with your legs, keep your back straight, hold the object as close to your body as possible, and do not twist or jerk when lifting and carrying.

By increasing activities like exercising, you can help reduce pain and aid in recovery. If you have suffered an injury, a couple of days of rest can help, but without physical activity, the pain can worsen and often lead to a prolonged recovery period. By strengthening the back, stomach, and leg muscles, you are not only less susceptible to various injuries, but this also supports the spine better, which reduces the pressure on the spinal discs. There are several different strengthening exercises like lifting weights, leg lifts, sit-ups, and many others that can aggravate the back. If this occurs, then avoid those exercises that contribute to the pain. Aerobic exercises like walking and swimming will help maintain health and help with a speedy recovery.

Physical therapy is also a great program for those that suffer from chronic pain. A trained healthcare professional can help you develop an exercise program that is safe and combines certain exercises that target your problem areas and help strengthen the muscles supporting your back. Chronic back pain can be very frustrating, and without properly stretching and exercising to strengthen the body, it can get very expensive with repeated doctor visits and missed work. Be sure to consult with your doctor prior to starting an exercise program or physical therapy. If pain still persists, there are alternative forms of physical therapy, as well as minimally invasive procedures to correct the problem if necessary.

Thank you for this great question and hopefully this has given you some answers that can help you recover quickly and prevent future injuries.