Hint: “Taking it easy” is really the last thing we want to do.
Consider that we are living much longer than previous generations. Our current average life expectancy hovers around 85 to 90 years. Some datapoints push expectancy beyond to even 100 years. What happens if, as a society, we grow used to shutting down our active lives at some arbitrary age (e.g., “retirement age”) because that’s what everybody expects us to do? What will happen to us if we shut ourselves down at the least sign of pain or illness?
Injury and disease are inevitable. It’s just life. Living a life entirely without some pain is difficult no matter how old (or young) you are. Nevertheless, and more often than not, pain is something that accompanies age. Joints wear out, spinal discs herniate, and pain develops. Naturally, when you feel pain, you want to back off and stop moving. The more pain you feel, the more you back off. Here’s the catch: the LONGER you back off and “take it easy,” the weaker your muscles become, thus increasing your risk for additional injury and more pain.
It’s called the “cycle of pain” for a reason and it can be vicious.
At my private practice in Beverly Hills, CA, I see many patients who are aging well and recognize the danger of the cycle of pain, and they want off. They want to maintain movement, prosper, and continue with the highest quality of life possible. In all of these patients, I see people who are determined to embark on a “life of movement.”
There are clear therapeutic paths when a spinal disorder produces debilitating pain. The most common producers of that level of pain is degenerative disc disease resulting in one or more herniated disc. Sometimes the damage to the spine can be a result of direct injury or a lifetime of repetitive use that may result from golfing, tennis, or ballet. I’ll add here that it is proven that even habitual cell phone use is also a potential cause for cervical (neck) damage.
Read about Text Neck and its causes.
When there is degeneration of the semi-flexible cushion between the vertebrae (the disc), some of the material may rupture and press onto one of the many nerves that exit the spinal canal. As degeneration advances, bone spurs may develop, narrowing nerve pathways resulting in additional nerve compression. In these cases, symptoms may include gradual deterioration in range of motion as the frequency and intensity of pain and numbness increases.
Getting Off the Cycle of Pain
If conditions allow, I may prescribe a fitness program to help my patients gain back some muscle mass. I don’t mean that you have to fight through pain for gain. No. You back off when there’s risk for additional injury. But in my experience, certain sets of exercise routines may get you off the cycle of pain by strengthening muscles, especially your core (torso) and along the spine. The main point is ‘easing off’ the areas that cause pain while maintaining movement elsewhere.
I may include tailored nutrition programs, mineral supplements, hormone treatments, and additional disease screenings (to rule out other health problems). The goal here is to keep your body healthy and restore as much muscle resilience as we can as we heal.
As your physician, I’ll try to avoid surgery for as long as possible. However, if surgery is necessary, we’ll consider minimally invasive procedures. Laminectomies (removal of portions of bone to relieve pressure on a nerve) and discectomies (removal of a part of ruptured disc material) are often performed outpatient with minimal postop recovery. If a more invasive approach is needed, I’ll recommend artificial disc replacement (ADR). Introduced in the U.S. in 2005 for lumbar applications and in 2007 for cervical, the procedure now has a proven clinical track record of success and accepted by nearly all health insurance. It also offers the added benefit of retaining the natural flexibility of the spine, while removing the ruptured disc.
Artificial disc replacement surgery brings me to another advocacy as it presents rather considerable improvement over spinal fusion. As the previous “go to” surgical procedure for treatment of chronic back and neck pain, it is fading out in significance. While fusion can eliminate the pain generators, it also stops the motion of the vertebral level (segment). I estimate that each fusion may result in 5-10 percent reduction of our natural range of motion. It doesn’t take an athlete to notice a significant change in flexibility after even one fusion surgery. It also doesn’t take a surgeon to recognize that fusions add strain to other levels of the spine and additional disc failures.
Given the success of ADR and its growing acceptance in the medical community, I am now performing restorative motion surgery – a procedure that removes fusions and replaces them with artificial discs. Restorative motion surgery is off-label. What that means is that the procedure, while not tacitly approved by the FDA, is allowed for surgeons like me who have the wherewithal to customize treatment for their patients. Based on my clinical background, practicing neurosurgery for nearly 30 years and research for the past 10 years, I believe restorative motion surgery to be a significant development for patients who want to get off the cycle of pain and recover lost range of motion and flexibility from previous spinal fusions.
This is one of the most difficult areas of my advocacy for patient care. No one is safe from pain, and there’s no cure for aging. What we want is to be out and functional and enjoying life. If you love to travel, hike, ski, golf, tennis, or just walking along the beach, these are hard to do when you have chronic and persistent pain. We can reduce our vulnerability to things that can slow us down and reduce movement. And the most important thing we can do is to keep moving.
