Top Causes Of Healthcare Expense

Top Drivers Of Healthcare Costs Are Back, Diabetes, And Heart Disease

In 2013, a conducted analysis focused on the amount of money spent on 155 health conditions. Surprisingly, results of this study showed that only 20 problems were accommodated by total money spent on health conditions.

Among these conditions, diabetes topped the list, with $101 billion spent in total for diagnoses and treatments. Cost for addressing this condition is also 36 times as fast as that of ischemic heart disease, which is the primary cause of death among individuals in the past 18 years. Diabetes and ischemic heart disease are common in people 65 years and older. On the other hand, low back and neck pain are third-most expensive health conditions, and they are more commonly diagnosed in working class.

The top three most expensive health conditions, as well as hypertension and injuries from fall, account for 18% of total cost, which is $347 billion in 2013, spent for personal health.

The study was aimed at differentiating public health programs and personal health spending, which cover individual payment and those that are paid by private and government insurance programs. The study focused on 155 conditions.

US allocates large budget for health care purposes. However, there is little information regarding the diseases that affect amount of money spent. According to Dr. Joseph Dieleman, lead author of the mentioned study and Assistant Professor at the Institute for Health Metrics and Evaluation at University of Washington, he and his team are gathering more information to provide people with better understand of money spent on health care and help all sectors involved to plan and distribute their resources more effectively.

Based on the $2.1 trillion spent on 155 health conditions covered by the study, Dr. Dieleman claims that around $300 million of total cost was unaccounted for. As result, total money spent on health care possibly reached $2.4 trillion in 2013.

Some of the most expensive studies indicated in the study are the following: musculoskeletal disorders, such as tendinitis, carpal tunnel syndrome, rheumatoid arthritis; dental visits; pregnancy and postpartum care.

The indicated study spanned 18 years and covered $30.1 trillion personal health care expenses from 1996–2013. Most of diseases included are non-communicable, though some infectious diseases were noted. The top infectious category was respiratory infections, which include bronchitis and pneumonia.

The paper also provided some remarkable findings, which are as follows;

  • In 2013, people who spent the most were women ages 85 and older, and cost is around $31,000. Around 58% of total expenses covered nursing facilities, while the remaining 40% was spent on various conditions, including, heart diseases, Alzheimer’s diseases, and falls.

  • Men with ages 85 and older expended around $24,000 for health care cost in 2013. An estimated 37% of this total expenses is spent on nursing facilities. The lower cost spent on nursing facilities can be attributed to longer life span of women than men.

  • As for the total personal health care costs, only less than 10% is spend on nursing care facilities. Meanwhile, a small percentage (5%) accounts for emergency department care. Highest expenditure spend on health care facilities are determined by onsets of Alzheimer’s disease and stroke. On the other hand, falls is top condition leading to highest expenditure in emergency departments.

  • A total of $77.9 billion was spent on public health education and advocacy initiatives, including awareness campaigns for anti-tobacco and cancer. This amount accounted for less than 3% of total health spending.

  • Well-care comprises care activities that are not related to diagnosis and treatment of diseases or injuries, and this category was only covered by 6% of expenses for personal health care. Under this category, 1/3 was estimated to be spent on pregnancy and postpartum care; this portion accounts for 10th largest spending category.

With the information provided by the study, various people, including insurers, health policy experts, physicians, and government leaders gain deeper insights into how health care services can be given to people in a more effective and efficient manner. Moreover, they are given the chance to make impact on the future, both through short- and long-term planning and strategizing.

The following consists list of top 10 most costly health expenses in 2013:

  1. Diabetes ($101.4 billion)

  2. Ischemic heart disease ($88.1 billion)

  3. Low back and neck pain ($87.6 billion)

  4. Hypertension ($83.9 billion)

  5. Injuries from falls ($76.3 billion)

  6. Depressive disorders ($71.1 billion)

  7. Oral-related problems ($66.4 billion)

  8. Vision and hearing problems ($59 billion)

  9. Skin-related problems, including cellulitis and acne ($55.7 billion)

  10. Pregnancy and postpartum care ($55.6 billion)

One of the b est ways to keep healthcare expenses low over a life time is to live a healthy lifestyle.  This would require the a healthy diet and exercise.  Other important things that are crucial are sleep, drinking enough water on a daily basis, low stress and getting enough fruits and vegetables.

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Out Patient Back Surgery

New Procedures No Longer Require A Hospital Stay

 

At least 31 million Americans are prone to having back pain. Pain or numbness in the back results from problem in discs in the spine; these discs are situated between vertebrae and act as shock absorbers.

With this problem, a new technique is developed to ensure quick relief in patients experiencing back pain.

One patient, Michael Ryan, is a competitive biker, and his passion for biking helped in keeping off the 50 pounds of weight that he lost. The man believes his extreme desire to exercise with all the extra weight that he had greatly contributed to his present condition.

A few year ago, Ryan started experiencing sharp pains in his back; his legs and feet also felt numbness. It turned out that he developed a degenerative disc disease.

In most cases, Ryan would have been advised to undergo a major back surgery, but such procedure would limit his mobility.

However, thanks to Dr. Charles Edwards, there was some hope. The doctor recommended microscropic lumbar decompression, wherein instead of making a large incision, only a one-inch incision would be made on Ryan’s back.

In the procedure, Edwards dissected the muscles over the concerned area in the spin in order to view the nerves properly. Afterward, he removed a portion of the disc that was pressing the nerves to free them.

After the surgery, pain and numbness from Ryan’s leg vanished right away.

Then, a month after his treatment, Ryan started running again. He even managed to participate in Ironman Triathlon a couple of years later and qualified for the world championships.

Ryan was very grateful that he went through the procedure.

At present, most doctors still prefer using conservative methods to treat back pain. However, when medications and physical therapy are ineffective, then a patient may be asked to undergo spinal decompression surgery. Normally, decompression surgery does not require patients to stay in the hospital.

Surgery is expensive and risky and doesn’t always provide patients with the results they are looking for.  you should exhaust every possible option first.  Physical theropy does help most people and in a lot of cases a Chiropractor in Las Vegas or any major city can help.

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Gabapentin Side Effects

Commonly Used Gabapentin Helps Many But With Side Effects

Millions of papers are afflicted by seizures, hot flashes, neuropathic pain, and restless leg syndrome. These conditions lead to need for drug that can alleviate relief from symptoms that are hard to live with. In 1993, gabapentin, which is marketed as Neurontin, was approved by US Food and Drug Administration. The medication was formulated in 2004 to fight epilepsy and provide pain relief.

After the drug was approved in the US, Parke–David, a daughter company of Pfizer, prodded physicians to prescribe gabapentin to their clients for purposes that were not yet approved. As a result, the drug was easily accessed by a number of people, including healthcare providers, consumers, as well as insurer. It was not long before the drug was used to treat various illnesses, ranging from bipolar disorder to migraines.

Based on gathered data, around 10% to 20% of prescriptions account for off-label purposes. FDA regulations do not quite match results yet, that is why a number of doctors get way with prescribing off-label drugs. However, such practice may lead to undesirable circumstances.

A study including 46,000 patients’ health records showed that an estimated 80% of off-label prescribed drugs are not complemented with concrete scientific evidence. in fact, it was discovered that patients who were medicated with off-label medications had higher tendency of suffering from side effects compared with those treated in accordance with guidelines implemented by FDA.

As advised by Mayo Clinic, both treatment effectiveness and risks should be considered before prescribing a specific medication to a patient. Some of the notable side effects associated with off-label drug use include drowsiness, depression, aggressive behavior, distrust, drowsiness, rapid mood changes, tremors, false sense of well-being, sexual dysfunction, and suicide.

It was not until 25 years later that adverse effects of using off-label Neurontin have been discovered. One patient, Caryl Westwood, was prescribed with Neurontin to treat her lower back pain. She used the drug for several months until she started suffering from insomnia, fog, and anxiety. Westwood went back to her doctor and found out that the drug given to her was not really for pain but was instead, a strong epilepsy medication.

Thus, despite lack of scientific proof, Westwood’s doctor prescribed Neurontin to her. Statistics taken in 2004 showed that around 90% of $2.7 billion sales of Neurontin can be attributed to off-label prescriptions. This result show that doctors manage to fill patient prescription even if the drugs are not proven to be effective in treating their diseases.

Pfizer was implicated the scandal involving off-label use of Neurontin, and they paid $430 million in settlement. However, off-label use of drugs did not stop afterward.

Millions of papers are afflicted by seizures, hot flashes, neuropathic pain, and restless leg syndrome. These conditions lead to need for drug that can alleviate relief from symptoms that are hard to live with. In 1993, gabapentin, which is marketed as Neurontin, was approved by US Food and Drug Administration. The medication was formulated in 2004 to fight epilepsy and provide pain relief.

After the drug was approved in the US, Parke–David, a daughter company of Pfizer, prodded physicians to prescribe gabapentin to their clients for purposes that were not yet approved. As a result, the drug was easily accessed by a number of people, including healthcare providers, consumers, as well as insurer. It was not long before the drug was used to treat various illnesses, ranging from bipolar disorder to migraines.

Based on gathered data, around 10% to 20% of prescriptions account for off-label purposes. FDA regulations do not quite match results yet, that is why a number of doctors get way with prescribing off-label drugs. However, such practice may lead to undesirable circumstances.

A study including 46,000 patients’ health records showed that an estimated 80% of off-label prescribed drugs are not complemented with concrete scientific evidence. in fact, it was discovered that patients who were medicated with off-label medications had higher tendency of suffering from side effects compared with those treated in accordance with guidelines implemented by FDA.

As advised by Mayo Clinic, both treatment effectiveness and risks should be considered before prescribing a specific medication to a patient. Some of the notable side effects associated with off-label drug use include drowsiness, depression, aggressive behavior, distrust, drowsiness, rapid mood changes, tremors, false sense of well-being, sexual dysfunction, and suicide.

It was not until 25 years later that adverse effects of using off-label Neurontin have been discovered. One patient, Caryl Westwood, was prescribed with Neurontin to treat her lower back pain. She used the drug for several months until she started suffering from insomnia, fog, and anxiety. Westwood went back to her doctor and found out that the drug given to her was not really for pain but was instead, a strong epilepsy medication.

Thus, despite lack of scientific proof, Westwood’s doctor prescribed Neurontin to her. Statistics taken in 2004 showed that around 90% of $2.7 billion sales of Neurontin can be attributed to off-label prescriptions. This result show that doctors manage to fill patient prescription even if the drugs are not proven to be effective in treating their diseases.

Pfizer was implicated the scandal involving off-label use of Neurontin, and they paid $430 million in settlement. However, off-label use of drugs did not stop afterward.

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Lyrica Patent Expiration

Can Pfizer Overcome Release Of Generic Version Of Lyrica

Loss of patent protection for Lipitor was a great downfall for Pfizer, that the company is now taking care of Lyrica (pregabalin). Lyrica became most popular in 2014, with $5.2 billion of sales to add to Pfizer’s profits. However, that same year, the drug lost exclusivity in European countries, and Pfizer was faced with worldwide decrease in sales of Lyrica. During the first 3 quarters of 2016, Lyrica accounted for 9.5% or $3.7 billion in total sales of Pfizer.

In the three quarters of 2016 indicated, Lyrica demonstrated an increase of 15% under Innovative Health, and such value amounted to $3.1 billion. Provided that Lyrica is protected by United States patent, its revenue is categorized under IH business. In the United States, revenue of Lyrica increased by 19% because of increasing volume and price.

However, product patent for Lyrica in United States is expected to expired in 2018. Afterward, people can only expect its revenue to fall. For people investing in iShares US Healthcare ETF, they may be given backdoor access to diversified exposure to Pfizer, which holds 6.6% of IYH’s total investments in assets.

LYRICA TAKES PART IN EH BUSINESS

Under Essential Health (EH) business, Lyrica’s demonstrated a decrease in revenue because of loss of patent protection in specific places in Europe. The decrease reached 33% to $623 million during the first three quarters of 2016. Lyrica was a former member of Peri-LOE products line-up, which includes those that are waiting to lose patent protection or have already lost it.

Lyrica’s competitors include Johnson & Johnson’s Topamax, GlaxoSmithKline’s Lamictal, and Shire’s Buccolam.

PREDICTIONS FOR PFIZER’S REVENUE

At present, Pfizer already suffers from 4.2% decrease in stocks. The company has made a number of acquisitions to redeem itself, but it seems that investors are not that interested with their offer. Pfizer is struggling revenue losses brought about by patent expiry of one its top line drug. The downtrend has been going on for five years not. In 2015, the company’s revenue was $48.9 billion, which was comparatively lower than the $67 billion it earned in 2010.

However, Pfizer seems to be unable to recover no how much more asset it acquires. In 2016, the expected revenue for the company is $52.9 billion, which is 8.3 increase from that of previous year. For 2017 and 2018, the expected increases are $55.4 billion and $57 billion, respectively. Pfizer’s growth is assumed to depend on Ibrance, Xeljanz, Eliquis, and avelumab.

FACTORS THAT WILL DRIVE TOP LINE GROWTH

As previously described, Pfizer acquired multiple assets for the purpose of hastening its IH business growth. Some of the key assets that the company acquired include Crisaborole from Anacor Pharmaceuticals and Xtandi from Medivation.

Pfizer also acquired Hospira’s Sterile Injectables and AstraZeneca’s small-molecule anti-infective businesses.

For those who intending to invest, they should place their bets on ETFs, including iShares US Healthcare ETF. IYH accounts for 6.6% of ETF on Pfizer, 10.1% in Johnson & Johnson, and 4.9% in Merck & Co.

ADVICE OF ANALYSTS

Based on Reuters consensus involving 21 brokerage companies last December 2016, most analysts (61.9%) suggest buying on Pfizer. Among these analysts, 23.8% provided “strong buys” recommendations, whereas 38.1% suggested just “buys.” Meanwhile, a still considerable number of analysts (33.3%) gave “hold” ratings, whereas very few (4.8%) suggested “sells” on Pfizer stocks.

People may gain access to Pfizer through investment in VanEck Vectors Pharmaceutical ETF, whose 5% of total holdings is owned by Pfizer.

PFIZER’S MEAN TARGET PRICE

On December 8 last year, mean target price for Pfizer is $37.85, which indicates a 22.3% increase from the $30.94 closing price calculated on that same day.

However, mean price still showed a decrease compared with $39.58 estimated on September 8, 2016.

ANALYSTS’ SUGGESTIONS FOR PFIZER’S PEERS

Four analyst participated in a Reuters survey on December 8, 2016. One (25%) of them gave “strong buy” ratings on AstraZeneca, whereas three (75%) suggested “hold” on stocks. With mean target price of $34.12, investors may gain return potential of 29.9% in AstraZeneca in the coming year.

Another Reuters surveyed included 20 analysts. Among the participants, 40% recommended “buy” on Merck & Co., and the rest (60%) suggested “buy.” Mean target price Merck & Co. was $68 last December 8. This poses a potential return of 13.1% for its closing price of $60.12.

On December 8, 2016, Reuters consensus consisting of three analysts yielded results of 33.3% “buy” recommendations on Sanofi and 66.7% “hold” recommendations on stocks. A total of 33.3% was allotted for “strong buy” ratings for mean target price of $50.67 for Sanofi. This price has return potential of 27.4% in the coming year.

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Alternative Treatments

A Comparison Of Alternative Medicine To Known Medical Drugs

Experience of pain, trauma, and certain injuries normally force people to seek medication for their pain. However, there are cases when doctors resort alternative forms of pain management and decide to prescribe to their patients cheaper medications.

Sone well-known pain management practices include acupuncture, physical therapy, chiropractic therapy, neural stimulation, massage therapy, surgical intervention and other procedures which are specific for management or treatment of chronic pain. A number of doctors address pain issues of their patients by focusing on pain causes instead of providing short-term treatments.

The most common sites afflicted by chronic pain are the back, neck, shoulders, head, and the joints, especially in cases of degenerative joint disease. Meanwhile, muscles are more susceptible to pain in cases of fibromyalgia. Chronic pain is pain condition that afflicts a person for more than size months. Moreover, such pain is more general and cannot be linked to just one injury or trauma.

When treating patients with chronic pain, doctors should be quite honest regarding possible risks of taking medicines that they prescribe to their patients. Moreover, medical professionals should properly advise sick individuals when to stop lessening the amount or completely stop taking their prescribed medications. Monitoring medication intake of patients is important to avoid causing addiction. In cases of people taking oxycodone, when they become addicted to the drug, they may resort to using heroin when their doctors cease providing them with prescriptions.

Meanwhile, some doctors practice the habit of using alternative drugs for nerve-based pain to lessen risk for addiction of their patients. For example, patients taking gabatentin or neurontin, lyrica, or symbalta are less prone to being addicted compared when patients are prescribed with stronger counterparts of such drugs.

On the other hand, when patients seek treatment for their pain, they expect doctors to completely eliminate their pain problems after their consultation. However, the main task of physicians is to aid their clients in managing daily tasks while minimizing or relieving a portion of the pain that they feel.

That is why there are some doctors who advise their patients to exercise to remedy their pain. Physical activities aid in alleviating pain by strengthening surrounding muscles. However, people should allow some time to pass before they start noticing positive effects of engaging in physical exercises.

In addition, it is also important that doctors motivate their patients to stick to their pain management plan. As long as they stick to the plan, patients will soon be able to perform certain tasks without necessarily feeling too much pain. Though these tasks may seem simple to a normal person, accomplishing with less pain as possible is a great achievement for people suffering from chronic pain.

One example of method used for pain management is aquatic physical therapy, and a number of people benefitted from this procedure through increase in their mobility. Aquatic physical therapy is conducted in pools, where people feel more free performing physical movements because of the decreased pressure on their joints and within when they are submerged in water. In this type of therapy, doctors try out with their patients various techniques and determine which approach works best for them.

According to Tara Welty, a licensed acupuncturist, pain management is one way of addressing holistically people’s health. She claims that only people in the US have zero pain expectation, and this means that Americans have unusual standards when it comes to pain medication. In fact, they tend to think that their doctors will just pay actual attention to them when their pain level is beyond the scale of three.

On the other hand, when prescribing intervention-based therapeutic treatments, insurance is a great determining factor. Doctors realize the uselessness of prescribing effective treatments for patients whose insurance does not cover such procedures. Thus, it has become a great issue that insurance poses some restrictions regarding proper treatment for patients.

Meanwhile, some doctors find it hard to take insurance, especially when it seems that the government and health care system are more profit-oriented than health oriented.

As for patients suffering from chronic pain, some have already tried acupuncture as the treatment is one way of inhibiting use of prescriptions drugs, such as Vicodin, for management of chronic back pain. Some patients decided to undergo acupuncture, especially when their medications, such as naproxen, were ineffective in alleviating their pain. There are cases when people could not handle the pain on their body not until needles were used penetrate trigger points in specific trigger points, such as those in the feet.

Meanwhile, some patients had problems with their insurance companies, of which some do not cover alternative treatments. For instance, having an appointment with chiropractor is considered cosmetic need and not a medical one. Thus, in some cases, people resort to exercising at YMCA just so they can maintain the health and strength of their bodies.

Other chronic-pain sufferers opted to forego taking prescribed medications because of their negative side effects. For instance, some people felt worse after suffering from side effects of their medications. Thus, they opted to seek other treatment forms, such as those offered by chiropractors to alleviate their pain. In this case, being mindful of their diet is important. Patients of chiropractor are encouraged to eat food that enhance anti-inflammatory actions of their bodies.

Given the problem in opioid and opiate addiction caused by taking prescribed pain medications, more and more experts are hoping that people will finally realize the importance of prevention and intervention in alleviating and treating pain.

Thus, in addressing the problem of chronic pain, a number of people should be involved. Physicians as well as physical and behavioral therapists should collaborate with one another and prioritize patient health when developing treatment or management program.

Meanwhile, abuse of pharmaceutical systems is another issue faced by people who are seeking medical attention for their pain. It is better if doctors gain an audience in front of board of pharmaceutical companies. Doctors can then ask for reports that can help them identify patients who are prescribed with controlled substances. This way, they can prevent other physicians from giving their patients multiple prescriptions of certain drugs.

For those who want to learn more about pain management, they can ask their physicians regarding the following:

  • Physical therapy

  • Acupuncture

  • Neural stimulation

  • Surgical intervention

  • Psychiatric therapy

  • Yoga

  • Massage therapy

  • Aromatherapy

Meanwhile, people should be also aware of some medications with potential addictive effects:

  • Valium

  • Xanax

  • Opioids

  • Benzodiazepines

  • Oxycodone

  • Klonopin

  • Demerol

  • Percodan

  • Davrocet

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Marijuana For Back Pain

New York Knicks Phil Jackson Uses Medical Marijuana For Back

Given the multitude of alternatives for treating back pain, it is not impossible that people try some of them. One particular example is New York Knicks president Phil Jackson, who claimed using marijuana for alleviating his problem in back pain.

Jackson underwent back surgery in 1969–1970 campaign. During that time, his injury caused him to miss participating in entire season. While recovering from his surgery, Jackson said that marijuana served as pain reliever though he never considered the plant as part of his medication.

Recently, issues on marijuana and its use in pain relief recently arose because of Golden State Warriors head coach, Steve Kerr, who also used marijuana for managing his chronic back pain.

Meanwhile, compared with claims made by Jackson, Kerr stated that marijuana did nothing to relieve his back pain. However, he greatly believes that players should be taught regarding discipline of using marijuana as pain reliever.

Jackson claims that actions have been taken to stop marijuana use. However, decision has still needs to be made on whether players who use the product should be punished.

The situation has become a bit more complicated because several states have now legalized marijuana use. Moreover, there are test protocols that are strictly implemented in NBA, so most coaches and other members of the league are arguing regarding the law that must be followed within their organization. Still, they believe that in the near future, a certain decision must be made regarding marijuana use of NBA players.

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Potential Complications of Herniated Disc Surgery

hospital

 

Surgical treatments for herniated discs may be considered for patients who suffer from back pain. Spine specialists often recommend herniated disc surgery when pain in the lower back is evident along with the following symptoms:

  • leg pain that doesn’t improve after 4 weeks of non-surgical treatment
  • pain that is severe enough to interfere with normal activities and require strong pain medications
  • weakness, abnormal sensitivity, and loss of motion

Herniated disc surgery can be particularly tricky as it brings many potential health complications. Surgical treatments for herniated discs – such as discectomy, percutaneous discectomy, laminotomy, and laminectomy – can cause the following complications in patients:

  • Pre-surgery

Complications can develop from herniated discs even before the surgery begins. One of the most serious complications of herniated discs is cauda equina syndrome. This condition develops when a large chunk of disc material ruptures into the spinal canal, particularly in the area where the nerves for bowel and bladder control travel before they leave the spine. Excess pressure on these nerves may cause serious damage to them; as a result, you permanently lose the ability to control your bowels and bladder.

The good news is that cauda equina syndrome is relatively rare. If your doctor suspects that you’re developing this syndrome, he or she may recommend immediate surgery to relieve pressure on these nerves.

  • During surgery

Many complications may occur while the surgical procedure is performed. For instance, the anesthesia used during any type of herniated disc surgery may cause some complications in the patient. During the removal of a herniated disc, nerve injury or a dural tear may also ensue.

During any surgery on the spine, there is always a risk of nerve injury or nerve damage. Nerves may be damaged due to bruising or accidental scalpel cuts. The damage may also be caused by inflammation of the tissues around them. Surgical nerve damage can manifest post-surgery, as numbness, tingling, or weakness in the region of the damaged nerve or in other areas of the body. Difficulties in walking or changes in regular walking patterns may also be evident.

Dural tears, on the other hand, occurs when a tear develops in the watertight covering of the spinal cord and spinal nerves. This watertight sac of tissue is referred to medically as dura mater. Dural tears are not uncommon during spinal surgery; if they occur, the tear is simply repaired and the tear often heals without complications.

If a dural tear goes unnoticed, though, it continues to leak spinal fluid and cause problems down the road. Spinal headaches (caused by leaking spinal fluid) may occur and an increased risk of spinal meningitis (infection of the spinal fluid) occurs. A second surgery may also be carried out to repair the dura, if the dural leak doesn’t seal itself off on its own.

  • Post-surgery

In many cases, complications don’t arise until after the surgical procedure is completed. Some of these complications are immediately evident, while others may take weeks or even months to develop.

    • Infection. Infection may develop along the skin incision, inside the disc, or even in the spinal canal around the nerves. If the area around the skin incision is infected, the patient is usually prescribed antibiotics. If the infection is in the spinal canal or the disc itself, a second surgery may be needed to drain the infection, along with antibiotics after the surgery.
    • Re-herniation. Even with a successful herniated disc surgery, there’s always a chance (10% to 15%) of the same disc herniating again. A re-herniation usually occurs in the first six weeks after a surgery, but it can occur at any time. This may require a second surgery for treatment.
    • Degenerative disc disease. When a disc herniates, the spinal segment it’s in becomes more prone to degeneration. Herniated disc surgery may add to the injury, as the surgery removes a portion of the herniated disc. Many specialists say that patients have an increased risk of developing complications in the area where a disc has been removed. A second surgery may also be required if the degenerative process causes severe, immobilizing pain in the patient. It may take years for patients to develop degenerative disc disease.
    • Persistent pain. In some cases, back pain can’t be relieved even by surgery. There are many reasons pain may still be present after herniated disc surgery. Nerves may have suffered permanent damage from the pressure from disc herniation and lost the ability to recover. Scar tissue may also develop around the nerves in the weeks after the surgery and cause further back pain.
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When You Should Consider Back Surgery

patient

Back pain is becoming an increasingly common health problem these days. There are many remedies available for different kinds of back pain, ranging from home remedies, to massage and physical therapy, to anti-inflammatory medications. Sometimes, back pain resolves on its own within a couple of months.

In some cases, though, back pain is resolved through back surgery.

When back surgery is needed

Back surgery is not usually recommended by doctors because non-surgical treatments are usually effective. In the following cases, though, back surgery may be needed.

  • Persistent, severe back pain. Back pain sometimes doesn’t respond to conservative treatments. If the pain is persistent or severe enough to disable the patient, surgery is often required.
  • Pain and numbness has spread from the back down to one or both arms or legs. Numbness or pain in one or both arms or legs can be caused by the compression of nerves in your spine.

Nerve compression may be the result of many conditions, the most common of which are disk problems and bone overgrowth. With disk problems, bulging or herniated (ruptured) disks, which are the cushions between the bones of your spine, press to close against a spinal nerve. As a result, the spinal nerve’s function is affected. With bone overgrowth, on the other hand, bone spurs may develop on your spine as a result of osteoarthritis.

  • Loss of control over bowels and bladder. In some cases, like in the development of cauda equina syndrome, back problems result in the loss of control over the bowels and the bladder. This occurs when the nerves for the control of the bowels and bladder are damaged, mostly due to excess pressure from leaking material from herniated discs. This requires immediate attention through surgery, as it can become a permanent condition.

Even with advancements in medical knowledge and technology, pinpointing the exact cause of back pain remains difficult. Even if X-ray tests show that you have disk problems or bone spurs on your spine, these problems may not cause symptoms at all and therefore won’t require treatment. You may have to consult the opinion of two or more specialists before you can make a properly informed choice on back surgery.

Types of back surgery

There are many types of back surgery you can get, the most common of which are:

  • Laminectomy. This involves the removal of bones covering the spinal canal. The spinal canal is enlarged, to relieve the nerve pressure caused by spinal stenosis (the narrowing of spaces in the spine).
  • Diskectomy. This procedure aims to relieve the irritation and inflammation of nerves through the removal of the herniated portion of a disk. This usually involves the full or partial removal of the lamina (the back portion of a vertebra) to gain access to the ruptured disk.
  • Fusion. Spinal fusion is performed to permanently join two or more bones in the spine. This relieves pain and adds stability to a spinal fracture. In some cases, spinal fusion can relieve the painful movement between vertebrae, which can be caused by injured or degenerated disks.
  • Artificial disk implantation. The implantation of artificial disks is an alternative treatment for spinal fusion, as it also addresses the painful movement between vertebrae due to injured or degenerated disks. Unfortunately, this procedure involves generally new technology that aren’t available to many people.

Surgical procedures for treating back pain are largely elective, so you’ll have to consider whether you need back surgery at all. The truth is that only 5% of the 56 million Americans who suffer from lower back pain truly need surgery, according to studies by the Mayo Clinic.

Back surgery can cause a wide variety of complications, too, from surgical nerve damage, to dural tears and increased risk of spinal meningitis, to degenerative disc disease. In many cases, the surgical procedures aren’t even effective at easing lower back pain.

“An enormous number of back surgeries don’t give patients long-term relief,” says Charles Rosen, M.D., clinical professor of orthopedic surgery at the University of California, Irvine, School of Medicine.

Before you consider opting for back surgery, it’s always best to get a second or even third opinion from qualified spine specialists. A spine surgeon will also help you determine whether you need back surgery at all. These specialists may have differing points of view when it comes to the timing the operation and the specific surgical procedure needed, among other factors. You may also need to consult other health professionals for the diagnosis and treatment of pain in your arms or legs.

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10 Ways to Manage Back Pain at Home

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Back pain is one of the most common health problems among adults today. Recent studies actually show that one in four Americans have reported recent bouts of pain or discomfort in the back. And health experts even say that almost everyone can expect to experience some back pain at one point in their lives.

Back pain is caused by a number of reasons, like the lifting of heavy objects or degenerative conditions like arthritis. Unfortunately, even if back pain is common, it can be hard to get rid of. If you frequently suffer from mild levels of pain in your lower back, there are some home remedies that can help ease the discomfort. Try any of the following to manage back pain at home.

  • Put ice on it.

Ice is helpful in reducing inflammation as long as it’s applied in the first 24 to 48 hours after an injury, says E. Anne Reicherter, PHD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. Reicherter says that though the warmth can worse the inflammatory process, even though a hot water bottle on your sore muscles feels good because it helps cover up the pain and relax your muscles. When 48 hours have passed, you can switch to heat, if you prefer.

Whether you use an ice pack or a hot water bottle, it’s important that you take it off your skin after 20 minutes to let your skin rest. If the pain persists in your lower back, it might be time to talk to your doctor.

  • Be physically active.

“Our spines are like the rest of our body — they’re meant to move,” says Reicherter. Even with pain in your lower back, try to go through your normal everyday routine. Do your chores around the house, keep going to work, or even do some yardwork if the pain doesn’t significantly increase during these activities. Swimming, cycling, and walking keep your back more mobile, so these are great for when your back pain isn’t particularly severe.

Make sure to not overdo it, though. You won’t need to run a marathon to keep the back pain at bay. A moderate amount of activity is enough to keep your back mobile and help ease lower back pain.

  • Do exercises that work your back muscles.

Try to do back exercises, if your back pain isn’t at severe levels. This can help you avoid future episodes of back pain by strengthening the muscles that support your lower back, including the back extensor muscles. Reicherter says that these exercises also help you maintain proper posture and ensures that your spine is properly aligned. Hamstring stretches, partial crunches, wall sits, bridging, and knee-to-chest touches are all excellent workouts for your back muscles.

In addition to exercises for your back muscles, you might also want to do exercises for strengthening muscles in your hips, pelvic area, and abdomen. Avoid crunches, though, as these can actually put more strain on your back.

  • Stretch throughout the day.

Stretching is particularly important if your job requires you to sit in your desk chair all day. Try to get up every 20 minutes and stretch your back the other way. “Because most of us spend a lot of time bending forward in our jobs, it’s important to stand up and stretch backward throughout the day,” Reicherter says.

Remember to stretch your legs, too. Health experts say that some people are able to ease their back pain by doing a stretching routine, like yoga, daily.

  • Make sure your workspace is ergonomic.

Look around your office and make sure your computer is properly positioned so that you don’t have to hunch forward to look at your monitor or reach too far out to the side to use your mouse. Your desk chair makes a difference, too; make sure the chair you use provides support for your lower back, keeps your knees level with your hips, and lets you work with your feet planted firmly on the floor. Place a cushion between the curve of your lower back and the back of your chair, if needed. This ensures that your back is minimally strained as you work.

  • Fix your posture.

Having proper posture puts the least amount of strain possible on your lower back. Slumping actually makes it more difficult for your back to support your weight. It’s also important to be aware of your posture when lifting heavy objects. Rather than bending over from your waist to life that heavy box, bend and straighten from your knees. This can help you avoid throwing out your back when lifting heavy objects.

  • Wear low heels.

For many women, an outfit just isn’t complete without a pair of towering high heels. Unfortunately, chiropractors say that high heels, like those measuring three inches or higher, can create a more unstable posture and put more pressure on your lower spine. So you might want to exchange your four-inch pumps for flats or sandals. If you feel that your shoes must have a bit of height to them, make sure the heel height doesn’t exceed an inch or two.

  • Stop smoking.

Smoking has many negative effects on your health, including an increased risk for osteoporosis of the spine and other bone problems. Once you develop osteoporosis, you become more prone to compression fractures of the spine. Recent research even suggests that smokers are more likely to suffer from pain in the lower back compared with non-smokers.

  • Maintain a healthy weight.

Being overweight understandably puts more stress than necessary on your spine. For many health reasons, including the prevention of pain in the lower back, keeping yourself at the ideal weight for your height is important. Make sure your diet features only healthy food and get plenty of exercise so you can more easily manage your weight.

  • If all else fails, try an over-the-counter pain reliever.

There are many over-the-counter, anti-inflammatory drugs you can take to reduce back pain. Aspirin, ibuprofen (such as Advil, Motrin, Nuprin), and naproxen sodium (Aleve, Anaprox, Naprosyn) are all great at easing pain or discomfort in your lower back. Acetaminophen (Actamin, Panadol, and Tylenol) reportedly works great for managing pain in the lower back, too.

Before you take any over-the-counter medication, though, make sure to check with your doctor or pharmacist about potential side-effects, especially if you’re regularly taking other medications. For instance, people with a history of medical conditions in the kidney and liver may be recommended to avoid certain over-the-counter pain relievers.

The remedies listed above work best only for cases of mild levels of lower back pain. Sometimes, back pain is clearly serious and may cause additional discomfort such as weakness, numbness, or tingling in the legs. In such cases, it’s best to call a doctor as soon as you can.

Sometimes, back pain can be a symptom of a bigger, more serious medical condition, like nerve problems. You should also call your doctor if your lower back pain becomes severe and doesn’t go away after a few days. The same goes for back pain that persists even when you’re lying down or at rest or if you lose control over your bladder or bowels.

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Top Causes of Back Pain in Adults

backpain

Back pain is a common health problem in many adults, as this can manifest in individuals aged 30 to 60 years. Discomfort or pain in the muscles of the back can be caused by muscle strain in the lower back or from within the spinal disc space itself, like in lumbar disc herniation or lumbar degenerative disc disease.

If you’re an adult suffering from back pain, it might help to know what’s causing the pain in the first place. Read on for a description of the typical symptoms and causes of back pain in younger adults.

Symptoms:

  • Severe or persistent pain in the lower back that starts after activity, sudden movement, or lifting a heavy object.
  • The pain tends to be dull yet noticeable.
  • The pain may cause difficulty in moving, walking, or standing.
  • The pain moves around to the upper thigh, buttock, or groin, but rarely reaches below the knee.
  • Muscle spasms may result.
  • The area may be sore when touched.

Most common cause: back muscle strain

Health experts say that back muscle strain or ligament strain is one of the most common causes of acute lower back pain. Back muscle or ligament strain occurs when muscles or ligaments stretch or develop microscopic tears when you lift a heavy object, suddenly move, or even twist. With this type of back strain, the severity of the pain can range from mild discomfort to disabling pain, depending on the extent of the strain and the muscle spasms that result from the muscle strain.

Symptoms:

  • Back pain that moves to the buttock, leg, and foot (sciatica)
  • Ongoing, persistent pain (as opposed to pain that flares up for a few days or weeks and then subsides)
  • Pain is typically more severe and usually burns and tingles
  • Pain that is worse in the leg and foot than in the lower back
  • Pain may be accompanied by weakness, numbness, or difficulty moving the leg or foot
  • Typically felt only on one side of the buttock or leg
  • Pain that is worse after long periods of standing or sitting and is relieved when walking

Most common cause: lumbar herniated disc

Sciatica refers to the symptoms that result when a nerve root in the lower spine is compressed. This causes numbness and pain to travel along the large sciatic nerve, which also serves the buttocks, legs, and feet. In younger adults, sciatica is most commonly caused by a lumbar herniated disc but it can also be caused by other conditions such as isthmic spondylolisthesis, degenerative disc disease, and other conditions.

Symptoms:

  • Consistent pain in the lower back, worsened by episodes of severe pain or muscle spasms that last anywhere from a few days to a few months
  • Chronic pain that can range from dull to severe
  • Back pain that is worsened by sitting; walking or even running may feel better than sitting or standing
  • Frequently changing position helps relieve pain

Most common cause: degenerative disc disease

Individuals as young as 20 can suffer from lumbar degenerative disc disease. This disease is the result of lumbar discs between the vertebrae breaking down and becoming inflamed. This causes slight instability in the lower back, which in turn brings pain, muscle spasms, and, occasionally, sciatica. The good news is that lumbar degenerative disc disease is fairly common and can often be successfully treated.

Symptoms:

  • Deep, insistent ache in the lower back that worsens when standing or walking
  • The pain radiates into the buttocks and back of the thighs
  • The pain worsens when bending backward
  • The pain is alleviated when sitting, especially in a reclining position
  • A tired feeling in the legs, possibly numbness or tingling, especially after walking
  • Tight hamstrings (evident in the difficulty to touch the toes)

Most common cause: isthmic spondylolisthesis

Isthmic spondylolisthesis is the result of a vertebra in the low back slipping forward on the disc space below it. This condition most commonly occurs at the L5-S1 level and can cause pain in the lower back due to instability. Nerve root pain also occurs because of the compression of the nerve root. The fracture may occur in childhood, but will not normally create a noticeable amount of pain until the patient is a young adult.

Symptoms:

  • Pain in the lower back and/or buttocks or groin
  • Pain is most accurately described as an ache
  • Pain may radiate into the hips and thighs
  • The pain is worse when sitting and may be eased when reclining or lying down
  • Frequently changing positions may relieve the pain

Most common cause: sacroiliac joint disease

Disease or dysfunction in the sacroiliac joints can occur when there is too much or too little movement in the joints themselves. These joints connect the sacrum at the bottom of the spine to the hipbone on each side. Sacroiliac joint disease can be caused by a wide variety of conditions, including degenerative arthritis, pregnancy, and any condition that alters the normal walking pattern. Any disorder that affects the body’s joints, like gout, arthritis, and ankylosing spondylitis, can also cause inflammation in the sacroiliac joints.

Keep in mind that the symptoms and causes of back pain described above are not ultimately conclusive. It’s still best to consult your physician if you feel any unusual pain in your lower back or in any other back muscle.

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