4 Key Questions on Back Surgery and Arthritis for Senior Care


Back Health in Senior Care spine

Yesterday  my mom underwent a lumbar laminectomy for on-going and significant back and leg pain.   Recently a client of ours, a former physician, told me that this is now a common and usually very successful surgery.

My mom's surgeon reported that everything went well and she had little pain right after the surgery.  He did report that she has significant arthritis in her back, more than he had expected from the x-rays and MRI.  So, all of these got me thinking there was a lot of good information to be learned from her experience.  In this article I will cover 4 key topics:

  1. What are some of the ways the back, and especially the spine, changes with age?
  2. What is arthritis?
  3. What are the common treatments?
  4. How can you prevent these conditions?

What are some of the ways the back and spine change with age?

The "back" is mainly a collection of large muscles supported by the spine, through which runs all the nerves that lead out to all parts of the body.   Muscular disorders are a whole separate category and will not be covered here.  Rather, the spine, spinal cord, and nerves are where common forms of pain begin.

Nearly everyone will have some amount of degeneration of the spine in advanced aging.  However, some people will have no symptoms at all.  The most common symptoms are various types of pain as a result of the spine's bones (called vertebra) putting pressure on nerves.  Some common conditions include:

  • Spinal stenosis - this is what my mom suffered from and is a condition in which the spinal canal narrows and compresses the spinal cord and nerves
  • Osteoporotic compression fractures - fractures in the vertebrae often brought on by soft, weakened, thinning bones (osteoporosis); this is especially common in women over 50
  • Degenerative spondylolisthesis -  a condition whereby one vertebra slips forward over the one below it.  This condition occurs as a consequence of the general aging process in which the bones, joints, and ligaments in the spine become weak and less able to hold the spinal column in alignment
  • Adult scoliosis - when a person's spine twists and develops an "S"-shaped side-to-side curve, it  is a condition known as scoliosis.
  • Degenerative disc disease - one of the most common causes of low back pain.  Essentially, it is a progressive condition whereby the discs that cushion our spinal column deteriorates and becomes less of a shock absorber.

What is arthritis?

Arthritis is a category of disorders that all result in inflammation and pain in the joints or our bodies.  There are over 100 medical conditions in the category of arthritis.  The most common is osteoarthritis where the cartilage in our joints, which normally cushions our joints, loses is elasticity.  As the cartilage becomes damaged tendons and ligaments become stretched, causing pain. Eventually the bones may rub against each other causing very severe pain.

What are the common treatments?

Non-surgical options include:

  • Spinal Manipulation (by a chiropractor or osteopath)
  • Exercise Programs
  • Wearing a Brace
  • Pain medication and anti-inflammatory drugs
  • Epidural Steroid Injections where a small amount of steroids (which reduce inflammation) is  injected into the region around the spinal nerves.

Surgical options include:

  • Discectomy - surgical removal of all or part of a disc
  • Foraminotomy - a surgical procedure that takes pressure off of a nerve in your spinal column and allows the spine to move more easily
  • IntraDiscal Electrothermal Therapy (IDET)  - Its purpose is to reduce low back pain caused by the lumbar disc. IDET is an outpatient procedure performed with local anesthesia and light sedation. This invasive procedure utilizes fluoroscopic (x-ray) guidance to thread an electrothermal catheter through a needle into the lumbar disc. When the catheter
    is in place, power is turned on and the disc is heated for 15 to 20 minutes.
  • Nucleoplasty - a procedure to decompress a disc
  • Radiofrequency Lesioning  - a procedure  in which a portion of nerve tissue is heated to cause an interruption in pain signals and reduce pain in that area.
  • Spinal Fusion -  correction of an unstable part of the spine by joining two or more vertebrae; usually done surgically but sometimes done by traction or immobilization
  • Spinal Laminectomy - a part of the lamina (a part of the vertebra) is removed or trimmed to widen the spinal canal and create more space for the spinal nerves

How can you prevent these conditions?

As I write in many blogs, despite my own aversion to it, exercise is one of the key ways to prevent back problems.  Others include:

  • Maintain a healthy weight
  • Make sure your mattress properly supports your back (i.e. don't let it wear out)
  • Stretch before getting out of bed
  • Wear supportive shoes
  • Sit in a supportive chair that includes armrests

You can find many more back pain prevention ideas at this web site.

As for preventing arthritis:

  • Drink plenty of water (to support the cartilage)
  • Get enough calcium in your diet
  • Take a multi-vitamin daily (especially Vitamins C and D support joint health)
  • Take Flaxseed Oil as a supplement
  • Do yoga or other stretching as part of your exercise routine
  • Treat injuries promptly and adequately to avoid later in life complications such as arthritis
  • Reduce repetitive motions
  • Do not smoke - it weakens bone health and structure
  • Avoid drinking excessive alcohol

For more information:

A New York spine surgery practice has a great web site with an overview of spine aging where you can find more details.

You can also find much more information at www.spine-health.com.

Here's to your healthy back!