An Experts Guide to Avoiding Back Pain

Deciding whether to have spine surgery

By Alan S. Hilibrand, MD | Featured on AAOS

Orthopaedic surgeons encourage “shared decision-making” when it comes to treating patients, because the doctor and patient each provide information needed to make a decision about surgery.

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Physical Therapy For Lower Back Pain - 10 Best Exercises For Relief

Physical Therapy For Lower Back Pain – 10 Best Exercises For Relief

When you have a sedentary lifestyle, there are several problems that you might suffer. One of the most common issues is a problem with the lower back, which can be excruciatingly painful. Thankfully, a few easy exercises can offer relief. When you do them consistently, these exercises can give you long-term relief from chronic lower back pain. Here are ten exercises your physical therapist might suggest you use. Make sure you follow their instructions – these are just summaries.

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The Best Exercises for Spinal Cord Injury Survivors

The Best Exercises for Spinal Cord Injury Survivors

By Erin Jones | Article Featured on US News

AFTER A SPINAL CORD injury, it’s no surprise that life changes. Even daily tasks, like getting dressed in the morning, may become more difficult. Depending on a patient’s injury, however, certain exercises can help those with spinal cord injuries improve function and adapt to using a wheelchair.

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How Does a Surgeon Fix Scoliosis?

How Does a Surgeon Fix Scoliosis?

Most scoliosis surgeons agree that children who have very severe curves (45-50° and higher) will need surgery to lessen the curve and prevent it from getting worse.

The operation for scoliosis is a spinal fusion. The basic idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone.

With the tools and technology available today, scoliosis surgeons are able to improve curves significantly.

Surgical Treatment for Scoliosis

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

Common Questions About Spinal Fusion for Scoliosis

What is involved with a spinal fusion surgery?

In a spinal fusion, the curved vertebrae are fused together so that they heal into a single, solid bone. This will stop growth completely in the abnormal segment of the spine and prevent the curve from getting worse.

All spinal fusions use some type of bone material, called a bone graft, to help promote the fusion. Generally, small pieces of bone are placed into the spaces between the vertebrae to be fused. The bone grows together — similar to when a broken bone heals.

Metal rods are typically used to hold the spine in place until fusion happens. The rods are attached to the spine by screws, hooks, and/or wires.

Exactly how much of the spine is fused depends upon your curve(s).

What is a bone graft?

A bone graft is primarily used to stimulate bone healing. It increases bone production and helps the vertebrae heal together into a solid bone.

In the past, a bone graft harvested from the patient’s hip was the only option for fusing the vertebrae. This type of graft is called an autograft. Harvesting a bone graft may require an additional incision during the operation. It increases the length of surgery and can cause increased pain after the operation because of an additional region of the pelvis being included in the procedure.

One alternative to harvesting a bone graft is an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank.

Today, several artificial bone graft materials have also been developed.

How long does the surgery take?

Most fusions last from 4 to 8 hours, depending on the size of the patient’s curve and how much of the spine needs to be fused.

How much pain will I be in after surgery?

The amount of pain people report after surgery varies a great deal from patient to patient. The surgery is a major procedure that involves moving muscles and realigning the skeleton.

The first few days are usually quite uncomfortable, but most people improve rapidly by the third or fourth day, and they can walk around, and get in and out of bed well enough to go home. The pain continues to improve gradually and most teenagers can return to school by 2 to 4 weeks after surgery.

Mild pain may persist, but by 3 to 6 weeks after surgery, pain medicine should no longer be necessary.

What type of pain control will there be after the operation?

Pain control varies between different doctors and hospitals. In many cases, a PCA (patient controlled anesthesia machine) is used, which injects a small dose of pain medicine intravenously when you push a button. Some surgeons use an intravenous catheter (small plastic tube placed in a vein) to provide the medication in larger but less frequent doses. The pain relief system that your doctor is accustomed to using is probably the safest and most reliable for you after surgery.

On the second or third day after surgery, your doctor will most likely change your medication to pills or liquid pain relievers taken by mouth. These medicines are an opiate (morphine-like medicine.) Because these medications are known to be addictive if taken for a long time, you will be encouraged to switch to acetaminaphen as soon as possible after you go home.

Do the rods and other implants stay in my spine even after it has fused?

If rods are used in a fusion, they usually do not need to be removed. Very few people require rod removal, and this may be for a variety of reasons such as infection or broken rod.

Will fusion make my back stiff and unable to move?

The fused portion of your back will be permanently stiff. Most people have enough motion in the unfused portion of their backs to perform all activities of daily living and most sports. If you participate in activities that require a tremendous amount of flexibility, it may take awhile to adapt. Most people find that within a year or so their backs begin to feel “normal” when participating in those activities.

Can I have my scoliosis corrected without a fusion?

We wish that we had a method and materials that would straighten the spine and also allow normal motion between all the bones. Unfortunately, we do not have this capability. Anything we put in to hold the spine straight, also makes the spine stiff in the area of surgery.

Common Questions About Surgical Recovery

Most patients are in the hospital for 4 to 7 days, out of school for 2 to 4 weeks, and back into activities in 2 to 6 months.

How long do patients need pain medication after being discharged home?

Most surgeons prescribe strong pain medicines to patients after scoliosis surgery. Patients who have not used opiate pain killers before usually stop needing them within 2 to 4 weeks after surgery. If the patient has used these medicines frequently before surgery, it may take longer to stop needing them.

It is best to stop taking these strong medicines as soon as possible because they can be addictive if taken for long periods of time.

What limitations will I have right after surgery?

Your surgeon will detail any limitations you have after surgery. Most patients will be asked to avoid heavy lifting and to minimize the amount of bending forward for the first 6 to 12 weeks.

Does surgery lead to permanent restrictions on activities?

No, most patients are able to return to all their favorite activities and sports.Most patients return to non-contact sporting activities (running, weightlifting, exercises) approximately 4 to 6 months after surgery.

Before returning to all activities, including contact sports, the spine must be fully healed. It typically takes 6 to 12 months after surgery to obtain a solid fusion of the spine and get back to all activities.

Will I be able to walk after surgery?

Yes. Some patients may need physical therapy after surgery, but they are able to walk when they are discharged from the hospital.

When can I go back to school after the operation?

Most children miss between 2 to 4 weeks of school after surgery. It typically takes about 4 weeks before the spine is healed enough for carrying a backpack.

When will I be allowed to drive a car?

You will not be able to drive a car until you have healed well enough from surgery. In addition to being off of your narcotic pain medicines, you need to be moving around well enough to be safe. This typically takes 6 or more weeks.

When can I start hanging out with my friends again?

Your friends can visit you after surgery in the hospital and at home. Going out with your friends — like to school functions or the movies — can occur after you are off all pain medications and are feeling back to normal (this usually happens about 4 weeks after surgery).


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Scoliosis Treatment, Causes, Symptoms & Surgery

Scoliosis Treatment, Causes, Symptoms & Surgery

Medical Author: Charles Patrick Davis, MD, PhD | Medical Editor: Melissa Conrad Stöppler, MD | Article Featured on MedicineNet

What is scoliosis?

Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve in the spine seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side of the body, and the bones of the spine twist on each other, forming a “C” or an “S” shape in the spine.

Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over about 10 years of age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curves from one generation to the next.

What causes scoliosis?

Scoliosis affects about 2% of females and 0.5% of males. In most cases, the cause of scoliosis is unknown (known as idiopathic). This type of scoliosis is described based on the age when scoliosis develops, as are other some other types of scoliosis.

  • If the person is less than 3 years old, it is called infantile idiopathic scoliosis.
  • Scoliosis that develops between 3-10 years of age is called juvenile idiopathic scoliosis.
  • People who are over 10 years old (10-18 years old) have adolescent idiopathic scoliosis.

More than 80% of people with scoliosis have idiopathic scoliosis, and the majority of those are adolescent girls; the most common location for scoliosis is in the thoracic spine.

Medical literature often has more specific names or terms for scoliosis:

  • Kyphoscoliosis: a combination of outward and lateral spine curvature
  • Dextroscoliosis: curvature of the spine to the right
  • Rotoscoliosis (rotatory): curvature of the vertebral column turned on its axis
  • Levoconvex: curvature of the spine to the left
  • Thoracolumbar: curvature related to both the thoracic and lumbar regions of the spine

What are the causes of other types of scoliosis?

As stated above, idiopathic scoliosis and its subtypes comprise over 80% of all scoliosis patients. However, there are three other main types of scoliosis:

  • Functional: In this type of scoliosis, the spine is normal, but an abnormal curve develops because of a problem somewhere else in the body. This could be caused by one leg being shorter than the other or by muscle spasms in the back.
  • Neuromuscular: In this type of scoliosis, there is a problem when the bones of the spine are formed. Either the bones of the spine fail to form completely or they fail to separate from each other during fetal development. This type of congenital scoliosis develops in people with other disorders, including birth defects, muscular dystrophy, cerebral palsy, or Marfan syndrome (an inherited connective tissue disease). People with these conditions often develop a long C-shaped curve and have weak muscles that are unable to hold them up straight. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more severe and needs more aggressive treatment than other forms of scoliosis.
  • Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to arthritis known as spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.

There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce the amount of pressure applied to the tumor. This can lead to a spinal deformity. In addition, researchers suggest that genetics (hereditary), muscle disorders, and/or abnormal fibrillin metabolism may play a role in causing or contributing to scoliosis development.

What are risk factors for scoliosis?

Age is a risk factor as the symptoms often begin between 9-15 years of age. Being a female increases the risk of scoliosis, and females have a higher risk of worsening spine curvature than males. Although many individuals who develop the problem do not have family members with scoliosis, a family history of scoliosis increases the risk of the disease.

What are scoliosis symptoms and signs?

The most common symptom of scoliosis is an abnormal curve of the spine. Often this is a mild change and may be first noticed by a friend or family member or physician doing routine screening of children for school or sports. The change in the curve of the spine typically occurs very slowly so it is easy to miss until it becomes a more severe physical deformity. It can also be found on a routine school screening examination for scoliosis. Those affected may notice that their clothes do not fit as they did previously, they may notice an uneven waist, or that pant legs are longer on one side than the other.

Scoliosis may cause the head to appear off center, leaning to one side or notice one hip or shoulder to be higher than the opposite side. Someone may have a more obvious curve on one side of the rib cage on their back from twisting of the vertebrae and ribs. If the scoliosis is more severe, it can make it more difficult for the heart and lungs to work properly. This can cause shortness of breath and chest pain.

In most cases, scoliosis is not painful, but there are certain types of scoliosis than can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. Additionally, there are other causes of these nonspecific pains, which a doctor will want to look for as well to rule out other diseases.

What tests to health care professionals use to diagnose scoliosis?

If someone thinks he or she has scoliosis, see a doctor for an examination. The doctor will ask questions, including if there is any family history of scoliosis, or if there has been any pain, weakness, or other medical problems.

The physical examination involves looking at the curve of the spine from the sides, front, and back. The person will be asked to undress from the waist up to better see any abnormal curves, physical deformities, or uneven waist. The person will then bend over trying to touch their toes. This position can make the curve more obvious. The doctor will also look at the symmetry of the body to see if the hips and shoulders are at the same height, leaning to one side, or if there is sideways curvature. Any skin changes will also be identified that can suggest scoliosis due to a birth defect. A doctor may check your range of motion, muscle strength, and reflexes.

The more growth that a person has remaining increases the chances of scoliosis getting worse. As a result, the doctor may measure the person’s height and weight for comparison with future visits. Other clues to the amount of growth remaining are signs of puberty such as the presence of breasts or pubic hair and whether menstrual periods have begun in girls.

If the doctor believes a patient has scoliosis, the patient could either be asked to return for an additional examination in several months to see if there is any change or the doctor may obtain X-rays of the back. If X-rays are obtained, the doctor can make measurements from them to determine how large of a curve is present. This can help decide what treatment, if any, is necessary. Measurements from future visits can be compared to see if the curve is getting worse.

It is important that the doctor knows how much further growth the patient has left. Additional X-rays of the hand, wrist, or pelvis can help determine how much more the patient will grow. If a doctor finds any changes in the function of the nerves, he or she may order other imaging tests of your spine, including an MRI or CT scan to look more closely at the bones and nerves of the spine.

What types of specialists treat scoliosis?

Usually, a person’s primary care or pediatric physician notices the problem and consults an orthopedic surgeon or neurosurgeon who specializes in spine surgery. In addition, a rehabilitation specialist and/or a physical therapist may be consulted. Some patients may need a neurologist or an occupational therapist as part of the treatment team.

What is the treatment for scoliosis?

Treatment of scoliosis is based on the severity of the curve and the chances of the curve getting worse. Certain types of scoliosis have a greater chance of getting worse, so the type of scoliosis also helps to determine the proper treatment. There are three main categories of treatment: observation, bracing, and surgery. Consequently, there are treatments available that do not involve surgery, but in some individuals, surgery may be their best option.

Functional scoliosis is caused by an abnormality elsewhere in the body. This type of scoliosis is treated by treating that abnormality, such as a difference in leg length. A small wedge can be placed in the shoe to help even out the leg length and prevent the spine from curving. There is no direct treatment of the spine because the spine is normal in these people.

Neuromuscular scoliosis is caused by an abnormal development of the bones of the spine. These types of scoliosis have the greatest chance for getting worse. Observation and bracing do not normally work well for these people. The majority of these people will eventually need surgery to stop the curve from getting worse.

Treatment of idiopathic scoliosis usually is based on the age when it develops.

In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared on future visits to determine if the curve is getting worse. Bracing is not normally effective in these people.

Juvenile idiopathic scoliosis has the highest risk for getting worse of all of the idiopathic types of scoliosis. Bracing can be tried early if the curve is not very severe. The goal is to prevent the curve from getting worse until the person stops growing. Since the curve starts early in these people, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery.

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve or Cobb angle stays below about 20-25 degrees (Cobb method or angle, is a measurement of the degree of curvature), no other treatment is needed. The patient may return to see the doctor every three to four months to check for any worsening of the curve. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and the patient is still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

As explained above, scoliosis is not typically associated with back pain. However, in some patients with back pain, the symptoms can be lessened with physical therapy, massage, stretches, and exercises, including yoga (but refraining from twisting pressures on the spine). These activities can help to strengthen the muscles of the back. Medical treatment is mainly limited to pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) and anti-inflammatory injections. These treatments are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.

What is the treatment for scoliosis? (Continued)

There are several different types of braces available for scoliosis. Some need to be worn nearly 24 hours a day and are removed only for showering. Others can be worn only at night. The ability of a brace to work depends on the person following the instructions from the doctor and wearing the brace as directed. Braces are not designed to correct the curve. They are used to help slow or stop the curve from getting worse with good back brace management treatment. Intermittent or chronic discomfort may be a side effect of any treatments used to slow or correct the spinal curvature.

If the curve stays below 40 degrees until the person is finished growing, it is not likely to get worse later in life. However, if the curve is greater than 40 degrees, it is likely to continue to get worse by 1-2 degrees each year for the rest of the person’s life, a long-term effect of the disease. If this is not prevented, the person could eventually be at risk for heart or lung problems. The goals of surgery for scoliosis are as follows: correcting and stabilizing the curve, reducing pain, and restoring a more normal curve and appearance to the spinal column.

Surgery involves correcting the curve back to as close to normal as possible and performing a spinal fusion to hold it in place. This is done with a combination of screws, hooks, and rods that are attached to the bones of the spine to hold them in place. The surgeon places bone graft around the bones to be fused (spinal fusion) to get them to grow together and become solid. This prevents any further curvature in that portion of the spine. In most cases, the screws and rods will remain in the spine and not need to be removed. There are many different ways for a surgeon to perform the fusion surgery. It may be all performed from a single incision on the back of the spine or combined with another incision along your front or side. This decision is based on the location and severity of the curve.

Surgery recovery and scar formation varies some from person to person. A doctor will use medications to control the patient’s pain initially after surgery. A patient will likely be up out of bed to a chair the first day after surgery and will work with a physical therapist who will assist him or her in walking after the surgery. As the patient continues to recover, it is important to improve muscle strength. The physical therapist can help the patient with exercises for the muscles that will also help with the pain. Typically, a young person will miss about six weeks of school and may take about six months to return to their normal activities, although recovery time varies between individuals.

As with any surgery, there are risks of surgery for scoliosis. The amount of risk depends partially on the patient’s age, the degree of curve, the cause of the curve, and the amount of correction attempted. In most cases, the surgeon will use a technique called neuromonitoring during surgery. This allows the surgeon to monitor the function of the spinal cord and nerves during surgery. If they are being placed at increased risk of damage, the surgeon is alerted and can adjust the procedure to reduce those risks. There is a small risk of infection with any surgery. This risk is decreased with the use of antibiotics, but it can still occur in some cases. Other potential risks include injury to nerves or blood vessels, bleeding, continued curve progression after surgery, broken rods or screws, and the need for further surgery. Each of these is rare.

If a tumor such as osteoid osteoma is the cause of the scoliosis, surgery to remove the tumor is generally able to correct the curve.

People with degenerative scoliosis will often have more complaints of back pain and leg pain. This is related to the arthritis in the back and possible compression of the nerve roots that lead to the legs. Nonoperative treatment including physical therapy, exercises, and gentle chiropractic can help relieve these symptoms in some cases. People who fail to improve with these treatments may benefit from surgery. X-rays and possible MRIs will be obtained to plan for surgery. The surgery could include only a decompression or removal of bone spurs that are compressing the nerves. In some cases, a fusion will be necessary to stabilize the spine and possibly correct the abnormal curve. The cost of scoliosis surgery can be high; according to the Spinal Cord Society of surgeons, an average cost per operation (rod implants to straighten the spine) is $150,000 and may be higher or lower depending on the individual procedure.

Are there home remedies for scoliosis?

There are many home remedies that have been described for scoliosis; some involve herbal treatments, diet therapy, massage, physical therapy, stretches, certain exercises, and nutritional supplements like L-selenomethionine. A mattress that is composed of latex, memory foam, or cool gel (latex mattress infused with gel retains less heat than latex alone, also termed gel memory foam) and is adjustable (height of head and foot of bed can be adjusted) is recommended by some clinicians and patients. Patients are advised to discuss these treatments, especially exercises, with their doctor before starting any home remedies. Medical treatments are mainly over-the-counter pain medications when needed. Home remedies and medical treatments may reduce discomfort but do not provide a cure for scoliosis.

What is the prognosis for scoliosis?

School screening programs have helped to identify many cases of scoliosis early. This allows people to be treated with either observation or bracing and avoid the need for surgery in many cases. Most people with scoliosis can live full, productive, and normal lives with a relatively normal life expectancy. People with scoliosis are able to become pregnant and have children with no increased risk for complications. They may be at increased risk for additional low back pain during pregnancy. In general, as the degree of spine curvature increases, the prognosis worsens.

Newer advances in surgery have allowed for less invasive surgical methods that have less pain and shorter recovery periods. Surgery recovery time depends on the specific procedure that is performed; some may require an extended hospital stay with an in-patient stay at a rehabilitation facility (several weeks) while others may recover quickly and not require a rehabilitation facility. These techniques are still being developed, but the initial results are very promising.

Occasionally, untreated scoliosis can lead to deformity of the spine that is severe, painful, and result in the individual being unable to work or walk normally. Scoliosis may very rarely compromise breathing and cause death. Complications of pain and infections may rarely occur with treatments but may occur with surgery. Occasionally, patients are too optimistic about their treatments so patients are advised to discuss their expectations and follow up with their doctor to better understand the long-term prognosis and effects of their treatment.

The life expectancy has been reported to be reduced possibly by about 14 years in some individuals, especially those with more severe Cobb angle that is untreated but not all specialists agree with this controversial conclusion. Other clinicians either choose to avoid the controversy and say nothing while others suggest most people will have a near normal life span. Each individual with scoliosis should ask their treating physician about their life expectancy and potential for quality of life in the future with or without various treatment options.

Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

By Len Canter | Article Featured on US News

Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery: When is it a good idea?

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery can help relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own within three months.

Low back pain is one of the most common ailments seen by family doctors. Back problems typically respond to nonsurgical treatments — such as anti-inflammatory medications, heat and physical therapy.

Back surgery might be an option if conservative treatments haven’t worked and your pain is persistent and disabling. Back surgery often more predictably relieves associated pain or numbness that goes down one or both arms or legs.

These symptoms often are caused by compressed nerves in your spine. Nerves may become compressed for a variety of reasons, including:

  • Disk problems. Bulging or ruptured (herniated) disks — the rubbery cushions separating the bones of your spine — can sometimes press too tightly against a spinal nerve and affect its function.
  • Overgrowth of bone. Osteoarthritis can result in bone spurs on your spine. This excess bone most commonly affects the hinge joints on the back part of the spinal column and can narrow the amount of space available for nerves to pass through openings in your spine.

It can be very difficult to pinpoint the exact cause of your back pain, even if your X-rays show that you have disk problems or bone spurs. X-rays taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Different types of back surgery include:

  • Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. Diskectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
  • Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
  • Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
  • Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. But these relatively new devices aren’t an option for most people.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons may hold different opinions about when to operate, what type of surgery to perform and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

An Experts Guide to Avoiding Back Pain

An Expert’s Guide to Avoiding Back Pain

Article BY ROBERT PREIDT | Featured on US News

Back pain is a common problem in the United States, but there are ways to protect yourself, an expert says.

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Common Orthopedic Injuries & Conditions Frequently Asked Questions

Article Featured on OCPBC

What is the difference between a sprain and a strain?

A strain occurs when a muscle or tendon is stretched or torn. A sprain occurs when a ligament is stretched or torn.

Strains are often the result of overuse or improper use of a muscle, while sprains typically occur when a joint is subjected to excessive force or unnatural movements (e.g., sudden twists, turns, or stops). Sprains can be categorized by degree of severity:

  • A first-degree sprain stretches the ligament but does not tear it. Symptoms include mild pain with normal movement.
  • A second-degree sprain is characterized by a partially torn ligament, significant pain and swelling, restricted movement, and mild to moderate joint instability.
  • In a third-degree sprain, the ligament is completely torn with mild to severe pain, swelling, and significant joint instability.

What is sciatica?

In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

What is spinal stenosis?

Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine’s vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers.

As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.

What is degenerative disk disease?

Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).

Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur.

Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.

What is a torn rotator cuff?

The rotator cuff is a group of tendons and their related muscles that help keep the shoulder and upper arm bone securely placed in to the socket of the shoulder blade. The rotator cuff stabilizes the shoulder joint and helps you to move your arm in space.

What is shoulder impingement?

Impingement syndrome is a common disorder of the shoulder that refers to an improper alignment of the bones and tissues in the upper arm. Inflammatory conditions such as tendinitis, bursitis, and arthritis are all closely related to impingement syndrome, as are tears to the rotator cuff tendons.

If the rotator cuff becomes inflamed from overuse or there is a bone deformity or spur on the end of the shoulder blade, then the space between the upper arm bone and tip of the shoulder blade is narrowed, causing the rotator cuff and its fluid-filled bursa to be squeezed or pinched. This impingement causes irritation and pain to the rotator cuff when the shoulder is raised.

What is frozen shoulder?

Frozen shoulder (adhesive capsulitis) is a condition in which the tissues around the shoulder joint stiffen, scar tissue forms, andSeparated Shouldershoulder movements become difficult and painful. It can develop when you stop using the joint normally because of pain, other injury, or a chronic health condition, such as diabetes. Any shoulder problem can lead to frozen shoulder if you do not work to maintain its full range of motion.

What is a separated shoulder?

A shoulder separation (acromioclavicular joint injury) occurs when the outer end of the collarbone separates from the end of the shoulder blade because of torn ligaments. This injury occurs most often from a blow to the shoulder or a fall on a shoulder or outstretched hand or arm.

What is a dislocated shoulder?

A shoulder dislocation (shoulder instability) occurs when the upper end of the arm bone ball pops out of the shoulder joint socket. This injury may be caused by a direct blow to the shoulder, a fall on an outstretched hand or arm, or an exaggerated overhead throwing motion.

What are shin splints?

Shin splints are an inflammation of the periosteum, a fibrous sheath that surrounds bone. In this case, the affected bone is the shin bone, or tibia. Shin splints are usually accompanied by pain and swelling in the front of the lower leg. Most frequent in runners, this overuse injury is caused by the repetitive stress of running on hard surfaces.

What is a torn ACL? MCL?

There are four ligaments in the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The ACL and PCL stabilize front-to-back knee movements, while the MCL and LCL stabilize side-to-side movements.

The ACL can be sprained or torn if the knee is straightened beyond its normal limits (hyperextended), twisted, or bent side-to-side. A sprained or torn ACL is common in sports and usually results from a hard stop or aggressive twisting of the knee. The PCL is the least common ligament to be injured.

The MCL is injured when a force is exerted on the outside of the knee, pushing it inward, while the LCL is injured by a force exerted on the inside of the knee that pushes it outward. This type of hit is frequent in contact sports like football or hockey.

A torn knee ligament is usually accompanied by feeling or hearing a pop in the knee at the time of injury, severe pain and swelling, and joint instability.

What are muscle spasms?

When muscles become inflamed, they can also spasm, or contract tightly, as a response to injury. While they are the body’s way of protecting itself from further injury, they often produce excruciating and often debilitating pain. Muscle spasms are common in the low back (lumbar) muscles.

What is a torn meniscus?

The medial and lateral menisci (plural of meniscus) of the knee are two crescent moon-shaped disks of tough tissue that lie between the ends of the upper leg bone and lower leg bone that form the knee joint. Meniscus tears commonly occur during sports when the knee is twisted while the foot is planted firmly on the ground. In people over the age of 40 whose menisci are worn down, a tear might occur with normal movement, minimal activity, or minor injury.

What is tendinitis?

Teninitis is inflammation of a tendon, a band of tissue that connects muscle to bone. It is most commonly the result of overuse during physical activities. Repetitive motions can stretch and irritate the tendon, causing pain and swelling. Tendinitis occurs around joints such as the elbow, shoulder, wrist, ankle, or knee.

What is bursitis?

Bursitis is inflammation of a bursa or bursae (more than one bursa), small fluid-filled sacs that cushion areas of friction around joints. Bursae contain synovial fluid that lubricates the joints. Bursitis typically occurs as a result of overuse during physical activities or infection of the synovial fluid. If a bursa becomes infected or irritated from repetitive stress, it will cause pain and limited movementJoint Pain. Bursitis is most common in the shoulder, knee, hip, elbow, or heel.

What is arthritis?

The most common form of arthritis, osteoarthritis, can affect any joint in the body, but most often afflicts the knees, hips, and fingers. Most people will develop osteoarthritis from the normal wear and tear on the joints through the years. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff after long periods of activity or inactivity.

What is a stress fracture?

A stress fracture is a microscopic crack in a bone that occurs from overuse. Muscles normally absorb the shock of physical activities, but when they become too fatigued to do so, they transfer the stress to the bones which results in a hairline-sized fracture.

Stress fractures usually develop in the weightbearing bones of the feet and lower legs, often after a rapid increase in the duration or intensity of exercise or from wearing improper or worn out athletic shoes.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is the term used to describe a specific group of symptoms (tingling, numbness, weakness, or pain) in the fingers or hand and occasionally in the lower arm and elbow. These symptoms occur when there is pressure on a nerve (median nerve) within the wrist (carpal tunnel). Carpal tunnel syndrome develops over time because of repetitive hand motions that damage muscle and bone in the wrist area.

What is tennis elbow?

Lateral epicondylitis, commonly known as tennis elbow, is inflammation of the tendon that connects the muscles of the forearm, wrist, and hand to the upper arm at the elbow. The tendon on the bony outside (lateral) part of the elbow (the epicondyle) is most often irritated by overuse during physical activity.

What is plantar fasciitis (heel spur)?

Plantar fasciitis is the most common cause of heel pain. It is commonly referred to as a heel spur, although a heel spur, or bony growth on the heel bone, develops as a result of plantar fasciitis. The condition occurs when the long, flat ligament on the bottom of the foot (plantar fascia) stretches irregularly and develops small tears that cause the ligament to become inflamed. This inflammation is most often caused by walking with an abnormal inward twisting of the foot, called pronation. Over time, this slightly abnormal step may increase tension on the plantar fascia and cause it to become inflamed.

What is a ruptured Achilles tendon?

The Achilles tendon is the largest tendon in the body. It connects the muscles in the lower leg (calf) to the heel bone. With every movement of the foot, the Achilles tendon stretches and tightens. Because it is under so much stress, it can partially or completely tear (rupture) from excess force or overuse. Ruptures usually occur about two inches above where the tendon attaches to the heel bone.

An Achilles tendon rupture is most common in middle-aged “weekend warriors” who are not conditioned for athletics and who neglect to properly warm up and stretch prior to exercise. Ruptures frequently occur from sudden movements that stress the calf muscles, such as jumping or quick stops; from overstretching; from vigorous exercise after a long period of inactivity; or from untreated Achilles tendinitis/tendinosis (overuse).

What is a bulging/ruptured/herniated disk?

The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a “bulging” disk. This condition may or may not be painful and is extremely common.

Herniated disks are often referred to as “slipped” or “ruptured” disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually “slip,” strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk.

If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.

If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.

What is radiculopathy/nerve impingement?

Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a “pinched nerve.” Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

After Years of Paralysis, A Man Walks the Length of a Football Field

Original Article By Emily Willingham | Scientific Journal

An electrical stimulation device combined with intensive rehabilitation restores walking ability to a spinal cord injury patient

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