Q: How long does it usually take to get better from a back pain episode?

A: About 80% of people with lower back pain are 80% better within 2-4 weeks.

Q: If I have sciatica do I need surgery?

A: If your sciatica is persisting for 2-3 month then you are definitely a surgical candidate. If it is causing progressive muscle weakness you would be a surgical candidate even sooner. If you have any bowel or bladder incontinence then a more urgent surgical consultation is required. However, 90% of people with sciatica will improve with conservative care.
An interesting scientific study showed that in the "long term" at 2 years or 10 years there was no difference in outcome in those having surgery vs. those that did not. An eminent neurosurgeon Edward Caragee, M.D. from Stanford University wrote that the decision to operate is not a medical one, but is a social one. If you are not improving within 12 weeks then you may get better quicker with surgery. But, eventually even without surgery if you can manage the pain you will have the same result either way.

Q: If my M.R.I. shows a herniated disc can you help me?

A: Herniated discs are very common. It has been found that they are present in people who have no symptoms - even 20 year olds! Experts now say that spinal changes such as herniated discs and arthritis are related to age (like graying hair or wrinkling skin) not symptoms. It appears that the difference between a person with a herniated disc who has no symptoms and one who has symptoms has to do with how their body is coping or stabilizing their back. At Pro Medical Rehab we specialize in enhancing your functional ability to stabilize your back so that the disc bulge is not as relevant.

Q: If I have had back or neck surgery can I see you post-operatively?

A: Yes. We have seen many patients after their surgery. We work closely with each surgeon so we can forge a team approach to the timing and intensity of your rehabilitation program.

Q: What is the most important thing I can do for myself for back pain?

A: Stay active!

In 1986, the New England Journal of Medicine reported that for most back pain, rest and inactivity should be limited to two days at most. After that time, patients should be encouraged to start moving and exercising to strengthen the back muscles and increase flexibility. In turn, part of the rehabilitative process requires a commitment on the part of the patient to work closely with the therapist during those first few weeks to ensure a successful long-term recovery.

While drugs and manipulation may relieve initial pain, neither of these changes the musculature of the back which is necessary for long-term recovery. Only exercise can strengthen the back muscles and make them more flexible and resistant to future strain.

Q: What are some comfortable positions I can get in to help reduce back pain?

Avoid Sitting for long periods

The spine likes movement. Anything that puts the spine in a static position creates stress and that can cause back and neck pain. Once an hour, stand, walk around, bend, arch backward gently, and twist. Doing so at regular intervals will lengthen the time you can sit comfortably. Also, get an ergonomically designed chair or an orthopedic insert to support your spine – especially if your job involves long periods of sitting. Or roll up a towel and place it behind your low back.

A comfortable way to stand

Prolonged standing can also strain the back. If you have to stand for long periods, prop one foot on a small stool or telephone book to decrease stress in the low back. Alternate with the other foot. Every half hour, bend over and touch your toes with your knees slightly bent or do some of the stretching exercises. This will help loosen muscles, ligaments and joints.

The best sleeping position

Avoid sleeping on your stomach because that arches your back and puts pressure on your spine. Instead, lie on your back with a small pillow tucked under your knees. This position unloads the spine. An alternate position is to lie on your side with a pillow between your knees. If you like sleeping on your stomach, place a soft, flat pillow under your stomach to eliminate some of the arch that can stress your back.

Q: What is the best mattress for people with back problems?

Mattress considerations

It is important to sleep on a mattress with good back support and pressure relief, whether it is a conventional mattress or tempurpedic mattress. A good mattress should relate to your body shape. Generally, go with what feels comfortable to you, the firmer usually the better.