A spine and pain specialist evaluates and treats a wide range of pain issues. The types of pain are based on tissue injury, nerve injury and a mix of tissue and nerve injury. They employ a diverse treatment approach where they begin with medications and injections that numb pain. Transcutaneous electrical nerve stimulators may also be used to deliver low voltage current in the pain-affected area. In the second stage, chemical agents are applied to the nerve to stop pain signals and is mainly administered for chronic pain issues. In the third stage, an implant with a pain pump or spinal cord stimulator relieves pain at the spinal cord level. Regenerative or stem cell treatment is another option. .
No. An orthopaedic spine surgeon specialises in the diagnosis and treatment of spine diseases. Spine speciality is an advanced speciality fellowship done by an orthopaedic surgeon. The specialist could be chiropractors, physical therapists, orthopaedic surgeons, neurosurgeons, pain management physicians, anesthesiologists, rheumatologists and neurologists.
Treatment of sciatica pain depends upon the type of sciatica nerve pain. The first primary physician recommends rest, pain killers, muscle relaxants and would ask the patient to go through an MRI diagnosis to decipher the source of pain. If the pain does not subside, neuro surgeon is referred to, since sciatica is a nerve problem and neurologist’s diagnosis and treatment could be beneficial. If the pain is unbearable or if rapid loss of leg function is observed, it could be severe nerve damage. Interventional pain management specialists who are trained to treat back and leg pain advice epidural steroid injections along with exercise and rest. For non-surgical options, physical therapist, chiropractor and acupuncturist are referred to.
In the first visit, the doctor would like to know the pain-affected area, the nature of pain (dull, aching or tingling), frequency of pain in day and night, the occurrence of pain during exercise or at rest, the strength of pain while standing, sitting or laying down, the response of pain to any medication and symptoms like loss of bowel or bladder control. Questions about medical history and prescriptions, are a part of the discussion. After deciphering the underlying conditions treatment is done by medicines, exercises and surgery.
Yes. A specialist in non surgical treatment for back pain like physiatrist, chiropractor and physical therapist for instances are approached for back pain treatment. They evaluate the condition and provide appropriate treatment. Many types of doctors specialize in specific areas of back pain treatment. When a general practitioner or family doctor prescribes medications and physical therapy and confirms their suspicions, they recommend one of the specialist like orthopedists if the pain is related to the musculoskeletal system, rheumatologists if the pain is due to arthritis or inflammation in the spine, neurologist if the pain is due to issues in peripheral nervous system and holistic specialists like osteopathic physicians and chiropractic specialists if it is chronic pain.
When the back pain does not subside within a week, it is advisable to start with a family doctor or chiropractor who conducts a physical examination. If the pain extends to other body parts it signifies presence of sciatica. Numbness, tingling or weakness is felt it may be nerve irritation or damage. Back pain during nights could be due to infection, severe nerve compression or due to cancer. Problems with bowels could be due to cauda syndrome where nerves in the lower spine may be paralysed. When back pain accompanies unexpected weight loss or if the above-mentioned conditions apply to you, it is best to approach a spine and pain specialist.
A spine and pain specialist is specialized in the evaluation, diagnosis and treatment of diseases and disorders related to the spine and spinal cord and does a two-year foundation course after his 5-year MBBS course. The spine and pain specialist obtains one of the specialities like Spine Surgery (ABNS), Spinal Cord Injury Medicine(ABPMR), Fellowship of the Faculty of Pain Medicine of the Royal College of Anaesthetists (FFPMRCA), Neurosurgery (MCh), Anaesthesia (DNB), Diploma in Anesthesiology, DNB Orthopaedics, MS Orthopaedics, M. Ch Orthopaedics, DNB Neurosurgery, MS Neurosurgery and MD Anaesthesiology.
In surgical care for spine, spine and pain specialist perform surgery including laminectomy, discectomy, spinal fusion, kyphoplasty and vertebroplasty based on causes behind the pain.
Neck pain is the primary symptom of rheumatoid arthritis. A spine and pain specialist can treat the issue by medicines, exercises and surgery like spinal fusion and laminectomy.
Yes. Non-surgical pain management is possible but depends upon the severity of the pain. Given that the pain is not chronic in nature, it can be treated through spinal manipulation, acupuncture, anti-inflammatory diet, good posture and lifestyle changes, to name a few.
Minimum cost of spine surgery in Chennai starts from rupees 60,000. Average charges for spine surgery in Chennai is approximately rupees 1,35,890. Maximum charges for spine surgery in Chennai is no more than 2,50,000. Expenses for spine surgery in Chennai is influenced by medical condition of the patient, surgeon’s fee, type of implants used, admission fee, patient’s age, type of hospital, the admission room chosen, post-surgical complications, lab tests such as X-rays and ECG and type of surgery planned to be performed.
Apart from minimally invasive techniques like endoscopic surgery, types of spine surgery includes facetectomy, spinal or vertebral fusion, laminectomy, laminotomy, discectomy, microdiscectomy, foraminotomy and disc replacement surgery.
Risks of spine surgery include infection, blood clot, dural tear, leakage of cerebrospinal fluid, facial sores, lack of vision, nerve injury and paralysis and even fatal consequences.
Success rate of spine surgery is 96 per cent and it is influenced by patient’s medical condition and age, surgeon’s experience and learning curve and type of surgery performed.
Spine surgery is a surgical method where the damaged spine is repaired and its functionality are restored. Spine surgery is completed within 40 to 90 minutes. Recovery is expected within 24 to 48 hours.
An orthopaedic surgeon or neurosurgeon performs spine surgery as per the nature of the spinal issue.
Benefits of minimally invasive spine surgery include minimum damage to muscles and tissues, less pain after surgery, short hospital stay, speedy recovery and resuming routine activities soon. Patients report less pain and better mobility after minimally invasive surgery which has 90 per cent success rate.
Symptoms like degenerative disc disease, thoracic outlet syndrome, Conus syndrome, spinal stenosis or tumours, isthmic spondylolisthesis, scoliosis, transitional vertebra, degenerative spondylosis, annular tear, fractures, non-dysraphic tethered cord and latrogenic cascade may require surgical intervention as treatment procedure.
Preparation of spine surgery begins weeks or months ahead. During preoperative evaluation, pre-existing health conditions of the patients are investigated so that medical staff can take measures to minimize risks. After evaluation sourced from patient’s medical history, X-rays, CT scans, MRI studies and other diagnostic studies, patients are referred to medical specialists for consultation before the surgery. Based on such findings, correct amount of anaesthesia to be provided, pre-operative medical treatment, monitoring during surgery and post operative pain management is decided upon. Information about allergies, side effects of medications, medication or dietary supplements that are taken, family history, tobacco or alcohol use, bleeding history and previous surgical experience are taken into study. A few hours before the surgery, patients are advised not to eat or drink anything. The patient is expected to sign a consent form before undergoing the operation.
For the first couple of weeks, patients can take only short walks and climb stairs only once a day, given that it does not cause pain or discomfort to the patients. Unless and until the doctor provides permission, patients must not swim, golf, run or do any strenuous activity. Activities that require bending, twisting or lifting, pushing and pulling must also be avoided. Do not sit or stand for too long. Dressings are changed repeatedly even if they are clean, which is not so for minimally invasive surgeries. A drain is inserted for major surgeries where bleeding is much so that they do not become source of infection. However at home patients do not need to change dressings until it is soaks or comes off. Patients can take shower for the first week but must avoid contact of soap water and wound so that infection is avoided. Patients can do household or desk work, provided they are comfortable. Patients must wear the brace provided to them while travelling and must avoid jerks. Bike rides must be avoided for the first month and in the car, the patient must be seated in recliner seat next to the driver. After a couple of weeks patients can drive car but with pillow or lumbar arch support. The car seat must be raised so that knees are at the same level or below hip level. In the toilet, the seat must be raised to comfortable level and laxative must be used for soft stools since excessive straining puts pressure on the wounds.
Not all spine surgeries are main surgeries, minimally invasive surgeries are faster and require less time for recovery compared to major surgeries.
Not all back pain issues require spine surgery. Non invasive and minimally invasive procedures are considered before opting for spine surgeries. A slipped disc that does not become better by its own, bone spurs that add pressure to the spinal cord, degenerative spinal condition like stenosis, weakness and numbness in arms or legs, trouble walking, lost bladder or bowel control, spinal infection, fever with back pain, dislocated bone or tumour in the spinal cord are conditions which require surgical intervention.
Pregnant women, septugenarians, patients who are going through chemotherapy and those allergic to anaesthesia are not eligible for spine surgery.
After spine surgery, a scar tissue is formed near the nerve root. Scar tissue formation which is known as epidural fibrosis, is a part of the healing process after spine surgery. It occurs for patients with successive surgical outcomes and the scar tissue can be the cause of back pain and leg pain. This pain is caused because scar tissue does not have nerve endings and especially so when the scar tissue binds lumbar nerve root with fibrous adhesions. Though the worst pain does not last more than 4 weeks, some patients experience pain 3 to 6 months after the surgery.
Yes. Spine surgery is a permanent surgery since it replaces or repairs the damaged part of the spine.
Spine surgery decreases symptoms and increases the functionality of the spine in the long run.
Scars at the operative site will confirm the surgery that was conducted.
When surgery was not successful and symptoms return, it is known as ‘Failed back surgery syndrom’ or FBSS. Neither the patient nor the doctor is unaccountable for failed back surgery since many factors which are out of control, lead to failed back surgery. The doctor employs multi-disciplinary approach to address pain, where they use a mix of treatments to address the pain. Various medications, reoperations, interventions including spinal cord stimulation, epidural injection and exercise therapy are advocated for surgeries that were not successful. While physical therapies improve the spine’s range of motion, medications help to manage symptoms. Spinal cord stimulation through implanted devices send mild electric signals to the nerve roots stemming from spinal cord, to mask pain.
Spinal manipulation, acupuncture, weight loss, anti-inflammatory diet, posture, exercise, therapy modalities like TENS for instance, stress management, foot wear and physical therapy are non surgical interventions available for spine pain treatment.