Eliminating Back & Joint Pain with Prolotherapy

performing exam for joint pain before prolotherapy

Back and joint pain can prevent you from enjoying life. In fact, just about every movement you make can become painful if you suffer from either one of these conditions. Chronic back pain affects your ability to work, participate in hobbies, and share important moments with family and friends. If you’ve tried conservative treatments without success…. Then, you’re probably desperate for the right answer. And, while surgery may be an option for you, you may also be leery of “going under the knife.”

Alternative therapies are available for those who wish to avoid surgery. Instead, prolotherapy uses the body’s natural healing response to treat a variety of painful orthopedic conditions. While prolotherapy has its roots in ancient Egyptian times, it’s modern-day origins can be traced to the early 20th century. Can this treatment help you? Use this guide to understand prolotherapy and how it can relieve your pain.

woman receiving prolotherapy injection in shoulder

What is Prolotherapy?

Prolotherapy uses injections to activate healing in the soft tissues of an affected joint. These tissues can include ligaments, muscles, tendons, or fascia. As a result, this triggers the body’s natural abilities to promote the growth of normal cells and tissues. Sometimes known as sclerotherapy or regenerative injection therapy, this treatment has shown promising results in treating back and joint pain. Studies are limited, however, and more widespread research is needed to determine overall success rates.

During prolotherapy, a trained physician or orthopedic doctor uses a series of injections over the course of 3 to 6 months. Generally, treatments take place every couple of weeks. Most injections contain a natural irritant—usually dextrose or glucose. In some cases, sodium morrhuate (a derivative of cod liver oil) may be used.

These injections activate special proteins in the body known as growth factors. Over time, these factors strengthen the affected soft tissues, helping to stabilize the joint.

What Conditions Does Prolotherapy Help?

Prolotherapy can be used to treat a variety of back and joint issues. While some evidence is anecdotal, a growing number of individuals who deal with joint pain swear by this treatment. Here are some conditions that doctors use prolotherapy to treat:

  • Degenerative Disc Disease:As we age, the discs protecting our spine tend to dry out and lose shape. This creates an instability in the spine that often leads to back pain and nerve damage.
  • Hip Arthritis or SI Joint Dysfunction: Issues with inflammation of the hip joints and improper movement of the lower spine can result in pain in the legs and lower back.
  • Spinal Arthritis: Arthritis involves the breakdown of cartilage in the joints and discs of the spine. This usually occurs in the neck or lower back.
  • Sciatica: Pain radiating from the lower back to one or both legs, caused by pressure on the sciatic nerve.
  • Ligament and Tendon Tears: Trauma, falls, and other injuries can cause pain and inflammation to the body’s connective tissues.
  • Shoulder Instability: If you‘ve suffered a shoulder dislocation because of repeated use or sudden injury, then it is more likely to pop out again without treatment.

man with shoulder instability who needs prolotherapy

Who is a Good Candidate for Prolotherapy?

While prolotherapy is helpful for some individuals, others may not benefit from this type of treatment. Talking to your doctor or spine surgeon can help you make an educated decision about pursuing prolotherapy.

Typically, those who would benefit from prolotherapy:

  • Have had back or joint pain, especially resulting from an injury to ligaments or tendons, for over six weeks.
  • Use medications for back and joint pain management.
  • Experience more joint pain during physical activities and less while resting.
  • Haven’t achieved long-term relief from physical therapy or other manual therapies.

Types of Prolotherapy

There are three types of prolotherapy in common use today. These include:

  • Growth Factor Injection Prolotherapy: Injecting a complex protein into a joint to activate the growth of certain cells. This may help to alleviate pain from arthritis and muscle sprains or strains.
  • Growth Factor Stimulation Prolotherapy: Instead of using complex proteins, this type of injection uses a non-inflammatory injection of dextrose—less than 10% of the injection solution. This encourages the body to produce growth factors on its own.
  • Inflammatory Prolotherapy: A higher concentration of dextrose (up to 25%) may be used to stimulate temporary inflammation to the affected area. This triggers a more vigorous growth response in the body.

What to Expect During a Prolotherapy Treatment

Before receiving any type of injection, your doctor will make sure your back and joint pain is properly diagnosed. This involves obtaining a full medical history, discussing the onset and severity of symptoms, and receiving a physical examination. In addition, your doctor may order X-rays and other diagnostic imaging to obtain a clearer picture of the affected area. Since prolotherapy may not benefit everyone, it is crucial to know the exact cause of your pain.

After the examination, your doctor will discuss treatment options, benefits, and side effects of prolotherapy. If it is advised, then you should stop taking any anti-inflammatory medications a couple days before the procedure. Unlike some procedures, your doctor may also ask you to eat a protein-rich meal prior to the injection.

During a prolotherapy treatment, a doctor uses local anesthesia, such as lidocaine or procaine, to numb the area. Then the doctor uses a long, thin needle to deliver the injections around the damaged area. The number of injections will depend on your specific condition.

After the injections, you may experience side effects for up to three days after the procedure. This includes stiffness, pain, and swelling. Pain medications can help during this interval. Be sure not to use aspirin or an anti-inflammatory medication. These types of drugs may make the injections less effective. In addition, icing the area and mild exercise can be beneficial to achieving relief. Physical therapy is also often required to restore function to the affected area.

x-ray of shoulder and spine

Other Therapies That May Be Helpful for Treating Pain

  • Platelet Rich Plasma Therapy (PRP): News reports of famous athletes using PRP gave this therapy national attention. Your platelets, cell fragments in the blood, contain hundreds of growth factors that help to heal injuries. By injecting a high concentration of platelets into an affected area, it stimulates the body’s natural healing process.
  • Stem Cell Therapy: Stem cells have the ability to build and rebuild every tissue in the body. Think of these as “wild card” cells. They can divide continuously to make whatever the body needs for healthy regeneration of an injured area. Implanting these cells back into the body can potentially address a variety of injuries, diseases, and disorders.

Are You Ready to Get Help with Your Back and Joint Pain?

If you tried other conservative treatments and still haven’t found success, Orthopedic & Laser Spine Surgery is ready to help you. We take the time to listen to your story, symptoms, and goals for treatment. After pinpointing the source of your pain, we discuss the most appropriate options for your condition.

At Orthopedic & Laser Spine Surgery, our back doctors use the latest technology and research to help you achieve a pain-free life. This includes alternative treatments like prolotherapy, stem cell therapy, and platelet-rich plasma therapy. In addition, we specialize in minimally invasive procedures for a variety of spine and orthopedic issues.

With access to so many treatments, you may finally be able to find the answer to a pain-free life. Don’t suffer any longer. Calling (855) 853-6542 will put you in touch with a dedicated team who is devoted to your recovery.

The Anatomy of Back Pain

doctor with spine model - anatomy of back pain cover photo

Everything we do—laying, sitting, walking, and more—depends on our spine working properly. Unfortunately, we don’t tend to think of our spine or back unless we start to feel pain. Back pain is a condition that up to 80% of the population will suffer at some point in their lives. It is the most common reason for lost work days, disability claims, and missing out on the things we love to do. Back pain can range from dull and nagging to agonizing or debilitating.

What exactly causes back pain? The key to understanding back pain is taking a closer look at the spine, nervous system, and other tissues that help to manage our movement.

Understanding the Spine & Back

The anatomy of the spine is complex. A series of bones, muscles, and connective tissues work together to help it function. The key role of the spine is to protect the spinal cord and nerve roots so they can safely relay messages to and from the brain. Without these messages, you wouldn’t be able to survive.

In addition, your spine enables movement and assists with activities such as weight-bearing, shock absorption, and posture. Most adults have 33 vertebrae which divide the spine into five areas:

  • Cervical Spine: 7 vertebrae in the neck region
  • Thoracic Spine: 12 vertebrae in the upper back
  • Lumbar Spine: 5 vertebrae in the lower back
  • Sacral Region: 4 vertebrae near the tailbone.

The lower areas of the spine bear more of the body’s weight to support movement and other daily activities. The cervical and lumbar spine enable the most movement, and, as a result, are the most prone to injuries.

the anatomy of back pain: vertebrae, spinal nerves, discs, and spinal cord

Each vertebra has a rounded bone at the front of the spine called the vertebral body. A ring formed by two bones attaches to the back of the vertebral body. Inside of this ring resides the spinal cord—the nervous system’s “superhighway” that sends and receives messages between the body and the brain. The back of the spine also has other canals that allow nerves to extend from the spinal cord throughout the body.

In addition, our vertebrae are connected by joints. Many of these joints are known as synovial joints—the most flexible joints in our body. Without these joints, our bones would not have any movement. Furthermore, flexible, fibrous tissue, known as ligaments, connect the bones to each other.

Of course, another key component to movement is muscles. These fibrous tissues connect to the spine with the help of tendons. Muscles contract and expand, with the help of nerves, to move our bones.

Spinal Discs: The Spine’s Built-in Shock Absorbers

Intervertebral discs are important structures that deserve their own section. If you’ve ever had a bulging or herniated disc, you know firsthand the kind of pain that these little cushions can cause.

Intervertebral discs are tough ligaments between each vertebra that connect the spine, allow for flexibility, and absorb shock as the body moves. In addition, cartilage, a glossy lubricating tissue, covers the ends of bones at the joint to facilitate motion and minimize friction.

Degenerative Disc Disease occurs when these discs break down from years of overuse or the natural consequences of aging. In fact, one of the most common causes of back pain in individuals over age 45 can be attributed to Degenerative Disc Disease.

rubbery intervertebral discs

How Does Each of These Components Contribute To Back Pain?

There are many reasons why you may experience back pain. In some cases, a simple strain to a back muscle can cause discomfort. Many people find that injury or changes to spinal structure often set off a chain reaction that can affect others areas. Let’s look at how the different components of the spine can cause you discomfort.

Muscle & Soft Tissue Disorders

As you know, tendons connect muscles to vertebrae. These muscles support the spine and make the trunk of the body bend, twist, and perform other daily functions. Many people who suffer from back pain have hidden damage to their muscles and tendons. This can be due to stress on these soft tissues from improper lifting, obesity, poor posture, or trauma to the area. A muscle strain occurs when lower back muscles are overused or stretched too far. Ligaments, the tissue connecting bones, can also suffer damage, leading to pain and limited mobility.

In addition, when people suffer from back pain, they try their hardest not to move in ways that cause them even more pain. This can cause muscle weakness and a reduction in flexibility, which often leads to even more issues down the road.

Sometimes the origins of your back pain don’t even start with your spine. For example, people with tight hamstrings (the muscles at the back of your thigh) can develop lower back pain as a result.

Spine Conditions Caused By Intervertebral Discs

As we age, the discs separating our vertebrae tend to dry out and lose shape. Commonly known as degenerative disc disease, this causes structural changes in the spine and can lead to a pinched nerve.

In addition, a ruptured disc occurs when the gel-like center of a disc breaks through the outer fibrous ring. Sports and work-related injuries, falls, and accidents commonly lead to this type of condition. In most cases, people develop ruptured discs in the lower back. Ruptured discs can, however, occur anywhere in the spine, from the neck all the way down to the lumbar region.

Vertebral Fractures & Diseases

A spinal vertebra is not a single bone but a series of small bones connected by joints and soft tissues. There are structures in place, like the discs, to help protect the spine and absorb the shocks of everyday movement. Unfortunately, the vertebrae are not immune to injury. Osteoporosis, or weakened bones, can lead to compression fractures of the vertebrae. In addition, a vertebral fracture may occur following a bad fall, accident, or sports injury.

Likewise, if the joints at the back of the spine, known as facet joints, become injured, it can trigger muscle spasms and apply pressure to nerves.

Spinal Cord & Nerve Dysfunction

The spinal column houses the spinal cord and contains openings to allow nerves to reach every area of the body. Changes in the vertebrae, joints, and discs can cause narrowing of the spinal canal, known as spinal stenosis. This condition can be extremely painful and even lead to more serious conditions like muscle weakness or paralysis.

Since the nerves are connected to other areas of the body, your pain isn’t limited to the back. Radiculitis, or pain that starts at one area and radiates to other parts of the body, is a common symptom when nerves are compressed. For example, sciatica is a condition that occurs when the sciatic nerve is compressed. A patient who suffers from sciatica often feels lower back pain that radiates to the back of the thigh and leg.

spinal stenosis from lumbar herniated disc

Diagnosing & Treating Your Lower Back Pain

As you can see, the cause of your back pain may not be a simple answer. Some people experience back pain for a short period of time. Others develop chronic, painful conditions that limit their activities and quality of life.

If conservative treatments like rest or over-the-counter medications aren’t helping with your back pain, it’s time to get the guidance you need from an orthopedic doctor. Since many back pain conditions have a similar set of symptoms, receiving a proper diagnosis is key to finding the best treatments for you. Be wary of a doctor who listens to your complaints about back pain and sends you off with only pain medications. While these can provide temporary relief, they may not treat the underlying problem.

An orthopedic doctor will review your medical history, symptoms, and everyday activities. The doctor also performs a thorough physical examination and may request diagnostic imaging tests depending on your situation. This information will help your doctor determine the most appropriate treatments for you.

Finding Solutions for Your Neck & Back Pain Now

If you’ve been struggling with back pain, then you’ll want to find the best way to manage your discomfort and successfully treat your condition. You’ll want a knowledgeable and trusted source who has shown proven results in helping others with similar troubles.

Our team at Orthopedic & Laser Spine Surgery are experts in treating back pain. Using the latest research, technology, and treatments, our doctors will accurately diagnose your condition and suggest the best solutions for you. In fact, our team of spine experts often finds non-surgical treatments that can help with your specific condition.

If surgery is necessary, then we use the latest, minimally invasive surgeries to minimize pain and scarring. Since these procedures do less harm than traditional open surgeries, you can expect less pain and reliance on pain medications. In fact, most of our patients experience a faster recovery time so they can get back to doing what they love even sooner.

Give yourself a brighter future by taking care of your pain today. Take some time right now to schedule a consultation at Orthopedic & Laser Spine Surgery by calling (855) 853-6542.

Managing Arthritis Pain with CBD Oil

cbd oil for arthritis pain and stethoscope in background

Cannabidiol (CBD) oil, or hemp oil, is a special type of oil that we can extract from cannabis plants. Many people use this type of oil to relieve pain-related symptoms that are associated with chronic conditions that cause pain. Unlike marijuana, CBD oils do not contain THC, which is the compound that produces the “high” in humans.

So far, studies that focus on the effects of CBD on chronic conditions, such as arthritis, have been promising. CBD products may or may not work for everyone, but studies show that they certainly work for some patients.

cbd or cannabidiol as a compound

What is CBD Oil?

CBD is a type of chemical that occurs naturally in cannabis plants. While this is the case, the chemical is not currently considered to be a psychoactive substance. Cannabis itself contains a variety of different chemicals. Specifically, the chemical that can produce a psychoactive reaction in humans is called tetrahydrocannabinol (or THC).

CBD products come in many different shapes and sizes, and their contents vary wildly. Some products contain higher amounts of CBD, while others are a bit more toned down. Because many people use the associated plant to achieve recreational highs, there is an unfortunate stigma surrounding CBD products. Naturally, many people automatically assume that CBD products and marijuana are one and the same. This is simply not the case. In fact, most people extract CBD oils from hemp plants, rather than from marijuana plants. Both of these plants fall under the cannabis classification, so the confusion is natural. However, like CBD oil, hemp plants do not contain any THC.

How do CBD Products Relieve Pain?

It would not be truthful to say that the extracted oil from CBD does not affect brain activity. It certainly does, but not in the same way that THC alters our perception. CBD oil reacts with two receptors in the brain, aptly named the CB1 and CB2 receptors. The interaction that takes place between the oil and these receptors is what can reduce chronic pain, such as cancer pain, and inflammation.

Additionally, CB2 also reacts with the immune system. In particular, this is beneficial for people with rheumatoid arthritis (RA), a condition in which the immune system attacks the joints. The relationship between this receptor type and the immune system is likely why CBD products seem to work so well in RA patients.

Of course, the benefits of using CBD products in RA patients do not just end at the immune system. Because of the oil’s anti-inflammatory properties, CBD also slows down the progression of the disease. In some instances, the supplement may even stop the progression altogether. Additionally, CBD products may alleviate symptoms such as fever and fatigue. This is because these problems are closely associated with the inflammation that RA causes.

CBD Application

As previously mentioned, CBD products come in different shapes and sizes. You can find CBD oil in the form of a capsule or even a liquid, for example. One is not really better than the other, it more or less depends on your personal preferences. Some people even mix the oil in with other lotions that they already use. This mixture is effective when applied directly to the affected joints.

To find out the appropriate dosage for you, experts recommend that you consult with your doctor. Dosages in CBD products vary wildly, from 2.5 mg all the way up to over 1000 mg. Most patients start out with small doses and work their way up to determine effectiveness, but it is still recommended that you consult a doctor. If the current dosage you are taking is not providing any benefits, then try slowly increasing the dosage until you notice a change.

Always purchase CBD products from a reputable provider and make sure that they include a full list of ingredients. Although not as common, topical CBD creams and lotions are slowly becoming more available. This will benefit those who already make their own DIY mixtures, as the oil dosage will be much more clear-cut.

different forms of cbd oil

CBD Oil & Arthritis Pain Relief

Chronic pain, such as lumbago, is sort of the root of all evil—it leads to so many other problems. Many patients with chronic pain conditions often suffer from comorbid disorders, such as insomnia, depression, or anxiety. This just has to do with the way that a constant, suppressing feeling of pain interacts with the body. It makes us want to do less, and it keeps us from sleeping at night.

Conditions known to produce this dilemma are:

  • Osteoarthritis(OA): A degenerative disease caused by age-related wear and tear. Also, one of the most common types of arthritis. Osteoarthritis typically affects joint cartilage and bones, leading to pain and stiffness. Usually, OA primarily attacks the hip, knee, and thumb joints.
  • Rheumatoid Arthritis (RA): The other incredibly common form of arthritis. This one is a little different, however, as it is more of an autoimmune disease than a degenerative disorder. Rheumatoid arthritis causes the immune system to attack the joint cartilage and bones, leading to pain and stiffness. Usually, this condition targets the hands and feet.
  • Psoriatic Arthritis (PA): Not as common as the other two, but not exactly rare either. PA occurs in patients with psoriasis—a condition that causes red, scaly skin patches. Most people develop psoriasis first, and then PA follows. That being said, there are cases where joint problems appear before the skin lesions.
  • Multiple Sclerosis (MS): A disabling disease of the central nervous system. With this condition, the immune system attacks the myelin sheath that covers our nerve fibers. This leads to misfirings and gradual nerve deterioration.

These are just a few conditions that CBD can help. It’s important to note that you do not have to fall on this list to receive the benefits of CBD oil. CBD oil also aids with chronic pain, which for some people, is a condition all on its own.

arthritis pain and cbd oil

Does CBD Oil Work?

In that regard, it’s honestly like any other medical treatment. The answer is sometimes. However, CBD constitutes a much better alternative to opioids and comes with fewer side effects. Of course, that statement is case-dependent, but the real appeal here is that CBD oil is not risky. At most, the reported side effects of CBD products are mild. These include fatigue, insomnia, irritability, and nausea. Even still, it is uncommon for these effects to occur. Basically, it almost never hurts to try. CBD oil provides a conservative avenue to explore for those with opioid sensitivity

But, what does the scientific evidence indicate? Studies for cannabis-based treatments in RA patients began in roughly 2006. Researchers concluded that after five weeks of use cannabis-based treatments reduced inflammation and pain in RA patients. Moreover, these patients also experienced improved sleep and little to no negative side effects.

Additional studies have been performed, but they all reveal pretty much the same thing. The only issue with these studies is that they have relatively small sample sizes. That being said, what they do show is quite promising. It is very likely that the future will bring even larger studies that will provide us with even better scientific results that indicate the treatment’s effectiveness.

Are CBD Products Legal?

The answer to this depends on your state, but in most of them, it is. You can easily find interactive maps online that detail your state’s laws on the matter.
Do you have a chronic pain condition? Maybe CBD oil is right for you. As always, if you have any questions on the matter, please contact us at (855)853-6542. Our spine doctors at OLSS are leading experts in the field of conservative treatment options. They will be able to answer any questions you may have about this treatment.

Tips to Quit Smoking Before Spinal Fusion

tips to quit smoking before spinal fusion surgery cover photo

Research shows beyond any shadow of a doubt that cigarette smoking negatively affects spinal fusion surgery. In fact, the rate of non-fusion (or pseudarthrosis) in smoking patients is twice as much as that found in those who do not smoke. Of course, studies on non-fusion rates vary wildly as they depend on a variety of factors. That being said, there is most certainly a correlation between non-fusion rates and cigarette smoking. The prevailing theory is that nicotine adversely affects bone growth, which is a vital part of the fusion process.

Because nicotine is the problem here, that means that any tobacco product–patches, vaping, and so on–can affect fusion. This may be hard to hear, as there are many people who have been smoking for decades. However, it is absolutely vital to quit smoking if you have a fusion procedure planned ahead of you. If you cut back on tobacco products or use substitutes instead, there is still a small chance that you may end up back in the operating room.

spinal fixation from spinal fusion surgery

Smoking and Spinal Fusion Surgery

As we have already established, nicotine affects the bone healing process as well as fusion. Additionally, the use of other tobacco products such as patches and e-cigarettes are either known or suspected to cause the same problems. The effects of the latter are not exactly known yet, so medical experts still suggest eliminating e-cigarette use as well. Additionally, once the patient has undergone spinal fusion surgery, doctors recommend ceasing to smoke for at least 6 weeks to avoid postoperative complications. Similarly, medical experts also suggest that the patient stops smoking at least a month prior to the procedure. Obviously, doctors urge even more strongly that you quit altogether, but that is another story.

Tobacco products do not just affect fusion, they also affect blood circulation in smaller vessels. Blood circulation plays a vital part in carrying oxygen and nutrients to hungry cells. In the context of the spine, reduced circulation has a particularly harsh effect on the shock-absorbing spinal discs. When blood flow reduces, less oxygen and nutrients are able to travel to the discs. Smoking also deters wound healing after surgery, leading to a higher risk of infection

It is important to mention that not all doctors require tobacco cessation prior to fusion. Instead, they may recommend that a patient quits smoking to avoid failed back surgery syndrome. If a patient has particular trouble with dropping the habit, then their doctor will assist them in any way possible. For one, doctors address wound complications via minimally invasive techniques. As far as fusion goes, doctors are able to optimize the process by using bone morphogenetic proteins (BMP), which encourage bone growth.

Use of BMPs in Spinal Fusion Surgery

BMPs are one of the newest approaches that doctors use to help mitigate the risks associated with smoking before spinal fusion. These proteins are known for their ability to promote bone and cartilage formation. For this treatment, the doctor places the BMP before the procedure with the goal of enhancing bone growth. More specifically, the goal is to accelerate bone growth beyond what would be considered normal bone growth from autografting.

So far, studies show that BMPs help the success rate of fusion procedures in patients who smoke. One such study shows that out of a group of patients who were followed for over two years, 95% of smokers had a successful procedure. This number is much higher than groups of smokers that did not have BMPs and suggests a strong correlation. It, however, is still important to note that even though these fusions were successful, the results were not nearly as positive as the non-smoker fusions. For non-smokers, the fusion procedures showed measurably higher functionality and symptom alleviation from chronic back pain.

bone morphogenetic proteins

Difficulty Of Quitting After Surgery

If the patient has not quit smoking before fusion surgery, then it is most likely that they will continue to smoke afterward. In most cases, patients will either continue smoking or quit for only a brief period of time.

Post-operative smoking cessation is incredibly difficult for a variety of reasons. The main reason for this is that the recovery period from a spinal fusion is very hard on a person. It is stressful, both physically and mentally. And, many people smoke in order to reduce such stressors. Additionally, recovery from any medical procedure is hardly exciting or fun. It is difficult for some patients to pass the time, so they may look to cigarettes as a means of handling the boredom or dealing with the stress.

It is possible to decrease the chance of post-operative smoking, and that is by quitting as soon as possible. Studies show that the longer a person has been off cigarettes, the easier it is to stay off cigarettes. This is a useful piece of advice for patients preparing for surgery, as well as for the post-operative doldrum.

How To Quit Smoking

There are many different ways to quit smoking, but by far the most common method is cold turkey (with no outside help). In fact, nine out of ten people try to quit smoking this way before trying anything else. Unfortunately, only a small minority (around 5% to 7%) are actually successful with this method. It certainly doesn’t hurt to try this method, but it is important to understand that it likely will not work for you.

Cognitive Behavioral Therapy

This method involves receiving advice from a specialist or guidance counselor to find useful coping techniques for you. The goal is to discover what your triggers are (what makes you reach for a cigarette) and how to avoid those situations. Sometimes, however, those situations are not avoidable. In these cases, the counselor will guide you with coping mechanisms for dealing with these cravings.

Smoking cessation programs are also known to yield good results when it comes to kicking the habit. Cessation programs are very similar to cognitive behavioral therapy in a lot of cases, with the difference being that they are conducted in a group environment instead of on a one-on-one basis.

Nicotine Replacement Therapy

This method is more of a supplementary treatment that patients can use to get off on the right foot. For patients who are going to undergo spinal fusion, it is important to understand that nicotine is still harmful. That being said, this method does help smokers quit cigarettes. This is especially true when patients use this method in tandem with cognitive behavioral therapy. Nicotine replacements come in a variety of forms, such as gum, patches, and lozenges. The key to this method is to think of it as a temporary crutch, and not a full-time replacement.

patch for nicotine replacement therapy


Prescription medicines such as Chantix or Wellbutrin are known to help smokers deal with the cravings and withdrawal symptoms of cessation. Additionally, these medications contain no nicotine in them and thus are not a form of nicotine replacement therapy. Ask your doctor about these medications, because they may or may not be right for you.

Other Methods

Exercise is a well-known aid when it comes to smoking cessation, and is probably the most effective natural treatment. Though not as documented, many people claim that acupuncture and meditation have helped them kick the habit. Ultimately, the best approach for you will depend on your personal preferences. Any of these methods listed here are very effective supplementary treatments to any of the other techniques detailed above.

If you need spinal fusion surgery, please contact us at (855) 853-6542. OLLS is regarded as the best spine center in Florida for minimally invasive surgery, and its employees are well-versed in conservative methods. The back doctors at OLSS will go above and beyond to ensure that you receive a treatment plan that serves your specific needs–and this includes helping you receive the resources you need to quit smoking before fusion surgery.

Disc Diagnostics: What is a Discogram?

doctor with spine model explains need for discogram to patient

A discogram is a diagnostic imaging procedure that doctors use to evaluate back pain. Sometimes called a discography, this method uses x-ray imaging to reveal abnormalities in the intervertebral discs of the spine. With the aid of a special dye and a fluoroscope, discograms are able to locate the cause of the patient’s back pain. The procedure may vary slightly between discographers, but the general purpose is always the same. It’s a diagnostic tool that doctors use to identify probable causes for a patient’s symptoms.

Do I Need a Discogram?

Medical experts consider discographies as an invasive test. Naturally, this means that it is not usually the first treatment that doctors use for evaluating the patient’s condition. In most cases, your doctor will try to treat your back pain using more conservative methods. This may include treatments such as physical therapy or medication. If these non-surgical techniques do not prevail, your doctor will then consider more drastic solutions.

Sometimes, when a patient needs lumbar spinal fusion surgery, the doctor on the case will perform a discogram before the procedure. The diagnostic test is useful here, as it reveals the affected discs in the spine beforehand. While this may be so, it is important to illustrate that discograms do not always provide accurate results. Some doctors instead prefer using other techniques, such as MRI and CT scans. The method that will be used for your specific case will depend on a variety of factors. It will depend on your doctor, your condition, your medical history, and you. Make sure that you communicate with your doctor if you have any preferences for any procedure.

stethoscope and disc model with herniated disc

A doctor may consider using a discogram if the patient has the following conditions:

These are just a few general examples. Because discs act as the shock absorber between spinal bones, there are a lot of potential problems associated with them. Constant pressure and impact on these structures may lead to problems like the ones listed above.

Discogram Associated Risks

Discograms are quite safe, with complications happening only rarely. These risks are often minimized when the procedure is performed by a skilled specialist using modern discography methods. Although they are rare, the following complications may occur during this test:

  • Allergic Reaction: Some patients are sensitive to the contrast dye used in the test, which results in an allergic reaction. Usually, this risk is averted by providing your doctor with an extensive medical history beforehand. Aside from reactions with the dye, there is also a chance for the patient to be allergic to anesthesia. You should communicate all medication allergies to your doctor before getting a discogram.
  • Disc Space Infection: This is the most serious complication associated with discograms. Disc space infections are very rare but when they occur they are very hard to treat. Luckily, advances in sterilization have made this complication virtually nonexistent.
  • Nerve Root Injury: Discograms inject the contrast dye into the affected area using a needle that passes quite close to nerve roots. Because the needle travels so close to these structures, there is a very small chance of nerve injury. This complication leads to additional pain that the patient feels after the procedure.
  • Excessive Bleeding: Make sure to tell your doctor if you have any bleeding disorders before receiving any invasive treatment. Additionally, you should notify your doctor if you take any blood-thinning medications, such as aspirin. If you communicate with your doctor, the chances of this complication are very rare.

woman with fever from disc space infection

How is a Discogram Performed?

Firstly, the doctor must prepare the patient by using a local anesthesia and a sedative. This will relax the patient and reduce uncomfortable sensations during the test. The doctor will then either lie the patient face down or on the side for access to the back. After the doctor sterilizes the injection site, the hollow needle is inserted where it is needed.

To make the injection go as smoothly as possible, a radiologist will often aid navigation using fluoroscopic guidance. Once the doctor determines that the needle is at the affected site, the contrast dye is injected. This may intensify uncomfortable symptoms, causing the patient some level of discomfort. Though this may be the case, it is important that the patient stays still for the procedure to be a success.

Finally, the doctor removes the needle and takes x-ray images of the affected site. Again, in order to obtain accurate images, it is vital that the patient stays still. In some cases, the doctor may perform a subsequent CT scan after the procedure.

Although the procedure is more invasive than conservative methods, it is still a minimally invasive technique. Additionally, discograms are also outpatient procedures, as the patient is able to go home the same day. Typically, the medical staff will observe the patient for 30 minutes directly after the test. Once the patient is home, medical experts recommend that he or she rest for the next 24 hours. Some patients may experience headaches after having a discogram. In these cases, the patient should take ibuprofen or Tylenol, but never aspirin.

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If you have back pain that does not resolve on its own, please contact us at (855) 853-6542. At OLSS, you will find an efficient facility filled with caring spine doctors whose goal is to treat your ailments. Our doctors will take the time to understand the specifics of your case and they will come up with a treatment plan that best serves your needs.