5 Tips to Prevent Back Strain from Lifting

Most adults experience back pain at some point, and lifting is a leading cause of strain. Exercising proper lifting techniques can prevent back strain, but avoiding lifting heavy objects is sometimes best. Often the discomfort will go away on its own. However, long-term worsening pain may require a spine specialist in Grapevine, TX that patients can depend on. In severe cases, procedures such as cervical fusion or disc replacement may be necessary.

Your priority, however, should be to prevent back strain in the first place. First, it may be helpful to learn the origins of preventable back pain, the symptoms, and any risk factors that can increase your need for spine specialists in Dallas, Fort Worth, or anywhere in Texas.

What Is Preventable Back Pain

Pain is often due to tight, tense muscles, a lack of strength, or muscle fatigue. Muscle tissue is strained and damaged by sudden, strenuous movement or a task you are not used to. Nerve damage can cause pain as well. Although not as common as muscle pain, nerve pain may result from an injured disc, which puts pressure on nerves branching out from the spinal cord.

Excessive twisting and overexertion can damage back ligaments. An irritated facet joint can cause muscle spasms, while anything from sudden movements to an awkward posture can strain spinal joints. A bulging or ruptured disc requires immediate attention by a spine surgeon in Texas. Conditions such as osteoporosis and osteoarthritis can increase your risk of injury or exacerbate the problem.

Common Symptoms

  • Dull ache, soreness, or tightness
  • Pain intensifies with movement
  • Localized pain in the lower back, hips, or buttocks
  • Difficulty walking or standing
  • Tender and inflamed areas
  • Pain lessens with rest or by reclining

If you feel a hot, tingling pain or an electric sensation, the problem is likely an irritated nerve root. With sciatica, the pain can travel down the nerves of the legs. Pain is often triggered by muscle spasms. As muscle fibers abruptly contract, they pinch the nerves that intertwine with them, causing intense back pain.

Man with Back in Pain

Back Injury Prevention Tips

Being that improper lifting1 is one of the most common risk factors for back strain and pain, here are five tips to help you prevent back injury and the need for Texas spine and joint care:

  1. Practice Safe Lifting Techniques

Proper bending and lifting help avoid injury and a visit to, for example, the Texas Back Institute. Lift an object by bending at the knees (bending at the waist puts excess strain on lower back muscles) and spread your feet apart (increasing your support base). Standing as close to it as possible, lift the item using your leg muscles. Also, keep your stomach muscles tight for support when lifting or lowering anything.

OSHA’s safe lifting techniques2 are as follows:

  • Planning: Determine if there are obstacles to clear, the load needs to be reduced, or a material handling device is necessary, and when to rest.
  • Sizing: Lift an object at the corner to test its weight and ensure it’s balanced; if you can’t handle the load, use a material handling device.
  • Establish your base: Spread your feet to shoulder width and stabilize your gait by placing one foot ahead of the other while holding the load close to your body.
  • Keep a firm grip: Grip the object with your palms and make sure your hold is firm before lifting or moving it.
  • Be steady: Control the lift using your legs and feet and with your head/shoulders up and stomach muscles tight; avoid twisting or sudden motions.
  1. Exercise

Stretching is an important technique for protecting your back. In addition to the back muscles, focus on supporting muscle groups in your stomach, arms, and legs. By loosening your hamstrings, you can maximize pelvic motion and protect your lower back. Focus on strengthening hip and leg muscles, especially if they’re weak or you are recovering from a back injury.

Man with Weights

Common stretches include knees to chest while lying flat on your back, and lifting your chest off the floor with your arms while lying on your stomach. Other stretches can be performed while in a cat and dog position, sitting down, or standing up. Side leg lifts and pelvic tilts can help as well. The techniques outlined in the OSHA back injury prevention materials help reduce back strain while lifting.

Each stretch should yield mild tension, but no pain, numbness, or tingling. Hold the position for 5-10 seconds, and repeat each activity 3-5 times to abate any muscle tightness.

  1. Care with Repetitive Motion

For our spine team, Texas patients frequently show signs of repetitive motion injury caused by stressed muscles and joints. Such motions may occur every few seconds during an eight-hour shift and increase the likelihood of needing a Southlake orthopedics specialist. The risks depend on the frequency of the straining activity, how fast you move, and how many muscles are needed to complete the task. Posture and the amount of force needed to lift or move an object are also factors.

It is possible, however, to reduce the chances of injury. Handcarts, dollies, skid loaders, and lift trucks should be used to move heavy loads, rather than transporting them manually. If possible, alternate tasks, so you can switch muscle groups and engage in different motions and postures. This gives some muscle groups a rest and prevents improper lifting injuries. Also, do stretching exercises whenever you have a break.

  1. Health Habits

Proper posture is one of the best ways to avoid back strain. When lifting, do not bend forward or twist your body. Body posture controls the use and amount of forces on different muscles and joints. Awkward postures can be reduced, even at work, by changing the height from which you handle an item. Your back should be in a standing neutral position, with the spine in its natural S-curve.

Man Lifting Couch

Another good idea is to store materials at waist level (avoiding the need to bend while lifting)—but you shouldn’t need to reach over to lift the workload, either. Overexertion can be prevented with material handling devices, pushing rather than lifting, dividing up loads, and obtaining assistance from a coworker. It’s also important to reduce fatigue caused by using the same muscles or motions repeatedly.

Concentrate on your overall health since these same habits also benefit your lumbar spine, as our South Texas spinal clinic can attest to:

  • Stay hydrated with water.
  • Minimize alcohol consumption.
  • Avoid smoking and nicotine.
  • Consume fewer inflammatory foods.
  • Get enough sleep to restore damaged tissues.

Preventative treatment, including exercise, medication, and calcium and vitamin D, are also recommended by our Texas spine institute.

  1. Travel with Care

You can prevent back strain and existing injuries from getting worse by taking care when traveling. Lifting is often involved with travel. Heavy luggage should be handled in the same way as lifting and carrying work items. It should also be loaded in stages; for example, lift a suitcase from the floor to a chair/stool, and then into the trunk.

If you’re sitting for a long period of time, bring a lumbar support pillow or an inflatable travel pillow for your neck and head. Your feet should be placed on a firm surface to reduce lower back strain. Try to get up and stretch every 20 to 30 minutes (especially the hamstrings), and check on your posture from time to time to make sure your back is properly aligned.

These techniques will reduce the risks of back strain when traveling and when you need to lift a heavy item later.

How to Relieve Back Strain

  • Medications: Over-the-counter anti-inflammatory medicines (i.e., aspirin, ibuprofen) and pain medicines such as acetaminophen can help. Prescription muscle relaxants may, as well.
  • Cold/heat packs: An ice pack applied for 10- to 20-minutes at a time can relieve inflammation after a muscle injury.3 Heat packs help increase circulation, relieve tension, and speed up healing.
  • Walking: A 3- to 5-minute walk can alleviate the stiffness in your lower back. This helps you stay active and contributes to the normal spinal function and health.
  • Massage: Increases circulation, relaxes muscles, and releases endorphins, which reduce pain signals. Massage therapy can also increase your range of motion.
  • Modified activity: If you’re injured or experiencing back pain, lifting with your back injury is a bad idea. Rest when necessary, although prolonged rest periods can increase stiffness and decondition your back muscles.

Avoid jogging, contact sports, dancing, weight lifting, and situps and other strenuous activities unless a medical professional says it’s okay. At any time, it’s important to know how to protect your back while lifting weights.

If the problem is caused by serious structural problems, a neck fusion or cervical fusion surgery may be done. A Frisco spinal rehab may be recommended, whether you have surgery or are recovering from a strain or injury. Procedures include Anterior Cervical Discectomy Fusion and Transforaminal Lumbar Interbody Fusion. At 360 Back and Spine Center, we also treat vertebral compression fractures and conduct minimally invasive techniques.

Statistics on Back Pain

About 61% of Americans regularly have lower back pain, according to a survey by the American Physical Therapy Association, while 69% of respondents said it affects their lives on a daily basis.4 Nearly a quarter say work is affected and even more reported impacts on sleep and exercise. About 4 in 10 individuals with a back issue never seek medical attention.

The American Chiropractic Association has said 31 million people in the U.S. experience lower back pain at some point.5 It estimates 80% of the population will have a back problem during life, and most of the time the pain has mechanical origins and is not caused by disease. In fact, the single leading cause of disability in the world is low back pain.6 Also, about 1 in 5 workplace injuries involve the back,7 so safe lifting practices should always be considered.

Seek Treatment at 360 Back and Spine Center

Top providers such as the Laser Spine Institute, Texas and Texas Back Institute, Plano are known for great care. We offer nothing less. If your back pain is severe, come to us for a consultation. A qualified and experienced spine surgeon in Texas can recommend the best course of treatment. From lumbar spinal fusion to treating sacroiliac joint disease, to various other surgical and non-surgical interventions, our team is prepared to help.

Led by orthopedic surgeon Melanie B. Kinchen, MD, PA, our team specializes in cervical and lumbar fusions, disc replacement, micro disc surgery, scoliosis treatment, laser surgery, and tumor removal. For information about how we can help, chat with us online or call our Grapevine office at 682-223-1406 or our Fort Worth location at 682-808-4392 today.


  1. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
  2. https://www.osha.gov/dte/grant_materials/fy06/46g6-ht22/back_injury_prevention.pdf
  3. https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-treatment
  4. http://www.moveforwardpt.com/LowBackPain/Infographic
  5. https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics
  6. https://www.ncbi.nlm.nih.gov/pubmed/24665116
  7. http://ehs.virginia.edu/Ergonomics-BIP.html

What Is Laparoscopic (Minimally Invasive) Back Surgery?

Anyone who hasn’t experienced back pain at some time could count themselves among the lucky ones, according to an article published by the University of Kansas Medical Center. Researchers estimate that it affects about 90 percent of adults and 50 percent of workers. Sometimes it’s just a simple sprain. Other times, it involves something more serious like a need for a disc replacement or scoliosis.

Surgery Operation

Lower back and neck pain accounts for about $87.6 billion in health care spending, according to data compiled by the Institute for Health Metrics and Evaluation. It is the third most costly health condition, topped only by diabetes and heart disease, respectively. Just over 60 percent of spending for back and neck pain goes toward outpatient care, with another 28.8 percent for inpatient services.

Unless there is a specific cause, doctors typically begin treatment with non-surgical therapies. Surgeons have traditionally used open surgery to correct spinal problems. Minimally invasive procedures like laparoscopy offer better options for patients, along with some valuable health benefits.

Defining Minimally Invasive Surgery

Minimally invasive surgery tries to strike a balance between the need for these procedures with a means to minimize the amount of exposure and, hence, the risk of complications. It involves one or more small incisions versus the 5- to 6-inch one a doctor may make during a traditional open back surgery.

Surgeons use instruments called tubular retractors to clear a pathway between muscles and soft tissue to zero in on the affected area. Thus, its alternative name keyhole surgery becomes evident. That differs from the muscle retraction used in open surgery to expose a larger region. They can use an endoscope or lighted microscope to get a clear view of internal structures at this finer level.

Where it is applicable, it offers patients several advantages that make it an excellent option. The benefits of this approach include:

  • Shorter hospital stays or even outpatient surgery options
  • Fewer complications
  • Less muscle damage
  • Less postoperative pain medications with their associated side effects
  • Less pain
  • Less bleeding
  • Less external and internal scar tissue
  • Quicker return to normal activities

However, treatment using minimally invasive surgery isn’t yet possible for all conditions. It’s essential to realize that it still carries some risk of complications despite the advantages that it offers, but it’s safe to say that any surgical procedure raises these same concerns.

Minimally invasive surgery isn’t without its disadvantages that are worth considering when deciding if it is right for a given case. From the surgeon’s perspective, these procedures are often more difficult because of the smaller operative site. There’s also a steeper learning curve for doctors wanting to use these techniques.

There are certain procedures, conditions, and patients for which minimally invasive surgery isn’t appropriate. It is not, therefore, a be-all-end-all solution in all cases. On the downside, the duration of the surgery isn’t reduced significantly, either, when compared to open surgery, according to a study by the Santa Casa School of Medicine and Hospitals of São Paulo, Brazil.

Types of Laparoscopic Back Surgery

These technologies offer many opportunities for treating common conditions. For example, minimally invasive surgery for a herniated disc can precisely locate the damaged area and replace it with a bone graft to provide welcome pain relief. Other procedures include:

  • Cervical and lumbar fusions
  • Lumbar spinal stenosis
  • Extreme lateral interbody fusion
  • Direct lateral interbody fusion
  • Treatment of degenerative disc disease
  • Tumor removal
  • Spinal disorders such as scoliosis
  • Discectomy

A doctor may recommend spinal fusion surgery for conditions such as spondylolisthesis, which can cause an achy feeling and tight hamstring muscles. It is also an option for other disorders, such as degenerative disc disease. As the name implies, the surgeon will fuse two or more vertebrae into a more stable and solid bone to help strengthen the back.

In a spinal stenosis procedure for decompression, for example, the surgeon can remove bones or other materials that place undue pressure on nerves. This condition can cause a pins-and-needles sensation or shooting pain. There are two common ways to provide relief. Foraminotomy involves opening up the space through which a nerve travels. Another option is a laminectomy, which targets the rear portion of a vertebra to accomplish the same purpose.

A discectomy involves trimming or complete removal a spinal disc that is protruding out from its normal place as a cushion between two vertebrae. It can cause sharp or burning pain that travels from the lower back down the leg, especially when bending over or sitting down. As with decompression, the culprit is unnatural pressure on nerves, which the surgery aims to correct.

3D Spine

Many of these procedures can be performed on an outpatient basis to minimize disruption in the patient’s everyday life. They may receive regional or general anesthesia, depending on their health and the condition being treated. However, it isn’t an option for individuals with:

  • An active infection of any kind
  • Malignancy
  • Metal allergy or sensitivity
  • Tobacco use

The procedure typically involves creating the incision for the tubular retractor to enter the patient’s skin to the surgical site. Everything entering, such as a rod or graft, or leaving, in the case of any bone fragment, goes through this tool. The surgeon will use real-time imaging using a device called a fluoroscope to complete the procedure.

Doctor Looking at X-Ray

In contrast, in open surgery, muscles are dissected to gain access. With laparoscopy, they are moved aside or dilated and will return to a normal state once it is complete. The point of entry and the number of incisions needed vary with the type of procedure. Some, such as minimally invasive spinal fusion surgery, involve going through the side, back, or abdomen, explains an article from the American Academy of Orthopaedic Surgeons.

It’s worth mentioning that laparoscopic surgery has other applications, in addition to treating back issues, which stem from its early use in gynecologic surgery. The same patient benefits exist with these procedures, too. Other common applications include:

  • Cholecystectomy (gallstone removal)
  • Colectomy (selective removal of sections of a diseased colon)
  • Endovascular surgery (aneurysm repair)
  • Orthopedic surgery


Infections remain one of the main concerns when it comes to complications associated with laparoscopy or any surgical procedure. That’s why minimally invasive procedures hold such promise because of their reduction of internal exposure. Likewise, the risk of nerve damage also exists, especially considering the poor depth perception a surgeon may experience when using these techniques. Remember, their view of the surgery is second-hand from another device.

Smokers who undergo lumbar spinal fusion surgery are at a greater risk of developing pseudarthrosis. That describes a condition when solid bone formation fails to form. It can complicate the patient’s recovery and may necessitate another surgery with its associated risks.

Another concern exists with the development of scar tissue if bleeding has occurred around the nerve roots. That can place pressure on them and cause additional pain. Other potential risks to discuss prior to any surgery include:

  • Bleeding
  • Blood clots
  • Anesthesia complications or adverse reactions
  • Penetration of the small or large bowel
  • Fusion disease
  • Nerve pain

On a positive note, hospital stays are shorter, which can lead to significant cost savings for patients. Also, the recovery time is faster with minimally invasive procedures. Individuals may return to normal work and lifestyle activities quicker, too. The opportunity to provide them with a trouble-free life offers the additional benefit of a reduction in the use of prescription pain medications.

Minimally invasive procedures, such as cervical fusion or other types of laparoscopic surgery, can provide quick relief from the debilitating pain that often accompanies lower back and neck issues. While not a solution in every case, it has the potential to bring welcome comfort and a boost in a patient’s quality of life. That is the primary goal of the 360 Back & Spine Center team from Texas.


  1. http://www.aafp.org/afp/2000/0315/p1779.html#afp20000315p1779-b33
  2. https://jamanetwork.com/journals/jama/fullarticle/2594716
  3. https://www.ncbi.nlm.nih.gov/pubmed/17881967
  4. https://orthoinfo.aaos.org/en/treatment/minimally-invasive-spine-surgery

What Medical Conditions Does Spinal Fusion Treat?

360 Back and Spine Center uses a conservative approach to the treatment of decompression, scoliosis, and other back and neck conditions. In partnership with our patients, we ensure they have the information they need to make informed decisions about treatment.

Spinal fusion is a very common surgery that treats a number of conditions. However, not everyone with pain will require this surgery.

History of Spinal Fusion

The surgery is by no means a new concept. However, the techniques used to complete it, as well as the conditions it treats, have evolved and expanded.

Spinal fusion surgery, originally introduced in the early 1900s, was initially done to correct spinal deformities that occurred as the result of tuberculosis infections. The surgeries performed for this purpose were found to be successful, not only because the surgery limited deformities in patients, but because it was also able to reduce the low back pain these patients suffered.

Spinal fusion in the 1900s saw bone being taken from the patient’s tibia. This bone was then broken into small fragments before being packed between affected vertebrae. Over time, the fragmented bone would ossify or harden like cement. When this happened, the affected segments would be immobilized.

After a decade of improvements, the procedure was improved upon, and, in 1929, was used to treat other degenerative conditions of the spine. The publication of a paper by two general surgeons in 1934 concluded that the most frequent cause of back pain and sciatica needing spinal rehab was due to nerve-root-compressive disc herniation, and not due to a disc tumor as was previously suspected.

The paper identified the origin of these herniations to be from the disc’s center. Finally, the paper identified that the best way to correct this type of herniation was via fusion.

It wouldn’t be until 1953 that the modern version of spinal fusion would be pioneered. This modern version saw the tissue being removed from affected vertebrae. The bony cortex is then removed via grinding, and this ground bone is placed between affected vertebrae, where it hardens into bone.

Today, the bone that is placed between vertebrae can be obtained via donation. Plastic or metal spacers may be needed if a certain condition dictates it.

Conditions That Spinal Fusion Treats

In its infancy, spinal fusion surgery was used to treat deformities as a result of tuberculosis, fractures, and other issues. Today, it is used to treat spinal stenosis and age-related spinal problems.

Spinal fusion surgery may also be done as a follow-up treatment to treatments completed for the purpose of treating tumors, infection, injury, disc herniation, and spinal stenosis.

Modern Spinal Fusion Surgery

Spinal fusion surgery involves accessing the spine from the front, the side, or the back. In all cases, the surgeon will take bone and use it to create a bridge between vertebrae. As well, the surgeon will likely insert metal implants, which will hold the vertebrae together until new bone has grown.

Anterior (Frontal) Lumbar Spinal Fusion

Also known as anterior lumbar interbody fusion, or ALIF, this process involves the patient lying on their back, and the surgeon accessing the spine via an incision in the abdomen. In order to access the spine, the surgeon must retract vascular and abdominal structures.

Once the spine is able to be accessed, the surgeon removes disc material and replaces it with bone graft material, as well as inserts spinal implants.

Posterior (Back) Transformational Lumbar Interbody Fusion

Transformational lumbar interbody fusion, also known as TLIF, requires the patient to lie on their stomach, and the surgeon accesses the spine via an incision in the back. In order to access the spine, the surgeon must retract nerve roots and muscles. Once the spine is in view, the disc material is removed and replaced by bone graft material and spinal implants.

Direct Lateral (Side) Interbody Fusion

Direct lateral interbody fusion, also known as DLIF, sees the patient lying on their side. The surgeon makes an incision into the side and forms a small passageway to the spine through the soft tissue and the psoas muscle.

In order to access the spine, the surgeon uses a real-time, fluoroscopic x-ray guide to insert tubular dilators which create this passageway and allow for the removal of disc material and the insertion of bone material and implants.

Hospital Stay and Recovery Time

Regardless of the way in which spinal fusion surgery is performed, the length of time that the patient will remain in the hospital will depend solely on what Texas spine institute surgeons and their patients decide in terms of postoperative treatment. However, a patient should expect to remain in the hospital for a few days for monitoring.

Once home, a patient may not necessarily require bed rest, although their doctor may recommend that they wear a back brace during their recovery. The total time for recovery after spinal fusion surgery can be extensive and require participating in swimming, stationary cycling, and walking to reclaim spinal mobility.

Risks and Success Rate for Spinal Fusion

There are risks involved with any surgical procedure. In the case of spinal fusion surgery, the overall health and age of the patient will determine the level of risk. In addition, the reason for surgery and the type of spinal fusion will also determine the risk level.

Patient risks include injury to the nerves, breakage of metal implants, surgery failure, pain at the site of the bone graft, infection, and rejection of the bone graft. There may also be risks not immediately evident due to a rare allergic reaction, undiagnosed heart and other diseases, blood clots, or risks which present themselves following anesthesia of the patient.

Depending on the severity of these occurrences, a longer stay in the hospital may be necessary. Regardless, a surgeon will inform the patient of all possible risks prior to surgery. Finally, the decision to undergo surgery is solely the patient’s.

Alternatives to Spinal Fusion

A patient who is experiencing low back pain due to degenerative lumbar disc disease, but who does not wish to undergo spinal or cervical fusion surgery, has four options: disc regeneration, posterior dynamic stabilization, disc replacement, and annuloplasty.

Disc Regeneration

Although still being tested as a treatment, disc regeneration is showing much promise. This process involves the use of gene therapy to stimulate disc regeneration or to slow the rate of disc degeneration.

In addition to the above, research continues into the inhibiting of disc degeneration via gene therapy. Research into gene therapy for the treatment of intervertebral discs is still in its early stages.

Posterior Dynamic Stabilization

The aim of posterior dynamic stabilization is to preserve spinal motion while relieving pressure on affected discs. Several systems are available to achieve this stabilization. Each one acts as an internal brace to allow controlled movement in the affected area. Systems utilize screws, cords, spacers, and rods of different levels of flexibility and moving parts.

Disc Replacement

The disc replacement process involves the removal of the affected disc, which is then replaced by an artificial disc. The goal of disc replacement surgery is to preserve normal spine motion, which is thought to reduce the risk of degeneration for other segments in the lumbar spine. As well, greater pain reduction may be possible with disc replacement than with spinal fusion.


Also known as intradiscal electrothermal coagulation (IDET), this procedure involves the insertion of a needle into the space between affected discs, through which a catheter is passed. The catheter heats up the outer core of the disc space to relieve pain. The procedure cauterizes nerve endings, which South Texas spinal clinics suspect makes them less sensitive.

This procedure is minimally invasive and usually is performed on an outpatient basis. Mild sedation and a local anesthetic are required as part of the surgery.

Some of the above procedures are still in their infancy, in terms of research and testing, while others are no longer preferred by spinal specialists. This is why consultation with a spinal specialist is so important; they can offer advice and information on current procedures.

Getting Professional Advice About Spinal Fusion and Alternatives

If your condition requires the assistance of a professional to treat and correct it, the best option is a location that is dedicated to presenting patients with all of their options. 360 Back and Spine Center specialists help patients with herniated discs, spinal deformities, and other conditions by suggesting a range of comprehensive treatments, including non-invasive options. Learn more about the benefits of Frisco spinal rehab by contacting 360 Back and Spine Center: (682) 808-4389.

How Does Scoliosis Affect Quality of Life?

Around two to three percent of the U.S. population is afflicted with the chronic medical condition known as scoliosis,1 a type of abnormal curvature of the spine that usually develops in its sufferers during childhood. The effects of scoliosis vary widely in severity; in the most serious cases, the condition can impose major lifestyle challenges on those who suffer from it.

Despite its prevalence among the general population, scoliosis remains a mystery to the majority of people, as few have more than a shadowy idea about what this disorder is. If you’ve been diagnosed with scoliosis, or you know someone who has, you owe it to yourself to learn about this often uncomfortable condition. Let’s take a closer look at scoliosis and the ways that it can negatively impact an individual’s day-to-day life.

What Is Scoliosis?

First, you need to be clear on what a “normal” spine is supposed to look like. Contrary to what many believe, a healthy spine has several natural curves, each corresponding to a distinct region.

When viewed from the side, the human spine assumes a rough “S” shape:

  • It curves slightly outward at the neck—the area known as the cervical spine.
  • It curves slightly inward at the middle—the area known as the thoracic spine.
  • It curves slightly outward toward the bottom—the area known as the lumbar spine.

Below these regions are the sacrum (hip) and the coccyx (tail bone).

These curves in the spine provide us with a degree of flexibility and the capacity to absorb bodily stresses.

When examined from the rear, the spine appears straight—if it is healthy. In persons suffering from scoliosis, though, the spine bends noticeably to the left or the right. These abnormal curves generally appear in the thoracic or—less commonly—the lumbar region.

Generally, the curvature of the spine must reach at least 10 degrees to qualify for a diagnosis of scoliosis. As a rule of thumb, the greater the curvature, the more severe the complications that result from it. Mild scoliosis is often no more than an intermittent inconvenience that requires little or no medical intervention. People with substantially more pronounced curvature, however, can develop multiple health issues.

Complications of Scoliosis

Scoliosis can result in a number of physical abnormalities, including uneven shoulders and/or waistline. In advanced cases, the curvature of the spine may cause it to twist, leading to an uneven appearance around the ribs as one side projects further outward than the others.

Scoliosis is often detectable from alternations in the patient’s normal gait, as the misalignment of the hips creates an uneven walking pattern. Sometimes clothing will fit poorly.

It must be understood that scoliosis can cause issues that go far beyond affecting one’s outward appearance. Scoliosis sufferers sometimes report recurring issues with back pain, although, in many cases, this is mild in nature. In older patients, back pain can be more serious. Even simple everyday tasks can lead to significant discomfort—tying shoes, lifting groceries, sitting in chairs, and so on.

Due to the deformation of the spine, scoliosis patients can even develop breathing and heart disorders as the rib cage presses into the lungs. Potentially life-threatening complications like these are extremely uncommon, but they can happen.

Because scoliosis tends to develop at an early age, it can lead to serious self-esteem issues in growing children, who may become the target of teasing from their peers. They may become insecure about their appearance and develop a poor self-image. That’s one reason why it is important to ensure that afflicted children get medical attention as soon as possible. Another reason is that early treatment may prevent serious complications that require more drastic measures.

Types of Scoliosis

Scoliosis can occur at any age, but it usually develops between the ages of ten to fifteen—often immediately prior to puberty. It arises with equal frequency in boys and girls, but it tends to be more serious in girls and more likely to require medical intervention. Scoliosis can be particularly stressful in adolescents, who must cope with the stresses of growing up in addition to their medical disorder.

In approximately 80% of cases, scoliosis has no knowable cause. Where this holds true, it is said to be idiopathic (“of unknown cause”) in origin.

Scoliosis can be caused by neuromuscular disorders such as Marfan syndrome and muscular dystrophy. This is known, appropriately, as neuromuscular scoliosis. When this disorder is traceable to a defect present at birth, such as an improperly formed spine, it is referred to as congenital scoliosis.

So-called degenerative scoliosis is the type associated with older adults. Degeneration of the spine as the result of aging—osteoporosis is often a contributing factor, here—can interfere with the spine’s capacity to retain its normal shape. This type of scoliosis tends to appear in individuals over the age of 40.

Causes of Scoliosis

As we have indicated, scoliosis usually develops without any apparent cause. However, there are a few risk factors that may significantly increase the likelihood of developing this disorder.

Scoliosis seems to run in families—someone with a parent who has this affliction has a greater than average chance of suffering from it as well. According to the Scoliosis Research Society, “About 1 in 3 children whose parents have scoliosis will develop scoliosis.”2 The disorder is believed to have a genetic component but, at the present time, the specific genes involved have yet to be conclusively identified. Parents who have scoliosis need to be especially attentive to physical changes in their children that might indicate the presence of this disorder.

By the same token, it is important to understand what does not cause scoliosis. Given that it so often arises in childhood, many parents worry about the potential effect of a child’s physical activity, like playing sports, in the development of scoliosis, but there is no reason to fear; scoliosis does not stem from playground injuries or anything of that nature. Likewise, bad posture does not lead to scoliosis—although it may be a symptom of an existing condition.

Diagnosing Scoliosis

If you suspect that your child is stricken with scoliosis, do not hesitate to seek medical attention. Scoliosis can worsen with age, and it is essential to seek treatment as soon as possible to prevent major complications down the road.

The most commonly used diagnostic test for scoliosis—though it is not sufficient in itself to reach a diagnosis—is the Adams Forward Bend Test. Many people first become aware of their disorder when a medical practitioner at school leads them through this test.

The test is simple: The patient bends forward at the waist, with arms dangling down until their upper body is at a 90-degree angle. This position enables the medical practitioner to spot asymmetrical features that may indicate scoliosis, such as uneven shoulder blades. Sometimes the practitioner uses a simple screening device called a scoliometer to help detect these irregularities.

If scoliosis is suspected, it will be necessary to undergo x-rays for a closer look. The practitioner will analyze the x-rays and calculate the degree of curvature with the Cobb angle measurement. The Cobb angle score will largely determine the recommended treatment for the scoliosis patient. When it is low—indicating relatively mild curvature—the patient will likely require routine monitoring to ensure that the condition does not worsen, but no further treatment will likely be necessary. This is the case for most individuals diagnosed with scoliosis. In children and adolescents, it is particularly vital to continue monitoring the spine because the patient’s skeleton is still growing, and a mild case could develop into a more serious one.

Treatment Options

If the curvature of the spine is more advanced, there are several treatment options available:

  • Back Brace – This is a common option for adolescents with moderate scoliosis. The brace keeps the condition of the spine from worsening, to forestall the need for surgery. Typically, the patient will have to wear the brace for most of the day until they reach physical maturity.
  • Surgery – In more serious cases, surgery may be necessary. There are several types of surgeries to correct or stabilize scoliosis. The most common one involves fusing two or more vertebrae together, which can markedly improve the patient’s condition with only a small degree of lost mobility. Alternatively, fusionless surgery involving growing rods, vertebral stapling, and similar techniques may achieve positive results as well.

Scoliosis can cause serious difficulties to children and adolescents who are afflicted with this disorder, but help is available. Don’t wait to seek out treatment—call a qualified medical professional today.



  1. http://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis
  2. http://www.srs.org/patients-and-families/common-questions-and-glossary/frequently-asked-questions

It’s a Pain in the Neck

Neck pain can be a nuisance at best and debilitating at worst. Here are two common culprits behind the pain:

neck pain

Strained or Pulled Muscles

Strained and pulled muscles are the same thing. You strain your muscles when you stretch your muscle or tendon too far, which causes tears in your muscle/tendon fibers. This is different from a sprain, which is what happens when you stretch ligaments too far (ligaments are the things that connect one bone to another bone). Strained muscles are fairly common; on the other hand, athletes and other active individuals are at the highest risk for getting sprains.

If your neck feels really stiff, or if you have a hard time moving or rotating your head, you might have a strained neck muscle. If you have a minor strain, you can try alleviating the pain by alternating with hot and cold compresses, which will help with healing and reducing inflammation. Over-the-counter meds might help with the pain, as well. If it’s a more serious strain, or if the pain lasts for longer than a couple of days, seriously consider seeing a doctor.

Pinched Nerve

There are two different causes of pinched nerves: herniated discs and degeneration.

To understand how a herniated disc can cause a pinched nerve, let’s first look at the anatomy of the spine. A spinal disc is the little “shock absorber” that sits between two vertebrae in the spine. It’s what allows your spine to move back and forth, side to side. There are two layers to a spinal disc: the outer layer (called the annulus fibrosus) and the inner layer (called the nucleus pulposus). The outer layer simply protects and contains the inner layer. When the outer portion is weak, sometimes the inner portion leaks out and presses against (or pinches) the nearby nerve. Chemicals released by the broken disc can also irritate the nerve, causing more pain.

Degenerative disc disease can cause bone spurs, which can pinch your nerves. Bone spurs are abnormal growths of the bone, and if the growths get large enough, they can rub on the nerve root or pinch it.

Pinched nerves are often painful (and sometimes, that’s your only symptom). It might be centralized to the area where the pinched nerve is, or it might radiate through other parts of your body. You might feel pins and needles or numbness.

Your treatment will depend on your body and the severity of the pinched nerve. You may need physical therapy or pain medications. A few people with herniated discs require surgery to fix the issue. Talk with your doctor about what options are best for you.

Since each patient is unique, don’t rely simply on the information you find on the web to give yourself a diagnosis. Schedule an appointment with a doctor who can help you figure out what’s causing your neck pain and what you can do to fix it. You can schedule an appointment with 360 Back and Spine by calling 682-223-1406 today!

How Did My Child Get Scoliosis?

There are lots of different types of scoliosis. Congenital scoliosis is when a baby’s spine vertebrae don’t fully form while they’re in the womb. Early onset scoliosis can have a variety of causes, but this kind of scoliosis is when a curve in the spine happens between birth and age 10. Degenerative scoliosis happens in adults, either because of a family history of scoliosis or simply wear and tear on the spine. Certain neurological disorders result in neuromuscular scoliosis (cerebral palsy, spina bifida, muscular dystrophy). But the kind of scoliosis I’m talking about today is called adolescent idiopathic scoliosis (AIS).

adolescent idiopathic scoliosis What Is It?

Out of all the different kinds of scoliosis, AIS is the most common today; about 4% of adolescents have it. It affects more girls than boys (in fact, girls are treated 10 times more often). The word “idiopathic” means that the cause is unknown. Researchers are still working to figure out the specifics, but here are some of the more popular theories:

Family history. Family genetics might play a role, since 30% of adolescents with AIS have a family history of scoliosis. Several researchers have suggested that a mutated gene on the X chromosome may play a role. Other scientists think that AIS may have to do with several chromosomes.

Muscle disorders. One study suggests a relationship between AIS and a primary muscle disorder involving platelet calmodulin (proteins that help with cellular metabolism). The researchers found that individuals with AIS had statistically higher levels of platelet calmodulin. If researchers conducted additional studies like this one on a larger scale and found similar results, doctors might be able to monitor platelet calmodulin levels and identify individuals who are at risk for AIS before its onset.

Growth anomalies. Another theory points at osteopenia (i.e., lower-than-average bone density) and the genes involved with skeletal growth.

Again, no one has definitive answers yet, but science is still searching. The good news is that if AIS is caught, there are treatments available to help.

Watch for These Red Flags

With AIS, there are some physical symptoms that can indicate its onset. You can easily see these symptoms either while the child is standing up straight or if they do a standard Adam’s Forward Bend Test (when the child bends at their waist to touch their toes, keeping their arms and legs straight). Here’s what to look out for:

  • One shoulder is higher than the other
  • One shoulder blade sticks out more prominently than the other
  • One hip is higher than the other
  • The waist looks uneven (one side looks more curved)
  • The body leans to one side
  • The head isn’t centered over the pelvis

If you think your child has AIS, schedule an appointment today with 360 Back and Spine by calling 682-223-1406. We’ll determine whether or not they have scoliosis and help you figure out the next steps.





Ankylosing Spondylitis: What You Should Know


Did you know that back pain is one of the leading causes of missed work days? And over 80% of adults seek treatment for back pain at some point in their lives? It may be a relatively common condition, but sometimes it’s more than a strained back or a pulled muscle. Sometimes it’s an indicator of ankylosing spondylitis (AS).

What Is AS?

In short, AS is a form of arthritis. While it can affect multiple areas in the body, it mostly affects the vertebrae in the spine. The vertebrae become inflamed and, after an extended period of time, they can actually fuse together, resulting in a deformed spine.

It affects men and women alike, and although it can occur at any age, it often starts in the teenage years and when people are in their twenties.

There is no known cause, but there seems to be a strong genetic factor that scientists are still trying to explain. Several genes are said to potentially play a role, but one gene mentioned in particular is HLA-B27. Not everyone with this gene gets AS, and not everyone with AS has this gene, but there is a strong correlation.

Warning Signs and Symptoms

Symptoms of AS will vary depending on the individual, but some of them include:

  • Stiffness or pain in your lower back
  • Progressively worsening back pain
  • Stiffness or pain in your hips
  • Neck pain
  • Fatigue
  • Pain that improves with exercise
  • Pain that worsens with rest
  • Short, painful episodes of pain (called “flares”)
  • Eye inflammation

The only way to know for sure is to meet with a health care provider and have a detailed physical exam. The provider will also probably order some sort of imaging test, like an X-ray or an MRI.

Treatment Options

At this time, there’s no cure for AS, but there are things you can do to make yourself more comfortable.

Physical therapy. This can help you in multiple ways, like maintaining good posture, increasing flexibility, and helping with pain relief. Therapists can create specific stretches and exercises for you and your situation.

Exercise. Daily exercise can really help reduce stiffness and strengthen your muscles. Swimming is one of the best forms of exercise for individuals with AS.

Pain management. Using nonsteroidal anti-inflammatory drugs (NSAIDs) is a popular choice, but these drugs can hurt your GI tract. Luckily, NSAIDs aren’t your only option. Certain pain management injections, like transforaminal nerve root blocks or caudal epidural injections, are incredibly effective. Transforaminal nerve root blocks will target the specific nerves around the vertebrae that are causing pain. Caudal epidural injections work in two ways: first, an anesthetic blocks the pain signals going to the brain, and then a steroid reduces the inflammation. For more information on the medical injections we offer at 360 Back and Spine Center, click here [link to blog on injections].

If you’ve been experiencing back pain, schedule an appointment today with 360 Back and Spine at 682-223-1406 to get your questions answered! Remember, AS is a chronic disease that only worsens over time. Getting the appropriate treatment early on will help you manage its progression.

Can Pain Management Injections Help Me?

At 360 Back and Spine Center, we now offer medical injections that can help with pain management. Check out what they’re for and how they work:

Lumbar (Lower Back) Epidural for Sciatica

Sciatica is the term used to describe pain that shoots down the back of your leg and into your foot or your calf muscle. The pain is usually triggered by certain positions, like sitting a particular way, or certain activities, like walking. A lumbar epidural can effectively and quickly provide pain relief. This is a short-term solution that can significantly help someone experiencing an episode of lower back/leg pain or someone trying to do rehabilitative exercises and stretching.

Facet Injections

There are two facet joints on each level of your vertebrae, and they’re positioned on opposite sides of the cartilage. Facet injections can help us with two aspects of pain: they help us determine which facet joint is the source of pain (based on whether the patient feels relief after numbing that specific facet joint), and then the injection helps alleviate the pain.

Medial Branch Blocks

Medial branch nerves connect to your facet joints and then carry pain signals to the brain. A medial branch block disrupts these pain signals, so they can also help us diagnose the source of pain and provide pain relief. Whereas a facet injection inserts the anesthetic into the joint itself, a medial branch block puts the medication just outside of the joint, right next to the medial branch nerves.


This procedure also relates to the facet joint. If the relief provided by a facet injection is only temporary, a rhizotomy injection could provide lasting relief. Similar to a medial branch block, the needle is placed outside of the joint instead of in it. Radio waves then disable the sensory nerve attached to the facet joint, stopping pain signals from reaching the brain.

Sacroiliac (SI) Joint Injections

You have two sacroiliac (SI) joints; these connect your sacrum to your hips. If you have joint inflammation or dysfunction in this area, it can be the source of a lot of pain. Like facet injections, SI joint injections help us determine where the pain is coming from and if SI joint dysfunction is the culprit.

Transforaminal Nerve Root Blocks

This injection is typically used when a specific nerve has been identified as the source of pain. The medication is then injected around that particular nerve root, relieving the pain.

Caudal Epidural Injection

This injection is generally meant to help with lower back pain. The medicine is injected into the lowest part of the spine and typically involves both an anesthetic (which blocks pain signals from going to the brain) and a steroid (which helps reduce irritation and inflammation).

Spinal Cord Stimulators

This is a method that’s been used for decades for a variety of conditions. Spinal cord stimulation involves sending mild electric pulses along the spinal cord. These electric pulses modify or stop pain messages from reaching the brain. This is a popular option for individuals with back pain that have tried surgery or other treatments, but weren’t able to find relief.

If you’ve been suffering from back, neck, joint, or leg pain, know that you have options. We understand that each person’s circumstances are unique. If you’d like to discuss the best treatment options for your situation, give us a call at 682-223-1406 to schedule an appointment.

What Is Bloodless Surgery?

bloodless surgeriesBloodless surgeries do not incorporate blood transfusions. When surgeons use specialized medical equipment, procedures, and meticulous technique, patients do not need their blood supplemented by outside blood sources.

For many surgical procedures, surgeons will utilize blood transfusions (transfer of donor blood to a patient through an IV) to restore blood that is being or was lost during the procedure. Patients can donate their own blood ahead of time to be used during the surgery, or a blood bank can also match and supply the blood instead. Other times only certain components of the blood may be used, depending on the patient’s needs. For example, red blood cells can help to increase the amount of oxygen carried to different tissues in the body, and platelets can help blood to clot better to control bleeding. Rather than receiving whole blood, the patient only receives the part they need.

Reasons for Bloodless Surgery

Health benefits include a faster recovery rate, a decreased risk of infection, and an eliminated risk of a transfusion reaction or receiving contaminated blood from the transfusion. Though these risks are small, they aren’t zero. Additionally, the greater time and care spent during the surgery minimize trauma to the tissues, making it less likely that patients will need blood during and after surgery.

Additionally, people of certain religions, including Jehovah’s Witnesses, consider the blood sacred and do not wish to have it removed or added to their system if their blood count drops as a result of the surgery. It is important for physicians to recognize and be respectful of their patient’s beliefs, even if they don’t match their own.

In this scenario, Dr. Kinchen plans the surgery with the patient and the religious leader who can serve as the patient’s advocate. The risk of blood loss and the options of prevention or minimization are discussed in detail. Other potentially viable options to increase blood volume are discussed. It is important that the patient feels comfortable with the plan prior to surgery. Dr. Kinchen respects every patient’s wishes and wants to make sure that her procedures meet the guidelines of each individual.

Some viable options may include:

  1. Staging the procedure (e.g., dividing the surgery into two days instead of one)
  2. Using the Cell Saver (which recycles the blood removed during the surgery and then gives it back through an IV)
  3. Using Epogen (a synthetic product that helps the body rejuvenate blood cells)
  4. Increasing iron intake pre- and post-operatively (this helps build up the blood count over several weeks)
  5. Using special tables that position the patient so that there is less pressure on the major blood vessels in the abdomen (this decreases blood loss)
  6. Using meticulous surgical technique, avoiding significant tissue trauma, using materials to help decrease blood loss during the surgery, and performing minimally invasive surgeries when possible (all of these things help to decrease blood loss during the procedure and during the post-operative period, as well)

Types of Scoliosis and Treatments for Adolescents

scoliosis treatmentDo you know someone who has a child with scoliosis, or do you have one yourself? Finding the best treatment for your child’s particular type of scoliosis can be a complicated process. Many patients who don’t meet the requirements for surgery are left to see only a nurse, leaving them with inadequate information to treat their child’s unique situation.

The Types of Scoliosis

Many parents don’t know that they have different options for treatment of scoliosis. Those left in the dark tend to take the first option suggested to them, but not every treatment is equal. Let’s explore some of the different types of scoliosis 360 Back and Spine treats and treatment options for adolescents.

What Is Scoliosis?

Scoliosis is a condition in which the spine is curved sideways. Children are most at risk for scoliosis because it typically occurs just before a child’s growth spurt/puberty, and the child’s growth plates will still be open and susceptible to spinal abnormalities. Scoliosis is typically caught during school-mandated physical screenings, but in many cases this condition slips by unnoticed and is dismissed as normal growth.

Idiopathic Scoliosis

The onset of idiopathic scoliosis can happen with very little warning, and the progression of this condition can be fast-moving between screenings. Idiopathic scoliosis is most common in adolescents (preteens and teenagers), and in children it can be grouped by age into three different types with the adolescent type being the most common by far.

  • Infantile (ages 0-3)
  • Juvenile (ages 3-9)
  • Adolescent (ages 10-18)

A lot of scoliosis cases in children don’t require any treatment. If a curvature is detected, a spinal surgeon will use an X-ray to determine the degree of curvature and the child’s skeletal maturity level, also known as the Risser sign. This will help determine the course of treatment.

If untreated, major issues can arise from the progression of scoliosis, such as reduced lung function. Issues like this can be quite debilitating, so it’s important for regular checkups to occur for children with scoliosis. There is, however, a silver lining: the risk of developing scoliosis drops dramatically after a child has gone through puberty. In boys, this refers to the age where they must shave regularly; for girls, it’s two years after their first menstruation.

Treatments For Adolescent Scoliosis

Detecting scoliosis and its symptoms is a simple task for an orthopedic surgeon, but it’s helpful to know the signs of scoliosis when you’re a parent. Symptoms of adolescent scoliosis include uneven shoulders, waist or hips, as well as ribs that stick out. Early signs of scoliosis don’t usually include pain, but more advanced scoliosis patients can experience soreness and more acute pain. After scoliosis is diagnosed by your doctor, there are several treatment options your doctor may suggest to you.

Treatment For Mild Scoliosis

Chances that your child with mild scoliosis will need a back brace are minimal, but the possibility still exists. Most children with mild scoliosis are given checkups with X-Rays every four to six months. Girls in particular are more at risk for a greater progression of scoliosis, so they’ll probably have more frequent checkups than boys. More frequent checkups are also recommended for those with S-curves and thoracic scoliosis, because of the natural rate of progression.

Treatment For Moderate Scoliosis

Children with moderate scoliosis may be given back braces to stop progression of a curved spine. Although back braces won’t reverse or cure scoliosis, they may prevent the curvature from increasing. Most braces will be made of a durable plastic that is worn majority of the time and can be taken off if necessary. The brace’s effectiveness increases the more it’s worn, so strict adherence to wearing it day and night is best. Most braces can be discarded when the child is no longer growing.

Surgery can be an option for young children with fast-progressing moderate scoliosis. If a child’s curvature is greater than 40 degrees, surgery is the most likely option, whereas children with curvatures in the 20–30 degree range are more often prescribed back braces.

Treatment For Severe Scoliosis

Adolescents with severe scoliosis will most likely need surgery to correct it. Spinal fusion is the most common form of surgery used on scoliosis patients and involves rotating the spine and placing it in a more anatomic position. Bone graft and hardware are added to maintain the correction.