Drs. Gino Chiappetta and Matthew McDonnell were featured in an article today in the Asbury Park Press discussing proper spine care. Both Drs. Chiappetta and McDonnell are highly qualified orthopedic spine surgeons at University Orthopaedic Associates and both serve as assistant clinical professors at Rutgers-Robert Wood Johnson Medical School’s Department of Orthopaedic Surgery.

Taking care of your spine

Gloria Averbuch

The spine does it all: it allows us to stand and perform a vast variety of movements, protects the spinal cord and nerve roots, allows for flexibility, and houses the strength-providing muscles, bones, ligaments, tendons, connective tissue and joints. But when it hurts, this vast and intricate anatomy can make it difficult to detect the cause of the pain or other problems. Unfortunately, this pain is a problem almost all of us will face, as widespread estimates are that 80 percent of the population will experience an episode of back pain at some point in our lives.

The spine is central to our lives: literally and figuratively. To that end, it seems prudent to consult not one, but two, highly qualified orthopedic spine surgeons for insight and advice. They are Dr. Gino Chiappetta and Dr. Matthew McDonnell, both of University Orthopaedic Associates (UOA) in New Jersey, one of the largest orthopedic practices in the state, to which many complicated spine cases are often referred. In addition, each doctor is an assistant clinical professor at Rutgers-Robert Wood Johnson Medical School’s Department of Orthopaedic Surgery.

“Because the spine is such a complex area of the body, many factors need to be taken into account when evaluating symptoms and disability. Unlike knee and hip arthritis, there are many sources of pain in the lower back and neck. Working together with the patient, we have to do our detective work to unearth them,” Chiappetta says.

The terms spine and back are often used interchangeably. To clarify, Dr. McDonnell says that the spine typically refers strictly to the bones, intervertebral discs, facet joints, joints of the spine, spinal cord and nerve roots. The back includes the spine, but also involves more of the soft tissue, such as the muscles.

“Patients complain of back pain, but it is more often a spine problem. The difficulty with the diagnosis is that you can have back pain from a strained muscle, kidney stones, an aortic aneurism, or in rare cases, even a tumor,” he says.

“But,” continues McDonnell, “ninety-nine percent of the time, back pain comes from a muscular strain or pull, or tweaking of the disc. Imaging studies (X-rays or MRI) come back negative. Patients eventually feel better and recover.”

An acute episode of back pain often comes from overdoing it, like with extra yard work or lifting objects. Both doctors say a sore back can typically be treated with over-the-counter anti-inflammatory medication, ice and heat. If it does not resolve after a week, they say, it is advisable to see your primary care doctor. If it continues for a month to six weeks, it is likely time to see a specialist such as an orthopedist.

According to McDonnell, “most commonly, we see issues in the lower back, and neck or cervical spine. In the lumbar region, that means disc herniations, sciatica, and issues related to arthritis of the spine, such as stenosis. In the cervical or neck area, disc herniations can result in arm symptoms, such as radiculopathy (injury to the nerve root), or pressure on the spinal cord. Also, we see issues related to arthritis in the neck.”

Neurological pain, however, such as pain in the lower back or neck that radiates and/or causes weakness in arms or legs, may be the result of spinal cord or nerve damage. This is more serious, and should be evaluated immediately.

Despite the spinal condition, however, both Chiapetta and McDonnell stress exhausting all conservative medical measures before a discussion of surgery. And if it should come to a surgical option, Chiappetta says that surgery has greatly evolved over the past 20 years. “It’s because of advancements in technology and also, in this day and age, surgery is very specialized.” Spine surgeries are all both doctors do. Chiappetta, for example, does 300 spine surgeries a year, through his UOA practice and as part of the spine trauma unit in the ER at Robert Wood Johnson.

What causes the almost universal back problems we all are likely to experience? Chiappetta explains that there are several factors. One is an underlying genetic predisposition; some people have more advanced degenerative changes than others. These manifest any time after age 30. Then, there is activity or events—such as work-related stress on the back, from excessive sitting to heavy lifting. “It is often a cumulative effect,” adds Chiappetta, who explains, “People these days are living and working longer, and they are more active with exercise and sports.”

Here are some tips from both McDonnell and Chiappetta on taking care of your spine with the hope of best avoiding or relieving back pain or problems:

• Do Cardiovascular Exercise- Whether it is walking, or something more vigorous, this helps weight maintenance and also strengthens bones to help avoid osteoporosis (weakening of the bones). Exercise can also help strengthen the core, providing support to the muscles that support the back.
• Pay Attention to Your Posture- Good posture can help maintain the proper anatomical characteristics of the spine. Poor posture can lead to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs, and joints which can result in back and neck pain, as well as headaches and fatigue.
• Maintain a Healthy Weight- Excess pounds, especially in the stomach area, put pressure on the structures of the back.
• Stop Smoking- It has been clearly proven that smokers have a higher rate of disc degeneration and back pain. The products in cigarettes affect the blood supply to the discs.
• Pay Attention to Details- Avoid high heels. Do not carry a purse or briefcase on a single, or the same shoulder. Try to balance its weight across your body with a longer strap (i.e. resting on the opposite shoulder of the side on which the bag is being carried).