Photo Courtesy: Patrick

A happy belated New Year to you.  If you are a smoker, I'm sure the health risks of smoking - lung, heart and other degenerative diseases - are not news to you.  But are you aware that back pain is also one of the risks? It is.  My two new articles will give you the facts:

Smoking and Back Pain Articles

• Health Risks of Smoking
• (Exactly) How Smoking Changes Your Spinal Structures

Spinal fusion is perhaps the most common surgery for a number of back ailments (scoliosis, degenerative disc disease and others), and has been for a very long time.  Just the same, it does come with risks.

One risk is pseudoarthrosis, which develops if the fusion fails (called non-union of fusion). Pseudoarthrosis can be very painful, and may require another surgery.

Another risk is adjacent segment degeneration. Adjacent segment degeneration, called ASD for short, may occur as a result of routine pressure put on the spinal joints located above and/or below the place where your fusion is done. In and of itself, ASD may not affect your daily well being too much, but should new symptoms develop, say pain or nerve related symptoms, your doctor may diagnose you with adjacent segment disease.

ASD and adjacent segment disease concern doctors and researchers so much that new approaches to spine repair are being developed. Motion sparing spine surgery (think total disc replacement) is one such approach.

• Are you at risk for ASD or adjacent segment disease?
• ASD Prevalence - Is ASD Common or Rare?

Photo Courtesy: Patrick

A while back a reader asked me why she gets so much neck pain after a day at her office. My first thought was about support for her lower body, believe it or not. The chair (bench, stool or even exercise ball) you sit on provides the foundation for not only your lumbar spine, but your mid-back, upper back, shoulders and neck, as well.

Think of your neck and back as units that stack on top of one another. When you sit, the bottom of your pelvis - your sitting bones, ideally - connect to the seat of your chair. The weight of your body transfers down to those sitting bones and into the chair.

The height, depth and seat tilt of your chair will likely affect the curve in your low back, which affects the positioning of your mid and upper back and so on. Each unit balances on top of the one beneath it. So you need a level, supportive foundation to keep the rest of your body in good alignment. That's where a well thought out investment in an ergonomic chair comes in.

Beyond that, if you have a similar concern as this reader, you might consider adjusting your workstation so that it fits you as an individual, as well as learning about best ways to incorporate exercise, work breaks and even company management into your ergonomic improvement plans.

If you're planning thyroid surgery, you may experience neck pain and stiffness after the procedure.

I asked Dr. Eric Wisotzky, Associate Director of Cancer Rehabilitation at the National Rehabilitation Hospital what causes it and what you can do to alleviate it.   Here's what he said:

Dr. Wisotzky says that several factors can cause neck pain and stiffness after thyroid surgery. The first, he says, is the position of your neck during the surgery. "The neck is often fully extended during thyroid surgery." He informs me that the pain may be due to compression of a nerve in your head, called the greater occipital nerve.

The second factor is neck positioning after surgery, according to Wisotzky. "You may have a tendency to keep your neck in one position after surgery, which can make it feel stiff." Wisotzky suggests moving your neck and shoulders as soon as you're cleared by your surgeon to do so.

The surgical incision can cause the pain, too, Wisotzky says. He adds that "severe post-operative nausea and vomiting may also contribute."

How long does neck pain after thyroid surgery usually last? What can you expect as time goes on?

"Typically, neck pain after thyroid surgery only lasts a few days, but there are cases where it lasts for weeks, months, or even years," Wisotzky says.

And your diagnosis may have something to do with it. "Patients with thyroid cancer seem to have longer periods of post-operative pain than those with benign thyroid diseases."

Dr. Wisotzky suggests addressing the pain as soon as you can. "Early pain control after surgery is important because without it you may be increasing the risk of chronic pain." Dr. Wisotzky says going to a physical therapist to get a neck exercise program is a good idea, as is seeing a physiatrist.  And to move out of stiffness, he suggests 3 simple exercises to be done for 10 repititions, 3 times per day:

1) Move the neck in the following planes of motion: look down, look to the left, look to the right, tilt the neck to the right, and tilt the neck to the left.

2) Rotate both shoulders forward in a circular motion.

3) Slowly raise the arms overhead and slowly lower them back down.

_Source:

_{Wisotzky, E., MD.  Associate Director of Oncology Rehabilitation, National Rehabilitation Hospital. Email Interview.  Jan 2012.}