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Carolyn Salazar, OT

7 Ways to Make Sure Your Office Isn’t Working Against Your Spine

Posted on June 14, 2013 by Carolyn Salazar, OT

 

Properly positioning your body and using good body mechanics when you’re at your office workstation are important to keep your spine and body healthy, especially if you are returning from an injury or surgery. Here are some simple tips for using good office ergonomics to keep your body healthy.

What is the ideal ergonomics set-up for your workstation?

  • • Shoulders completely relaxed at your side
  • • Elbows at approximately a 90-120 degree angle
  • • Wrists straight
  • • Head level or in-line with the your torso/trunk
  • • Feet flat on floor
  • • Hips slightly higher than knees

Start with your chair. All chairs are different and have a variety of features. Get to know your chair and how to adjust it.

  • 1. Sit all the way back in the chair so your buttocks touch the backrest. The lower curve of your spine should match the curve of the backrest so your spine feels fully supported. If it doesn’t, adjust the backrest height.
  • 2. Adjust the armrests so they are just below your forearms. Ideally, your forearms should be barely resting on the armrests. If the armrests are too high, your forearms will be pushed upward subsequently causing your shoulders to rise. This can cause pain in your shoulders and neck.
  • 3. Position yourself as close to your work as possible to prevent reaching, which can also contribute to shoulder and neck pain. If your armrests interfere with your ability to position yourself close to your work, remove them if possible.

Your keyboard, mouse, phone and monitor can also impact your spine.

  • 4. Ensure that your keyboard and mouse are close to you, immediately next to each other and at the same height. This will prevent reaching.
  • 5. If you use your phone frequently, position it close to you so you don’t have to twist and/or reach to access it. If possible, use a headset.
  • 6. When viewing your monitor or documents, the goal is to maintain a neutral or straight neck position. To ensure this positioning, your monitor should be directly in front of you and at least 20 inches away.  The top of the monitor should be at, or just below, eye level. If you use bifocals, the monitor should be slightly lower.  To prevent excessive neck rotation when viewing documents, keep them close to the monitor. A better option is to place the documents directly in-between the keyboard and monitor on a document holder.

Changing positions throughout the day will help keep your spine healthy.

  • 7. Sitting for a prolonged period and working in the same position is not healthy for your body or spine. Make sure you are changing your position frequently throughout the day by making small adjustments to your chair positioning, stretching and getting up to walk around.

 

Reference: www.osha.gov

Posted in Back Pain, body mechanics, Ergonomics, Occupational Health, Occupational Therapy, Spine, Spine health, Workplace, Workstation ergonomics | Tagged , , , , , , | Leave a comment
Jason H. Thompson, MD

The Effects of Obesity on Lumbar Disc Herniation Treatment

Posted on May 16, 2013 by Jason H. Thompson, MD

 

The January 2013 issue of The Journal of Bone & Joint Surgery includes an analysis of the effect of obesity* on lumbar disc herniation treatment. The study examines the results among nearly one thousand patients over a four year period of treatment of lumbar disc herniation, both surgically and non-surgically. Nearly a fourth of those in the group were considered to be obese. The researchers looked for changes or improvements in four different categories: bodily pain, physical function, disability, and mental components. No significant differences were noted in the mental component scores of obese and non-obese patients. Overall, the majority of patients appreciated better results after surgical treatment than after non-operative treatment.  After four years, however, the obese patients enjoyed significantly less improvement than the non-obese patients in the majority of measures, regardless of whether they were treated operatively or non-operatively.

In summary, the long term benefit from treatment of lumbar disc herniation is significantly better for those who maintain a healthy body weight.

*The most commonly used measure of weight status today is the body mass index, or BMI. BMI uses a simple calculation based on the ratio of someone’s height and weight (BMI = kg/m2). For adult men and women, a healthy BMI is between 18.5 and 24.9. Overweight is defined as a BMI between 25.0 and 29.9; and obesity, a BMI of 30 or higher. http://www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/

Posted in Back Pain, Effects of Obesity, Lumbar Disc Herniation, Uncategorized | Tagged , , , , , , , , , , | Leave a comment
Jason H. Thompson, MD

Is Your Office a Pain in the Back?

Posted on May 1, 2013 by Jason H. Thompson, MD

 

The New York Times Well blog recently addressed some concerns about back pain among office workers; specifically, the type of back pain experienced by workers who spend their days hunched over computers at their desks. The article discusses the importance of finding a chair with adequate lumbar support for your lower back. For many people, sitting in an office chair either causes or exacerbates lower back pain. The blog article offers several recommendations for expensive chairs that might help to prevent back pain associated with sitting all day, but concludes that a lumbar chair pillow may be plenty good enough.

You can easily find lumbar pillows at stores like Bed Bath & Beyond, Brookstone, Relax The Back, or even online at Amazon. The article also discusses a few exercises that you can do during the day to avoid back pain. The most important suggestion is to simply make sure you’re moving around and changing your position regularly. 

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Erica Bryant, DPT

Spring Into a Walking Program

Posted on April 17, 2013 by Erica Bryant, DPT

 

Hello! My name is Erica Bryant and I am a physical therapist at Valley Medical Center. I am excited to be joining Dr. Lundin and Dr. Thompson as a new contributor to the VMC Spine Blog.

Springtime is here bringing sunshine and warmer temperatures (we hope!), making it the perfect time for you to get started on a walking program. Walking is healthy for the spine because it increases your core and leg strength and improves your endurance. Walking can be part of a conservative treatment plan for low back pain. It’s also a great form of exercise before and after spine surgery because it is low impact on the body.

Before initiating a walking program after surgery, talk with your spine surgeon regarding any precautions. In most cases, it is encouraged to engage in light activity following surgery, as tolerated. I recommend to my patients that they start with short 5-10 minute walks on flat terrain, using an assistive device for support as needed. Then, gradually increase walking time by about 5 minutes, as tolerated and as long as you are pain-free. Multiple short walks throughout the day allow your muscles time to rest and help you build up your endurance. You may be overdoing it if you are feeling a significant increase in pain level following your walk, if you are having any sharp pains around your surgical site, or if you are feeling muscle soreness lasting more than 2 days.

If you have severe back pain, walking outdoors or on a treadmill may not be an option. Water walking at your local pool (forward, sideways, and backward) is a great alternative for you to get the benefits of walking without the pain. Exercising in water decreases the load on your body, including low back, hips, and knees. This allows you to move more freely than you would on land.

Please feel free to post any questions you have about starting a walking program pre- or post-surgery.

Thanks for reading!

Erica Bryant, DPT
Valley Rehabilitation Services

 

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Jason H. Thompson, MD

Smoking and Back Pain

Posted on April 3, 2013 by Jason H. Thompson, MD

 

A study published in the December 2012 issue of the Journal of Bone and Joint Surgery reported some interesting results regarding smoking and back pain. Previous research has shown that smoking is associated with a higher risk of surgical complications and less satisfying outcomes after surgery, but this particular study focused on the relationship between smoking and patients’ self-assessment of their own back pain.

The researchers compared over 5,000 patients with back pain, looking at their reports of pain over an average period of about eight months. Some of the patients had surgery, but most did not. They found that the patients who were current smokers reported significantly more pain, and significantly less improvement over the treatment period, than patients who had never smoked. What’s more, they found that patients who quit smoking during their course of care also experienced more improvement in their own assessment of pain. In short, they discovered a strong link between the improvement of patient-reported pain and not smoking, even if the patients quit smoking during the course of treatment.

To sum up, if you quit smoking, you may decrease your back pain in addition to saving money and, probably, living longer!

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Jason H. Thompson, MD

Best Surgical Approach Depends on Diagnosis

Posted on May 22, 2012 by Jason H. Thompson, MD

I’m often asked by patients who are contemplating surgery about my approach: Will the incision be big? Is it arthroscopic? Do I use lasers? My approach is completely dependent on each patient’s diagnosis and what our experience at the Spine Center tells us gives the best result for that diagnosis. I’m interested in outcomes that are lasting and durable, and sometimes that means I have to make major corrections which necessitate long incisions.

For example, last week I had the opportunity to dramatically change a patient’s life for the better. A woman came to see me with kyphoscoliosis (abnormal curvature) of the cervical spine, which, over time, left her chin resting on her chest, slightly askew. She had restricted range of motion in her neck; she was unable to walk or get around much because she couldn’t safely see where she was going, crushing her quality of life. For some conditions of the neck, a short, minimally-invasive procedure done as an outpatient is the perfect solution. But this woman’s extreme condition took eight hours of complex cervical spine reconstruction.

I’m proud to say that today she is walking tall, looking everyone straight in the eye again. When you weigh the vastly improved quality of life with the size of her scar, the length of the incision seems irrelevant to me. So while I often perform small-incision, quick-recovery, outpatient surgery, and I realize this is what many people would prefer, what I love most is relieving your pain and restoring well-being to your life using whatever procedure necessary.

If you are interested in learning more about your own spine condition and what procedure may be warranted, I am happy to meet with you and discuss your options. 

Thanks for reading!
Jason Thompson, MD

Phone: 425-656-5060
Web: seattlespinedoc.com

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David Lundin, MD

What is Cervical Disk Replacement? Is it Helpful for Neck Pain?

Posted on April 23, 2012 by David Lundin, MD

One of the most common conditions I see in our Neurosurgery Spine Clinic is neck pain and associated shoulder and arm pain due to a disk herniation. The cervical disks are the soft cushions between the vertebrae that act as shock absorbers and allow for movement of the neck. Occasionally, these disks will tear, leading to severe pain complaints or even neurological conditions with arm pain, sensory loss or weakness. When this occurs, neurosurgeons will frequently recommend removal of the ruptured disk if non-surgical treatments fail to improve things.

This surgery, called “anterior cervical discectomy,” is a minimally invasive and highly successful procedure which frequently allows patients to recover at home after an overnight stay. Most patients can return to light activity and even light exercise within a week or two. However, when the disk is removed, it is necessary to place a “structural support” between the vertebrae to keep the neck in normal alignment.

The standard structural support in the past was made by removing a small piece of your hip bone to fashion a new support. Over time, this bone (called autograft) would “fuse” to the adjacent vertebrae. Newer structural supports are made of cadaver bone (allograft) or high-grade medical plastics (PEEK cages). One issue with all three of these grafts is that by fusing to the spine, they reduce motion of the neck. Although this loss of motion is rarely noticed by the patient, the added stress on the spine can lead to degeneration of the adjacent levels many years or even decades down the road.

As such, in August of 2007, the FDA approved the first Disk Replacement for use in the United States. These disks allow for more natural motion and therefore have a theoretical advantage over fusion devises in preventing this “adjacent segment degeneration” in the years ahead.

During my training at the University of Washington, I was very fortunate to be a part of the official 2003/2004 FDA trial to study disk replacement and assisted in the placement of the very first artificial disk at the University Hospital in Seattle. Since that time, I have been a strong advocate for disk replacement and was one of the first surgeons in the US to be certified to place the disks since formal release in 2007. I have vast experience in placing these disks and have been on the forefront of obtaining authorization from insurance carriers in the private, public and labors and industries sector.

At this time, disk replacement surgery is only FDA approved for use at a single level which means if you have 2 or more disks that are torn or ruptured and need treatment, you unfortunately are not a candidate for this technology. Additionally, despite the wide base of medical literature to support disk replacement as an alternative to fusion, not all insurance carriers cover this technology. Here at the Spine Center we are experts in determining if you are a candidate and working with your insurance carrier to ensure you are covered.

Posted in Neck Pain, Surgical Techniques | Tagged , , , , , , , | 2 Comments
Jason H. Thompson, MD

What about chiropractic?

Posted on January 12, 2012 by Jason H. Thompson, MD

What about chiropractic? I don’t think a day goes by without my encountering this question — and it’s a good one! Patients will often make comments to me like, “I know you surgeons don’t like chiropractors, but….”

Fortunately, that’s just not true. For years, I have believed that chiropractors — just like physical therapists, surgeons, massage therapists, primary care providers, and acupuncturists — play a vital role in the care of patients’ spines. Now we have great evidence that their care is better than many other things, like medications or surgery, for some conditions! A recent article explains that for neck sprains and activity-related neck pain or muscle spasms (the classic “Doc, I woke up with a crick in my neck” problem), chiropractic care is better at alleviating symptoms than medications or shots, and certainly better than surgery.

So go for it! Go see your chiropractor, with my permission. They are part of the team! Just remember that if it’s not working, it’s time to move on. Come see us at the Spine Center if you’re unsure and we’ll help you find an appropriate path to spine wellness.

Phone: 425-656-5060
Web: seattlespinedoc.com

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Jason H. Thompson, MD

A New Year, A New Contributor to the Spine Blog

Posted on January 8, 2012 by Jason H. Thompson, MD

Happy New Year! I’m excited to introduce myself as a new contributor to the Spine Center blog, joining Dr. David Lundin.  I am a fellowship-trained, board-certified spine surgeon and the Medical Co-Director of The Spine Center at Valley Medical Center. I look forward to sharing my point-of-view, and responding to your questions on issues related to your neck and back.

Some people assume surgeons are quick to prescribe surgery to patients, but my approach is to suggest other treatments first, such as physical therapy, spinal injections, medications or massage. If surgery is warranted, I perform decompressions, disc replacement, scoliosis correction or spinal fusion to help patients regain their maximum potential. My special interest is in treating young adults with scoliosis, and when possible, using the latest technologies to reduce the “footprint” of spinal surgery.

As Medical Co-Directors of The Spine Center, Dr. Lundin and I have developed an outstanding orthopedic- and neuro-spine program and are continually working to improve the patient experience – from how you are treated in the office, to your care in the hospital, and post-surgery rehabilitation. The Spine Center is fortunate to offer specialty-trained nurses, therapists, technicians, and aides, larger patient rooms for easier mobility, and an environment conducive to healing. This level of care translates into superior results for our patients.

As a surgeon and care-giver there is no greater compliment than a satisfied patient. Your interaction with us and feedback is important as we continue to shape The Spine Center. I look forward to your questions and comments!  

Jason Thompson, MD

Phone: 425-656-5060
Web: seattlespinedoc.com

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David Lundin, MD

Minimally invasive surgery? Laser surgery? What are these techniques and do you perform them?

Posted on December 2, 2011 by David Lundin, MD

Many people at some time in their life will experience a period of severe back pain that radiates into their buttock or leg. This symptom, called “sciatica,” is typically due to a herniation of a lumbar disk that irritates or compresses one of the nerves in the lower back. Most cases of sciatica will improve with conservative, non-surgical treatment within 6 weeks. However, for those patients who do not improve, surgery may be an option. Many patients come into my office with this problem and often ask about “minimally invasive surgery” and “laser surgery” as they have seen it advertised in various places. I can understand why. Of course, minimally invasive surgery sounds less scary, implies less pain, a shorter recovery time and the thought of using a laser to perform this makes the technique appear cutting edge. At Valley Medical Center’s Spine Center I specialize in minimally invasive surgery on the spine. However, I do not use lasers in my techniques, and here’s why:

Recently, minimally invasive surgery has gained tremendous popularity as studies have shown that the less tissue disturbed during surgery, the faster patients can recover. As such, many new techniques have emerged to treat the herniated disk by actually removing the irritating fragment, without damaging the local muscles and tissues.

The most common minimally invasive techniques involve expanding what the surgeon’s eye can normally see. By expanding our vision we can make much smaller, less destructive incisions to access the disk and remove it. Minimally invasive techniques use tools such as operating loop glasses, direct 3D magnification that increases normal vision 2-5x, operating microscopes–which allow direct 3D vision to be greatly magnified (up to 60x normal vision), and the endoscope, which offers indirect 2D vision (i.e. a camera is used to project images onto a TV monitor.)

Theoretically, laser surgery is another way to reduce nerve irritation by shrinking the disk rather than removing it. Laser surgery, also called Percutaneous Laser Disc Decompression (PLDD), uses a small incision to introduce a fiber into the disk herniation. Laser energy vaporizes the water contained in the disk to shrink it. Think of a large water balloon – when you remove some of the water, the size of the balloon shrinks.

Although often advertised as a “new breakthrough in treating disk herniation,” the first clinical laser disc decompression was performed in 1986 and the technique was approved by the U.S. FDA in 1991. Despite more than 20 years of experience with this technique, there is a scarcity of literature featuring randomized clinical trials that show its effectiveness.

Currently, minimally invasive open discectomy using an operating microscope is considered to be the universal gold standard in the surgical treatment of lumbar disc herniation– that is why I choose to employ this technique at our Spine Center. We use cutting-edge equipment that allows for the best outcomes with the shortest recovery times. For patients needing surgery for this very common problem, we have had great success with this technique.

Posted in Back Pain, Surgical Techniques | Tagged , , , , , , | 8 Comments