We are back with our “2 for Tuesday” series on Back Talking! I am hosting weekly Facebook Live sessions every Tuesday at 2 pm, so check us out over on Facebook at The Joint Morrisville page. This week was our first show on Facebook live, so the first question that I answered was an easy one – Who am I, and why you should listen to me. The second question was asked of me in the office last week, someone was surprised to find out that x-rays weren’t necessary. So question 2 is “Are x-rays necessary?”

Are X-rays Necessary?

There are many tools that doctors have in their toolbox, and imaging studies such as x-ray, CT scans, and MRI allow us to peer into the body like never before. But in my opinion, the most important part of a patient encounter is the history. If the doctor asks the right questions, they have in their mind a working diagnoses before they have even touched the patient. In the answers that the patient is giving the doctor, they are listening to what are termed red flags. These are items that get the doctors attention and require further investigation.

In regards to x-rays for back pain, they are only indicated if one or more of the following red flags are present:

• severe or progressive neurologic deficits such as loss of motor control ( i.e. foot drop or loss of reflex upon exam)
• loss of bowel or bladder control
• fever
• unexplained weight loss
• previous history of cancer
• long term use of steroids or immunosuppressants
• trauma

So the answer to the question “are x-rays necessary?” is occasionally. Thank goodness that these red flags are not very common. In my practice maybe less than 5% of first time patients are referred out for some type of imaging.

To listen to the podcast, click on the link below.

We continue with the series titled “what is causing your low back pain?” on Blab. We’ve been hosting weekly blab episodes every Friday at 1p, so come check us out over at blab.im. This week we discuss John, he is an elder gentleman who has arthritis, most likely caused by the 30 plus years of working on a police force.

Arthritis

One of the most common causes of low back pain worldwide. There are actually over 100 different types of arthritis, which is essentially a condition where one or more of your joints is inflamed. The most common form is osteoarthritis. Its typical presentation is that of pain, stiffness, and in some cases swelling. It affects around 1 in 5 Americans, and it is estimated that more than 20 million Americans have severe limitations on a daily basis due to arthritis. It places a tremendous burden onto the US healthcare system and on the economy. It causes more than 1 million hospitalizations and 45 million doctor visits in a given year. We spend more than $100 billion in its treatment. Recent discoveries have found a genetic link to osteoarthritis. But yet we are no closer to having a solution to the problem.

In this episode we follow John. He is a retired cop who spent over 30+ years either walking a beat, or behind the wheel of a patrol car. I’ve seen him off and on for over 10 years now, so I know what he diagnosis is when he walks through the door. Typically he will have done something crazy to cause the arthritis in his back to flare up. This time around it was painting a room while sitting in a chair.

Take a listen to this episode below!

In this week’s episode of Back Talking! we continue with the series “What is causing your lower back pain?” Lumbar strains represent probably the largest single cause of someone struggling with a lower back pain issue. We decide to clean out the basement,  help a friend move that old couch down into the basement, or spread a truckload of mulch in a weekend, and the next thing you know is that you can’t get up off of the floor!

Lumbar Strain

There is always confusion regarding the words sprain and strain. People use them interchangeably, but there is a difference in the medical world. A sprain is the tearing or stretching of a ligament, a strain is the tearing or stretching of a muscle. When someone rolls their ankle and sprains it, they have suffered an injury to the ligaments surrounding the ankle joint. When someone overdoes it working in the yard, it’s typically a muscle injury. The good news is that muscle strains recovery fairly quickly.

In this case study we follow Jason. He is one of those guys that had a truckload of mulch dumped into his driveway. He then spent the next 2 days spreading that around his yard with a rake and a shovel. If that wasn’t enough, the following weekend he decides to tear a rotting deck off of the back of his house. The days that followed for him were a real struggle, so much that his wife had to help him dress and put on his shoes for him! He’s having a hard time sitting at work as well.

We also clarify the age old heat or ice debate that people so frequently ask about. We also discuss the use of topical creams such as Icy-Hot and Ben-Gay. So take a listen and see how Jason recovers from his weekends of work!