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Medical and Surgical Treatments The best treatment for each patient must be based on an accurate diagnosis. Although it is appealing to have the latest procedure, the newest medication, the smallest micro-surgery or arthroscopic surgery, best treatment must be appropriate for each individual patient’s condition. Treatment must also be based on scientific evidence, not marketing on television or in news magazines. At SpineCare, we pride ourselves on making correct and complete diagnoses, and then offering our patients the most effective treatment for their unique problems. We cannot jump at the latest fad, things that have not been proven to work. Our patients and our reputation mean too much for that. Spine surgery must be taken seriously. It is imperative to select the right procedure for the right patient at the right time. Many of the terms discussed here are also defined in the SpineCare glossary and illustrated in the section on anatomy. Rehabilitation After a back or neck injury, many people become inactive. Sometimes it is because of the pain. Other times it is because of fears of reinjury or making the pain worse. But inactivity leads to weak muscles, and weak muscles make it harder to get back to normal activity. A vicious cycle develops. We treat many professional and high-level amateur athletes. They know that they must continue to exercise to keep the injured muscles strong and to develop strength in other muscles to compensate for the injury. They practice the old saying, “no pain, no gain.” The process of using exercise, stretching, muscle substitution, and good body mechanics to help injuries to heal is referred to as rehabilitation. Many patients with back or neck injuries have not had adequate rehabilitation. They may have gone to physical therapy, but only received hot packs, ice, electrical stimulation, and massage. While these modalities feel good, they don’t help people get better. The job of the physical therapist is to design and exercise program that is safe, effective, and has a low risk of injury for each patient. We work with physical therapists to help them design the program for each patient. Some patients can do well with two or three sessions per week and an independent exercise program the other days. Other patients, especially those who have been injured for months or years, need programs that are eight hours per day, five days per week, for a month. The program that we emphasize is called lumbar dynamic stabilization training for back problems and cervical-thoracic dynamic stabilization training for the neck. These are programs of spine-safe strengthening, flexibility training, and training in the ways to use the spine properly at rest, at work, and at play. The therapist evaluates the patient to set the best initial goals, and then sees the patient regularly to increase the exercise regimen when the patient is ready. Eventually the person is discharged from formal rehabilitation, and transfers to an independent program at home or at a gym.

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