Have you ever felt a sharp stabbing pain in your back or experienced a shooting pain down your leg and wondered if it could be a symptom of a more serious problem?
A thorough exam by an interventional pain physician, along with diagnostic studies such as X-rays and an MRI, could provide you with some answers.
Interventional Pain Management Specialist Jonathan D. Grossman, MD, of Saint Agnes Care Brain & Spine Institute first determines if the source of the pain is muscular, fracture-related, or caused by a pinched nerve or disk injury.
“If the pain is concentrated in the lower back and leg, it may be nerve pain such as sciatica,” he says. “With muscular and discogenic pain, it can usually be positionally relieved with lying down. However, with spinal vertebral compression fractures, the pain is typically constant regardless of positional change and can be unrelenting for long periods of time.”
According to Dr. Grossman, spinal compression fractures are most commonly diagnosed in individuals who suffer from osteoporosis. Those individuals tend to be post-menopausal women, due to the overall weakening of their bones from lack of estrogen levels, which consequently results in less calcium absorption into the bone.
“This is why vitamin D, which enhances calcium absorption into bones, and calcium supplementation, are both so vital in this population,” he says.
Others at risk include individuals requiring chronic steroid use (as treatment for COPD, for example), patients with certain types of cancer, patients who are diabetic, or individuals who have experienced trauma from a car accident or sports injuries.
Fortunately, Dr. Grossman and the Saint Agnes Care Brain & Spine Institute offer the balloon kyphoplasty or vertebroplasty procedures, which are quick, minimally invasive outpatient procedures to repair compression fractures.
“With the vertebroplasty or kyphoplasty procedure, patients can undergo a 15-30 minute outpatient procedure and return home the same day,” Dr. Grossman says. “The vast majority of patients feel significant pain relief that day.”
During the balloon kyphoplasty procedure, a narrow pathway is made into the fractured bone for the balloon instrument to enter. A small balloon is then guided through the instrument and inflated to alleviate the fractured vertebrae while also creating a safe space for bone cement to fill the fracture.
Dr. Grossman explains that candidates for this procedure are those who experience significant pain that is limiting their daily function, mobility and quality of life as defined by Activities of Daily Living (ADLs) and Instrumental Activities Daily Living (IADLs).
“If it hurts for a patient to get out of bed, walk around the house or dress themselves, then their quality of life diminishes rapidly,” he says. “Painful vertebral compression fractures should not be accepted as a normal consequence of aging.”
That was the case for retired teacher Joyce Fisher of Fresno who suffered from debilitating back pain caused by a spinal compression fracture.
“I have no idea how it happened, I didn’t feel anything when it happened,” she says.
For the past year, Joyce has been undergoing treatment for osteoporosis. After experiencing significant pain for some time, her primary care physician ordered an X-ray that revealed a fracture in her spine and referred her to Dr. Grossman for kyphoplasty.
“The procedure went very well and I was able to go home after about 3 to 4 hours,” she says. “It’s still a process and I feel relief in certain positions and continue to improve. I look forward to getting back to gardening when I can.”
Patients who have acute and recent-onset symptomatic fractures generally feel better immediately after the procedure and can return to their normal activities. Patients who have sustained one or multiple fractures over long periods of time typically feel pain relief several weeks after the procedure. When combined with regular visits to a physical therapist, function and mobility are further enhanced by rehabilitating core and back muscle strength, stability and flexibility.
“Of all the varied interventional procedures I’ve performed, this one is the single most effective and gratifying – patients respond very well and quickly, pain is reduced, and function is restored,” Dr. Grossman says.
If you’re at risk for spinal fractures, Dr. Grossman says there are simple things you can do to build a healthier back:
- Maintain good posture.
- Perform physical activity on a regular basis to stay active.
- Practice core strengthening positional exercises to train the body to be more stable while performing daily tasks (e.g. bending over to put shoes on, vacuuming or cleaning). Two good body mechanics exercises are planks and bridges for the core, for example.
- Take calcium and vitamin D supplements. If you have osteoporosis, supplement with an osteoporosis-specific medication to help build back bone integrity.
Dr. Grossman is Board-certified in Physical Medicine and Rehabilitation with a sub-specialty Board-certification in Interventional Pain Management.
Practicing in the Central Valley for nearly 10 years, Dr. Grossman previously provided care for patients at Kaiser Permanente and CCFMG. He completed an Interventional and Non-interventional Pain Management Fellowship program at University of Minnesota/Fairview Pain and Palliative Care Center. He also completed Physical Medicine and Rehabilitation residency training at the University of Minnesota and an Internal Medicine residency at Atlantic City Medical Center in Atlantic City. He earned his medical degree from St. George’s University School of Medicine in Grenada, West Indies.
“I have wanted to be a physician for as long as I can remember,” he says. “I’ve always wanted to help people and be responsible in directing them to the right care.”
Our care philosophy
Our multidisciplinary team prides itself on offering the most advanced technology and innovative techniques, for neurological care that’s unrivaled in the Central Valley. This means patients get the care they need right here at home, delivered by experts who are part of our community.
4770 W. Herndon Ave., Suite 105
Fresno, CA 93722
Monday-Friday, 8 a.m.-5 p.m.