Lower Back Pain Basics


Lower back pain episodes, that resolve within 2 weeks, are typically caused by muscle strain or spasm. Even though this doesn’t sound serious, the pain can be severe. Strains, muscle spasms and other issues in the lumbar portion of the back are common because this area bears much of the body’s weight during walking, lifting, and other activities.

Problems arise when any part of the complex, interconnected network of muscles, nerves, discs and tendons become inflamed or injured. Sources of low back pain include strained or spasming muscles; irritated nerves; damaged bones, ligaments or joints; or issues involving disc degeneration.

Emergency Treatment

If you experience these symptoms, in conjunction with lower back pain, you should seek immediate treatment.

  • Fever
  • Abdominal pain
  • Bowel or bladder incontinence
  • Severe pain in legs or inability to bear weight on leg(s)

At Home Treatment

If pain is inconvenient, but not debilitating, most people start pain management and treatment at home. Most muscle inflammation and strain issues will resolve within 2 weeks of at home care. If you try these treatments and they fail to improve pain and mobility after 2 weeks, it may be time to consult a doctor.   

  • One or two days of rest for your back to minimize stress on the area.  
  • Application of ice and heat. Generally speaking, ice reduces inflammation and heat increases blood flow and relaxes muscles. Ice is typically recommended within the first 48 hours with heat used thereafter.
  • Over the counter pain relief medication ibuprofen, naproxen, aspirin or acetaminophen. Please consult your doctor about which is best and to confirm that they are safe for you to take.
  • Adjust sitting and posture to take stress off the lower back.
  • After brief period of rest, resume light exercise if possible such as walking short distances, gentle stretching and yoga or water activity.

Doctor Treatment

If lower back pain does not start to subside within one to two weeks, and continues to interfere with mobility and daily activities, consider seeking medical attention. Physicians can identify the source of pain and determine the best course of treatment.  Common treatments include, massage or physical therapy, prescription medications, steroid injections, and other pain management techniques. Surgical treatment is rare, but may be indicated for issues involving bone and disc degeneration.

If you have been suffering from chronic lower back pain for some time, consider a consultation with Dr. Berkowitz and his team at Center for Orthopedics. Call 440-329-2800.

Add comment Posted in  Back and Spine February 15, 2017

Caring for Senior Athletes

Senior athletes have spent their whole lives pushing themselves out of their comfort zones.  Unfortunately, aging bodies don’t respond the same to “toughing it out.” There are declines in muscle mass, bone mass and weakening of ligaments, tendons and cartilage to consider. Yet senior athletes are also minimizing some of this weakening by staying active, so it’s not a black and white issue. Senior athletes should not be benched, (or couched), but they also can’t ignore new limitations.

There are two important distinctions to consider when you are an orthopedic patient and also a senior athlete.

Approach to Limitations

National Institutes of Health says, “Most injuries in older athletes are chronic and overuse injuries that result in diminished flexibility and endurance. In addition, many aging athletes have medical and musculoskeletal problems that mandate tailoring athletic activity to the patient’s general health and functional requirements.”

Common overuse injuries, often aggravated by lumbar disc disease and osteoarthritis, include but are not limited to muscle strains, tendinopathy, meniscal tears and fractures. It’s also important for senior athletes to consider changes in heart, lung and blood flow capacity, which can affect reaction time (which helps prevent injury), muscle regeneration, and also general workout recovery.

Aging should not stop a senior athlete from doing what they love, but there is a difference between young and young at heart. It’s good to remember that the zone between discomfort and injury gets smaller as we age.  

Approach to Injuries

In sports medicine, it is common to treat athlete’s injuries not just with rest but also with corresponding strength training to improve future mobility, flexibility and strength. Sedentary seniors with injuries are often told to rest and avoid using the injured area. Seniors athletes, however, should not always be given total downtime recommendations just because they are seniors.

While total downtime may be the right course of action, it’s important for senior athletes to let their physicians know about active (or pre-injury active) lifestyles so that this can be taken into consideration during rest and rehab. They may need total rest, but they may also benefit from a physician with sports medicine experience who can recommend activity modification to help heal and restore functionality to injury areas.

Approach to surgical treatment may also be different for senior athletes. It’s important to let your orthopedic physician know what types of activities you want to continue to engage in after surgery. Some may be possible while others may have to be given up.

While some active seniors may be better candidates for certain surgeries, others may not. Senior athletes have different rates of aging and decline and different corresponding health issues and assets — BMI, strength, coordination, etc.  So, a squash partner’s shoulder surgery and recovery may look nothing like your own.   

If you are a senior athlete experiencing chronic pain or an injury, consider the sports medicine specialists and physicians at The Center for Orthopedics. Give us a call at 440.329.2800.


Add comment Posted in  Back and Spine ,Conditions ,Sports Medicine January 26, 2017

Not Your Father’s Back Surgery

Minimally Invasive Spine Surgery Leads to Faster Recovery

Dr Berkowitz smallMost all 20th century back surgery was done via “Open Surgery.” In this more traditional approach, the doctor makes an incision that is 5 to 6 in. long and “opens” or moves the surrounding tissue to access the area needing surgical treatment.  Now, thanks to advances in technology and technique, patients can have Minimally Invasive Spine Surgery (MISS), which uses a small (one inch or smaller) incision, along with specialized instruments, to gain targeted access to the problem area in the spine.

The benefits of MISS come from less surrounding tissue disruption and damage. As Dr. Robert Berkowitz, MISS specialist at The Center for Orthopedics explains, “With this minimally invasive technique, we can get to the affected area with a small tube, and in doing so, dial right into the problem spot. This means less ligament, muscle and bone disruption in the surrounding area, which leads to less bleeding, less pain, and faster recovery time.”  The MISS procedure can be used to treat herniated discs, spinal stenosis, spondylolisthesis and chronic leg or back pain. Fusion, laminectomy and microdiscectomy surgeries can all be done with MISS, which is a technique also used in cervical (neck) spinal surgery.

Dr. Berkowitz sees MISS as a great option for those suffering from herniated discs. “With minimally invasive spine surgery on a herniated disc, I will spend 30-45 minutes in the operating room. Essentially, we make an incision less than an inch long, remove the part of the disc impinging on the nerve, and then you go home the same day.  Most people have immediate relief of their pain. The bottom line is that those with less pain can start physical therapy sooner and then see a reduction in recovery time.”   

While patients can appreciate faster recovery, as a surgeon, Berkowitz appreciates the risk reduction associated with MISS. “I have not yet had to give an MISS patient a blood transfusion. Going minimally invasive significantly reduces that risk.”

Considering the obvious benefits of MISS, patients might wonder why open surgery is still common practice. One reason is that open surgery makes more sense for those with multi-level problems and diseases. Too many problems would lead to a higher volume of small incisions and at some point the larger incision simply makes more sense. However, for those with one or two level problems or disease, using a smaller incision is often the better option.   

But, according to Berkowitz, even those who are ideal candidates, are not always offered MISS, simply because the practice is not yet commonplace. “In fifteen years time, MISS will be standard care, once the technology and training comes further into the mainstream,” he says, “In the meantime, there are surgeons with additional training and experience who do MISS as their standard, and, for many patients, this can be more advantageous than traditional open surgery.”

If you’re interested in learning more about MISS as a treatment option, call to schedule an appointment with Dr. Berkowitz at The Center for Orthopedics. 330.329.2800.

Robert Berkowitz, MD is a board-certified orthopedic surgeon who specializes in minimally invasive surgery of the spine and was the first surgeon in Lorain County to perform a cervical disc replacement.  A visit with Dr. Berkowitz will ensure you treatment with the most current state of the art technology available today for operative and non-operative spine conditions.   

Add comment Posted in  Back and Spine October 31, 2016

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