Experiencing back or neck pain? We can help with that!

Michigan surgery specialists offers orthopedic services for your back and neck pain! We understand that conditions of the spine can be scary and seeking treatment might be pushed off because of the possibility of surgery. That’s why we asked one of our orthopedic spine surgeons, Dr. Paul Al-Attar, to shed some light on the common back/neck conditions and solutions to help put your mind at ease.

 What generally brings a patient into the office?

Patients often come into the office based on how their back and neck pain is affecting their daily life. Some sources of this pain may be due to a recent injury, while others can be due to chronic wear and tear over time. Although many individuals find that their back or neck pain may improve on its own with conservative options and some time, unfortunately for some people the pain is persistent.  

This pain isn’t always limited to the neck or back, many individuals also experience symptoms in their arms and legs, such as shooting or cramping pains, numbness/ tingling sensations, or even weakness, trouble handling objects or difficulties walking. These symptoms suggest a neurological problem, such as a pinched nerve; this can even happen in the absence of back or neck pain. All of these symptoms can severely limit an individual’s quality of life and affect daily activities like work, walking or running, playing with children, engaging in physical activities or even standing/sitting for long periods of time.

“Once these symptoms start to affect a patient’s quality of life, it is important to seek help from a specialist. As a spine surgeon, it is my job to figure out what is causing the issue and come up with a specific treatment plan with the patient that would restore his/her quality of life as best as possible.”

What are some of the more common diagnoses you’ve encountered?

One of the most common issues we see is generalized back and/or neck pain. Short-term, or acute, back/neck pain can often be caused by an injury, leading to muscle strain which results in inflammation. Falls or other traumatic injuries can also result in vertebral fractures, which can be a cause of both acute and chronic pain. Fractures commonly occur in patients with osteoporosis who suffer a fall.

Chronic, or more long-term pain is most commonly caused by arthritis of the joints in the spine, degeneration of the intervertebral discs, or scoliosis.

Another very common issue we see is sciatica, otherwise known as radiculopathy, which manifests as shooting pains into the buttocks, legs, and/or feet. This can also happen in the upper extremities, affecting the shoulders, arms, and/or hands, causing numbness, tingling, or weakness in the arms or legs. These symptoms are most likely caused by a pinched nerve in the neck or back. The nerve could be pinched due to a combination of severely bulging discs, bone spurs, or overgrown ligaments, which are usually due to arthritis. This is called spinal stenosis. Alternatively, a pinched nerve could also result from an acute or chronic disc herniation. Occasionally, patients will come in with issues involving gait or balance, which could signify pinching of the spinal cord in the neck or mid-back.

“It is important for a spine surgeon to properly investigate and discover the problem by listening to the patient, ordering the proper imaging and tests and developing a plan of action, whether it involves conservative or surgical recommendation.”

What is a typical first appointment like for a new patient?

A patient’s first appointment is a big milestone. Understandably so, many individuals are reluctant to see a doctor for an issue they are experiencing, especially when it comes to their back or neck and the potential for surgery. Through a combination of patient history, a physical exam and X-rays performed at the first appointment, we will be able to determine the next steps and develop a plan of action. If a patient has had any prior tests or imaging such as MRI or CT scans, we ask them to please bring all of these important items and any CDs with them so that we can review them together at the appointment.

“I always reassure my patients that just because they are at the spine surgeon’s office does not mean they are going to get surgery or even need surgery for their condition. At the first appointment, my job is to get to know my patients and what symptoms lead them to seek out care. Through our discussion, it is my goal to build a unique relationship with each patient as an individual, who has his/her own lifestyle, interests, and goals for their care.”

What conservative treatment options do you offer or recommend?

Many spine-related issues can be treated with conservative management. Physical therapy is one of the staple conservative treatment options for issues with the back or neck (learn more about our own in-house physical therapy department, Motus Rehabilitation).

Depending on the issue, certain conditions can be treated with an epidural steroid injection, which can be administered by a pain management specialist. Other forms of conservative management that patients may find beneficial include chiropractic manipulation, acupuncture, massage, or other forms of alternative interventions; however we do not offer these specific services.

“In general, I like to recommend trying conservative treatment options first if a patient has not had any prior to the office visit. Patients can benefit greatly from these treatments and sometimes avoid having to undergo surgery. In certain situations where surgery might cause more harm than good, these conservative treatment options can potentially allow a patient to have the ability to live a desirable quality of life.”

When it comes to surgery, what are the common procedures you perform?

When all conservative treatment options have been exhausted, surgical options are then explored with the patient, keeping in mind their condition, lifestyle, and needs. The patient is the most important part of the care team so it is essential to incorporate the patient’s opinion in every decision regarding his/her treatment, especially when it comes to surgery.  

I am fortunate to have received extensive training in diagnosing and treating the majority of spine conditions. The most common procedures I perform include a combination of open and minimally invasive techniques, whichever would be most beneficial to the patient’s unique condition. These include, but are not limited to, microdiscectomy, laminectomy, foraminotomy, cervical laminoplasty, posterior lumbar fusion, anterior lumbar fusion (ALIF/OLIF/XLIF), posterior cervical fusion, anterior cervical discectomy and fusion (ACDF), cervical disc replacement, and robotic-assisted surgery. 

What are the typical patient concerns when it comes to back and spine surgery?

One common concern is the recovery process after surgery, which really depends on the type of procedure being performed. Certain procedures can be performed on an outpatient basis while others may require a short inpatient hospital stay. Post operatively, patients will be up and walking as much as possible starting the day of surgery; patients are not bed bound. The majority of patients will complete a course of post-op physical therapy in order to accelerate the recovery process. Recovery protocols and timelines at discussed with the patient during appointments before and after surgery.

 Another concern is the safety of spine surgery. Spine surgery is major surgery and there is risk associated with it, which is discussed in detail during the preoperative visits.

“We keep the risks very low through working together with our anesthesiologists, nurses and the rest of the operating room and hospital staff to ensure safety and the best possible outcome for every individual patient undergoing surgery.”

A little about Dr. Al-Attar:

 What drew you to spine surgery?

During my orthopedic surgery residency training, we were exposed to all aspects of spine surgery, including taking extensive Level 1 spine trauma call where we had to treat complex spine cases. Spine surgery caught my interest during this time for many reasons, including the intricate anatomy, the unique biomechanics and the delicacy and precision required during these surgeries. However, what solidified my decision to become a spine surgeon was the realization that spine surgeons have the ability to truly make a positive difference in patients’ lives. Seeing patients who were debilitated from their condition achieve a quality of life after surgery that they hadn’t experienced in years was incredibly touching and rewarding. Each day, I am grateful to have the privilege of helping people in this manner.

What is your philosophy on patient care?

I am dedicated to providing comprehensive care to each individual patient. Not all spine conditions require surgical treatment, and I stress the importance of exploring conservative options first. If surgery is recommended, we will work together to develop a tailored treatment plan unique to the patient’s condition and needs to ensure the best clinical outcome. I strive to attain the highest quality of life for my patients and care for them as if they are my family.

To learn more about Dr. Al-Attar, check out his profile here. If you’re tired of living with back or neck pain and are interested in scheduling an appointment with one of our orthopedic spine surgeons, give us a call or complete our appointment request form!

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