At some point in their lives, 80% of Americans will have an attack of back pain or neck pain. Worse, once you have your first back pain attack, you are four times more likely to have a recurrence. That’s the bad news.
The good news is that in the vast majority of cases, back pain or neck pain symptoms will go away on their own a week or so. Other times, when the pain symptoms persist for longer than a week, most of these cases will also improve with some customized stretches that restore movement to inflamed ligaments and muscles, anti-inflammatories or spinal injections that relieve pain long enough to get moving again.
The root issue, however, is that for common acute back pain symptoms that do not involve nerve damage (numbness, weakness or pain in an arm or leg) physicians don’t know for sure which patients will respond to non-surgical treatment options, and which problems require more “invasive” treatment, such as spine surgery. Consequently, the best spine care exhausts non-surgical treatment options for back and neck pain before spine surgery is considered.
With back and neck pain so widespread, often those with back pain symptoms end up making a pilgrimage to multiple locations, from a chiropractor office, to their family practice physician, to then a referral to a spine specialist for an MRI and other diagnostics. For the person with an aching back, the journey to multiple locations to suffer through a variety of conflicting opinions and treatment plans can be a major headache on top of a backache.
Thankfully, for those in Northern New England, we are positioned to help.
Recognizing that the best way to care for complex health problems is through a Center of Excellence approach, Central Maine Orthopaedics created Maine Spinecare in 2010. Maine Spinecare combines the expertise of fellowship-trained spine surgeons, non-surgical spine MDs, interventional pain specialists, physician assistants experienced in spine and on-the-job injury, and spine-specialized physical therapists. The spine center assembles all these spine care specialists, along with X-ray, MRI diagnostics, an injection suite, and an ambulatory surgery center — all under one roof for the convenience of those with back and neck pain.
The spine center includes the expertise of:
Michael Regan, MD — a board-certified orthopaedic surgeon fellowship-trained in spine surgery, the highest level of medical training.
Matt McLaughlin, MD — a specialist in Physical Medicine & Rehabilitation, with an emphasis on non-surgical management of back and neck pain, including the use of spinal injections to relieve back pain and neck pain symptoms. He is board-certified in Physical Medicine & Rehabilitation; Electrodiagnostic Medicine; and Pain Medicine.
Maine Spinecare has an internal exercise gym with spine therapists who have advanced training in back pain and neck pain. By assembling all the physician offices, diagnostics and therapy gym in one location in Central Maine, the spine patient no longer has to drive around town for care. Best of all, by assembling all these spine specialists together, eliminates the need for multiple referrals, delayed care and confusion. Instead of conflicting recommendations, information is shared among the spine specialists reviewing the back pain patient’s case, and the person receives a conservative approach first, holding spine surgery as the last resort.
What makes Maine Spinecare unique is its emphasis on non-surgical treatment options for back and neck problems.
Unfortunately, the field of spine is characterized by extreme fragmentation where spine surgeons have their offices separate from non-surgical spine physicians, pain care specialists and spine therapists.
Consequently there can be a lack of coordination among all these providers, as well as “specialty silo bias” where each patient’s diagnosis is biased by the specialist seen. Sadly, health insurance medical directors often complain that a single back pain patient can see 10 different doctors and receive 10 different diagnoses and 10 different treatment recommendations.
Secondly, because these specialists are spread across towns or regions, there is typically no communication between them about a specific patient. This means that a patient will often travel from doctors office to doctors office, having to start from scratch with his or her story to build a new medical chart from scratch.
Thirdly, because non-surgical treatment options are poorly designed, it predestines the patient to failure of conservative non-surgical care. And when non-surgical options fail, this forces the patient to resort to surgery, in many cases, unnecessarily. An unnecessary spine surgery can unfortunately just create a bigger nightmare for the person, as scarring around a nerve root from surgery can create “failed back surgery syndrome” which is worse than any original pain symptom.
Because Maine Spinecare combines all these spine care specialists under one roof, with one medical record, there is no redundancy or duplication of effort. The physicians involved communicate and blend their expertise for the benefit of the patient. The patient goes to one central spine center location instead of multiple stops. As a result, these spine specialists are often able to help many patients resolve their back or neck pain symptoms without the need for spine surgery.
Sometimes, spine surgery is the right treatment. This may occur because symptoms of radiating pain have not responded to non-surgical treatment options like injection therapy or customized spine physical therapy. In other cases, some symptoms like weakness or numbness in a leg or hand, or loss of control of bowel or bladder, represent emergency symptoms where back or neck surgery must be done quickly to prevent permanent paralysis of the nerves that relate to these muscles or extremities.
If your back or neck problem requires surgery, Maine Spinecare has fellowship-trained orthopaedic spine surgeons who already are referred the most complex surgical cases across the States of Maine, Vermont and New Hampshire. Some residents of Quebec, Canada who desire to access specialized spine care may also travel to the spine center for care because it is the nearest medical center in the U.S.
These spine surgery cases can include herniated discs, spinal fractures, degenerative disc disease, facet joint problems and other complex spine problems.
Pain is a signal from the body to the brain that something is wrong. Either the back is too weak, too inflexible, something lifted was too heavy or the wrong body mechanics were used. And, unfortunately, those doctors who focus exclusively on pain symptoms often recommend a course of treatment that is the exact opposite of what the individual needs to recover from the back problem.
Years ago, for example, doctors treated back pain with bed rest and heavy drugs to mask the discomfort. It was found, however, that this type of treatment was actually damaging to the back, because it caused muscles in the back to get weaker, in turn, causing more strain and pain. Patients became more dependent on drugs and grew more inactive and disabled.
In fact, pain relief actually can come through movement. Low-impact sports like walking and swimming are the best way to make the back feel better and stronger. Maine Spinecare uses written clinical protocols to improve care and reduce treatment variation — the essence of true quality management. This enables us to make sure the right thing is done at the right time, every time. This also makes sure that every nonsurgical option has been explored — such as therapy and injections — before spine surgery is considered.
While others talk about quality, we measure outcomes with patient severity data at intake and functional status post treatment. Lastly, we audit patient satisfaction so we can continually improve, because that's what quality is all about.