Back Pain Caused by Arthritis


Back pain can affect anyone. From little aches that hopefully fade away with rest and medicine to deep, debilitating discomfort that makes every facet of life difficult, back pain can be tough to shake. Most back pain will go away on its own, but sometimes the source of the struggle is hard to detect. The causes of back pain are myriad – being overweight, muscle strain, bad posture, as the result of an accident, and, most commonly, age.

As you get older, the most frequent cause of long-term back pain is arthritis. The intricate web of bones, muscles, discs, and tendons that make up your back are all intertwined. Over time, they get worn down or even shrink, adding pressure to the nerves along your spine.

Rheumatoid arthritis (RA) is an especially worrisome disease. Rheumatoid arthritis leads to the destruction of joints. Though it commonly affects people’s hands and feet, it can also have an impact on the spine, primarily the neck and around the base of your skull. The pain can then travel down into your arms and legs. If untreated, RA can be debilitating.

While many pharmaceutical companies are working on treatments for RA, there are several other steps you can take to improve your health.

Pay attention to your posture – People have a tendency to slump their shoulders or not sit up straight. Make the effort push back your shoulders and keep your spine straight. You might consider purchasing special cushions for your desk chairs or for the seat or your car.
Exercise – The more active you are, the less stress you’ll feel around your back. Your activity will loosen up the joints, get blood flowing through your muscles, and generally make you feel better. How you choose to exercise is up to you, but make sure you stretch beforehand. Even a simple walk every day is helpful. Focus, too, on strengthening your core. Strengthening your abdominal muscles will reduce the amount of strain you put on your back.
Watch Your Diet – A balanced diet, couple with exercise, will help you avoid struggling with extra weight or obesity. When you carry more weight, your back has to do more work.
Get Therapy – Sometimes referred to as physical medicine, therapy includes rest or limited physical activity, chiropractic therapy, passive therapy (ice, heat, massage, electrical stimulation), active therapy (aerobics and weight lifting), stress relief (meditation, yoga, or other Easter disciplines), and braces you can wrap around your back.
Sleep Right – Sleeping in the wrong position can also lead to long-term damage. Try not to sleep on your stomach. Doing so causes your neck and back to twist and bend in poor directions. If you sleep on your side, place pillows between your knees and behind your back. If you prefer to sleep on your back, put a pillow under your knees.

Arthritis can be crippling if untreated. You can do your part to ensure back pain doesn’t limit your ability to enjoy life by following the steps listed above. To learn more, contact us today.

Aging, Osteoporosis and Spinal Compression Fractures

Spinal Fractures are Common As People Age
The type of fracture in the spine that is typically caused by osteoporosis is generally referred to as a compression fracture and are quite common – occurring in approximately 700,000 people in the U.S. each year.

The problem is that the fracture is not always recognized or accurately diagnosed – instead, the patient’s pain is often just thought of as general back pain or as a common part of aging. As a result, approximately two thirds of the vertebral fractures that occur each year are not diagnosed and therefore not treated.

Compression Fracture Risks
Vertebral fractures are usually followed by acute back pain, and may lead to chronic pain, deformity (thoracic kyphosis, commonly referred to as a dowager’s hump), loss of height, crowding of internal organs, and loss of muscle and aerobic conditioning due to lack of activity and exercise.

A combination of the above problems from vertebral fractures can also lead to changes in the individual’s self-image, which in turn can adversely affect self-esteem and ability to carry on the activities of daily living.

Because the majority of damage is limited to the front of the vertebral column, the fracture is usually stable and rarely associated with any nerve or spinal cord damage.

Two-Pronged Approach for Compression Fracture Treatment
Treatment of a spinal fracture caused by osteoporosis is usually two-pronged, including both treatment of the fracture, and treatment of the underlying osteoporosis that led to the fracture.

  1. Resolve Compression Fracture Pain: Kyphoplasty is a minimally invasive outpatient procedure that results in immediate pain relief in many cases. A special balloon is inserted and gently inflated inside the fractured vertebrae, then a cement-like material is injected. The goal of the balloon inflation is restore height to the bone thus reducing deformity of the spine. Most patients return to their normal daily activities after either procedure.
  2. Prevent Future Fractures: After sustaining one vertebral fracture, the patient is at risk for more fractures, so treatment of the patient’s underlying osteoporosis is an important part of the treatment plan. Osteoporosis treatment will typically include one or a combination of the following: calcium supplements, increased vitamin D, weight-bearing exercises, and hormone replacement therapy for women.

3 Things You Need To Know About Back Pain And Aging

At some point, most of us will suffer from back pain. For many it’s a mild but irritating ache that comes and goes; for others it’s a chronic, incapacitating pain that can make it difficult to stand, sit, and sleep. Back pain has several causes, including poor posture, ill-advised or awkward lifting, being overweight, or as the result of an accident. The most common cause of back pain, however, is simply age.

Whether we like it or not, there’s no escaping father time. Your back is an intricate system of bones, joints, muscles, and tendons. Your vertebrae – the bones in your spine – are lined up one on top of the other. Small joints between each vertebra enable your spine to move. Also crammed between the bones are disks. The centers of these disks have a softer consistency than bones. As a result, they buffer the impact on the bones while keeping them from bumping into each other.

The chances of pain increase as we get older. Over time, the disks between your vertebrae are worn down or shrink. When that happens, you experience stiffness and pain because your bones are now closer to rubbing against each other. Add in the fact that another element of aging is the narrowing of the space around your spinal cord – otherwise known as spinal stenosis – and you have additional pressure on the nerves in your back.

Treating Back Pain as You Age

You have three basic options for treating back pain: medicine, therapy, and surgery.

  1. Medicine – The least invasive of the three and the recommended first step for dealing with back pain. The types of medication available include aspirin or acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen, oral or injectable steroids, or more complex narcotics such as codeine and morphine.
  2. Therapy – Also called physical medicine, therapy includes rest or limited physical activity, chiropractic therapy, active therapy (aerobics, stretching, weight lifting), passive therapy (massage, ice, heat, electrical stimulation), stress relief (yoga, meditation, Pilates), and braces that you can wrap around your back or stomach.
  3. Surgery – The final option when you’ve exhausted less invasive methods. Types of surgery include disk replacement and spinal fusion, which removes the movement between the bones in your spine.

Back Pain Prevention

Some estimates indicate that four out of five American adults will miss work during their careers because of chronic back pain. For most, the pain is neither permanent nor serious – more than 90 percent of back-related issues resolve themselves within six weeks.

To avoid back pain, following a simple plan may be all the difference. Steps include the following:

  • Maintain good posture, standing and sitting
  • Exercise to keep your core flexible and strong, and to reduce stress
  • Follow a healthy diet and pay attention to your weight

The recommendations above won’t eliminate your chances of experience back pain, but they will minimize the likelihood as you get older. If you still experience back pain and discomfort despite a healthy lifestyle, take the time to speak with your physician.

What You Need To Know About Back Pain and Kyphoplasty

The kyphoplasty procedure is a minimally invasive, non-surgical, outpatient treatment performed through one or two needle holes for each spine fracture. The needles are inserted using the latest in high resolution imaging technology. Balloons are inserted through the needle(s) to re-expand the bone; the resultant cavity is filled with a bone cement to internally cast the broken bone. Kyphoplasty procedures typically result in greater than 90 percent of patients experiencing near-complete or complete pain relief. Patients with spinal compression fractures have a higher risk for additional fractures; these fractures can also be treated with kyphoplasty. Interventional Physicians of Indiana is one of the leading kyphoplasty centers in the U.S, with physicians performing more than 1000 kyphoplasties.

Avoiding Sports-Related Back Injuries

Maintaining a healthy lifestyle is important, and a key component of a solid health plan is frequent exercise. You have countless options for choosing the types of exercise in which you want to partake. Whether you opt for individual sports like running and swimming, or group events like basketball, soccer, or softball, you’re going to place a certain amount of strain on your back. That’s why it’s critical you understand the types of back injuries that can occur, and how you can avoid them.

Back Injuries

As many as one in five sports-related injuries affect the back or neck. Even injuries that don’t specifically cause trauma to the back can affect it, especially if you try to compensate for discomfort by altering your posture. You can suffer from one of three types of back injury:

  1. Neck Injuries – Your neck is more exposed in sports that have a heightened level of physical contact. Football, in particular, is a sport in which your neck is especially susceptible because of the frequent impacts your body takes.
  2. Lower Back Injuries – Trauma to your lower back is more common in range-of-motion exercises such as weightlifting or sports where there is substantial repetitive impact, like running. Basketball players also struggle with lower back pain because of the constant jumping. Golfers have also been known to suffer lower back strain due to the constant rotation and twisting needed to play the game.
  3. Upper Back Injuries – The least frequent types of sports-related injuries occur in the upper back. This portion of your back is less mobile, so there is less movement. The added support provided by your rib cage adds to its strength. You can still suffer from cracked ribs or muscle strains – the latter occur more often in sports like swimming and weightlifting.

Avoiding Injury

Before beginning any sport, it’s recommended you complete a thorough warm-up routine. Doing so will prepare your muscles while helping your back get ready for the added stress it’s about to endure. While warm-ups differ based on the type of sports you play, there are certain basic rules you can follow for all athletic pursuits.

  • Stretch – Take time to loosen the muscles you’ll be using during your exercise. Besides stretching common muscles like your triceps, calf muscles, and hamstrings, make sure you twist and rotate the muscles along your back and waist to increase your range of motion.
  • Increase Circulation – When you begin your stretching exercises, start gradually with simple movements to increase the flow of blood throughout your body. You can then increase the intensity of your regimen, which will help loosen the muscles in your back.
  • Model Your Efforts – If you’re going to throw a baseball, throw a few phantom pitches before you grab the ball. The same philosophy applies to swinging a golf club.

Are you suffering from sports-related back pain? If you have numbness, tingling, or severe pain that doesn’t improve with medication and rest, see a doctor. Back pain can sometimes signal more serious problems. To learn more about the effects of back pain, contact us today.

Top 3 Back Pain Treatment Approaches

An estimated 80 percent of American adults will miss work at some point in their careers because of back pain. For the majority, the pain is neither permanent nor serious – approximately 95 percent of backaches go away within six weeks without a specific treatment.

Unless you are totally immobilized from a back injury — your doctor will test your range of motion and nerve function and touch your body to locate the area of discomfort.

Importantly if you suffer from pain that doesn’t subside – or becomes worse – there are three levels of back pain treatment you should explore.

Conservative Treatments

The most common, and least invasive, treatments for back pain include physical therapy, bracing, medication, oral steroids, massage therapy, acupuncture, and chiropractic support.

Steroid Injections

Using imaging (x-ray) guidance for needle placements, these injections are performed by specialized physicians. Your doctor may recommend one of several types of steroid injections, depending on the location and level of pain you experience.

Epidural Steroid Injections (ESIs) – ESIs are a minimally invasive outpatient procedure performed by injecting a mixture of a steroid and long-acting anesthetic into the epidural space (a space containing nerves and nerve roots). ESIs are typically performed for central (axial) back or neck pain. Some indications for ESIs include back pain from degenerative, bulging, or herniated discs, spinal stenosis, and spinal nerve root inflammation (such as shingles). If successful at relieving pain, an ESI can be performed three times in a 6-month period.

Selective Nerve Root Block (SNRB) – SNRBs are a minimally invasive outpatient procedure performed by injecting a mixture of a steroid and long-acting anesthetic into a specific nerve root sleeve. The main indication for a SNRB is a patient with peripheral (arm or leg) pain, which is felt to be secondary to compression or inflammation of a specific nerve root (s).

Medial Branch (Facet Joint) Blocks – The facet joints in our back and neck have cartilage that allows our back and neck to bend, twist, and flex. As we age, these joints can become degenerative or arthritic. The cartilage loses fluid and height, which can lead to a bone-on-bone condition often resulting in bone spur formation and chronic neck or lower back pain. Facet joint arthritis is one of the most common causes of chronic neck or lower back pain. Medial branch (facet) blocks are performed by injecting a mixture of a steroid and long-anesthetic into the medial branch nerves going to the facet joints.

Medial Branch (Facet Joint ) Denervations – If a medial branch (facet) block results in pain relief for the patient but the pain recurs, the patient may then be a candidate for a medial branch (facet) denervation. Using a radiofrequency (RF) device is recommended to perform the denervation. A RF denervation is a minimally invasive, outpatient procedure performed by placing a needle electrode adjacent to medial branch nerve (s) and then ablating (burning) the nerves with RF heat energy. If successful, the RF denervation procedure can result in longer-lasting pain relief, from 6 months to 2 years.

Sacro-iliac (SI) Joint Injections – Degenerative arthritis and inflammation of the SI joints is a common cause of chronic low back and buttock pain. Patients often complain of chronic low back pain, groin pain, and sitting intolerance without associated leg pain. SI joint injections are minimally invasive, outpatient procedures performed by injecting a mixture of a steroid and long-acting anesthetic into the SI joint.

Kyphoplasty – This procedure is for patients with acute painful compression fractures of the spine. These fractures typically cause severe pain and may lead to the patients being wheelchair bound or bedridden, with severely limited daily activities. The most common reason for these fractures is the presence of osteoporosis; other less common causes are trauma and cancer. Kyphoplasty is a minimally invasive, non-surgical, outpatient treatment performed through one or two needle holes for each spine fracture. The needles are inserted using the latest in high resolution imaging technology. Balloons are inserted through the needles to re-expand the bone; the resultant cavity is filled with a bone cement to internally cast the broken bone. Kyphoplasty procedures typically result in greater than 90 percent of patients experiencing near-complete or complete pain relief. Patients with spinal compression fractures have a higher risk for additional fractures; these fractures can also be treated with kyphoplasty.


When patients with intolerable pain have exhausted all conservative therapies and injection treatments, the remaining option is surgery.

Top 8 Risk Factors for Back Pain

Back pain is an all-too-familiar problem. From a dull, constant ache to a sudden, sharp pain that leaves you incapacitated, back pain can come on suddenly and linger endlessly. It can occur from an accident, a fall, or by lifting something heavy. It can also develop slowly, a result of age-related changes to the spine. Regardless of how back pain begins, you know it when you have it.

Although anyone can have back pain, a number of factors increase your risk. Below are the top 8 risk factors for back pain:

Age – The first attack of low back pain typically occurs between ages 30 and 40. The older you get, the more likely you’ll begin to notice some discomfort.

Fitness Level – Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. In addition, consistent activity is critical. People who exercise heavily after being inactive all week are more likely to suffer painful back injuries than those who make moderate daily activity a habit.

Weight – When you carry extra weight, you’re putting added stress on the back.

Occupational Risk Factors – Some jobs just aren’t great for the back. If you have a job that requires heavy lifting, pushing, or pulling – particularly when it involves twisting or vibrating the spine – you run the risk of injury and back pain. An inactive job or a desk job may also lead to or contribute to pain, especially if you have poor posture or sit all day in an uncomfortable chair.

Heredity – It’s hard to escape hereditary issues. Some causes of back pain, such as ankylosing spondylitis, which is a form of arthritis that affects the spine – are tied in to genetics.

Race – Like heredity, race can factor in to your likelihood of developing back problems. African-American women, for example, are twice as likely as white women to develop spondylolisthesis, a condition in which a vertebra of the lower spine—also called the lumbar spine—slips out of place.

Other Diseases – Many diseases can cause or contribute to back pain, including various forms of arthritis such as osteoarthritis and rheumatoid arthritis. Cancer can also affect the spine if it spreads from other parts of the body.

Cigarettes – Smoking may not directly cause back pain, but it increases your risk of developing low back pain and low back pain with sciatica (back pain that radiates to the hip and/or leg due to pressure on a nerve). Smoking also slows healing and prolongs pain for people who have had back injuries, back surgery, or broken bones.

Alan’s Story

Alan struggled from considerable back pain caused by a number of incidents over the course of a year.

The first, which resulted in two collapsed vertebrae, was caused by tripping over an extension cord. After having his vertebrae repaired at the Indiana Back Pain Center, Alan returned to his exercise routine.

The second injury occurred when he fell at an exercise class and sustained a cracked vertebrae. He knew exactly who to turn to – Dr. Yedlicka, the doctor at the Indiana Back Pain Center, who had treated him so successfully after his first injury. That would not be the last time Alan would turn to Dr. Yedlicka.

In the fall of 2013, on a trip to Greece, Alan was lifting some bags when he felt a sharp pain in his back. Once again he turned to his doctor at the Indiana Back Pain center – and, once again, he was successfully treated.

Dr. Yedlicka performed kyphoplasty – a minimally invasive non-surgical outpatient treatment that creates space between collapsed vertebrae.

Within days of his treatments his back pain was virtually eliminated and he was able to walk without the considerable pain he had been suffering. The treatment has kept Alan active and mobile. Most importantly, he is sleeping better and enjoying his friends and family without the back pain that kept him from living his life to the fullest.

“I was extremely impressed with the professionalism and friendliness at the center,” he said. “The staff was right there with me from the beginning, guiding me through the process, which made me a lot less anxious. I wasn’t apprehensive because I trusted them. The transformation has been amazing.”

Top 5 Ways to Reduce Back Pain

Millions of Americans suffer from chronic back pain. The reasons vary greatly. Fortunately, there are ways you can minimize the discomfort and improve pain management. Below are 5 things you can do to relieve your back pain:

1. Stay Active

Activity is often the best medicine for back pain. Studies show that people with short-term, lower-back pain who rest feel more pain and have a harder time with daily tasks than those who stay active. You may feel like you need to lie down for relief, but you’re better off avoiding bed rest.

Developing an individualized exercise plan is essential to managing chronic back pain. Some patients need core strengthening while others benefit from stretching and improving flexibility.

Simple exercises like walking can be helpful by forcing you out of a sitting posture and putting your body in a neutral, upright position.

Most people with chronic back pain benefit from stronger abdominal muscles. Strengthening the abdominals often reduces the strain on the lower back.

2. Maintain Good Posture

The pain may have started after a long workout at the gym, but the strain that caused it has probably been building for years. Most people have poor posture when going about their daily activities, putting unnecessary strain on their backs. Little things add up. You can increase the pressure on your back by 50 percent simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and reduces back pain.

3. Apply Ice and Heat

Heating pads and cold packs can comfort tender trunks. It’s common to recommend using ice for the first 48 hours after an injury — particularly if there is swelling — and then switch to heat. It’s hard to say if ice or heat is more beneficial. We recommend patients use whichever they find comforting as long as their skin is protected.

4. Sleep the Right Way

The amount of rest you get is important, and so is the position you get it in. Sleeping in a bad position or on a mattress without support can cause back pain. Some pointers:

  • If you sleep on your back put pillows under your knees.
  • If you sleep on your side, place pillows between your knees to keep your spine in a neutral position.
  • Try not to sleep on your stomach. This causes the neck and head to twist and can put undue stress on the back.

5. See a Specialist

Find a doctor, such as an interventional radiologist, who specializes in back care. There are many noninvasive outpatient treatment options that quickly and effectively treat your back pain.

Meet Joseph W. Yedlicka, Jr., M.D., FSIR

Dr. Yedlicka, Jr. is director of vascular and interventional radiology at Community Hospitals. He was inducted into the Alpha Omega Alpha Honor Society and graduated with Honors from Rush Medical College (M.D. 1982). He subsequently completed two years of general surgery residency at Northwestern Memorial Hospital, and four years of diagnostic radiology training at Loyola University Medical Center, where he was chief resident. Following a fellowship in vascular and interventional radiology at the University of Minnesota Hospital, he served for three years as Assistant Professor of Radiology at that institution. Dr. Yedlicka was then named director of vascular and interventional radiology at Evanston Hospital/Northwestern University, and Associate Professor of Radiology at Northwestern University. In 1993, Dr. Yedlicka joined Interventional Physicians of Indiana and became director of vascular and interventional radiology at Community Hospitals of Indianapolis.
Dr. Yedlicka’s bibliography includes 41 scientific publications, 28 chapters in six textbooks, and more than 100 medical presentations in the United States and abroad. He received a Certificate of Added Qualification in Vascular and Interventional Radiology, and was elected as a Fellow in the Society of Cardiovascular and Interventional Radiology in 1998.