Suffering from neck or back pain?

Come to Lorain County Ohio's orthopedic spine specialist

If you're sidelined by neck or back pain, you're not alone. Statistics show that eight out of 10 people experience back pain at some point in their lives.

Dr. Robert Berkowitz, Lorain County, Ohio's only orthopedic spine surgeon, is trained to take care of many conditions involving the neck and back—especially patients who have symptoms in their arms and legs as a result of spine conditions.

Dr. Robert Berkowitz answers questions about neck and back pain

When should I see a doctor about neck or back pain?

“I would encourage you to be evaluated by a physician if you have had neck or back pain for more than a few weeks.. Nearly everybody gets back pain at one time or another.

“If you're experiencing pain for a few days, it's probably worth waiting a week or two before you go see a doctor, unless your pain is severe, due to an injury, or you are having associated arm or leg pain.”

How do you diagnose the cause of neck and back pain?

“The diagnosis is made by performing a thorough history and physical exam. When you come in for an examination, I begin by asking you questions about your neck or back pain, such as:

• When did the pain start?
• Were there any aggravating factors that started the pain?
• What makes your neck or back feel better?
• What makes it feel worse?
• Where is the pain?
• Does the pain radiate down your arms or legs?
• Is there numbness and tingling?
• Are having any other symptoms associated with your neck or back pain?
• Have you had this problem before?
• Have you ever had any treatment for this problem?
• If so, what types of treatment?
• Which treatments have worked for you, and which haven't?”

What does the physical exam involve?

“Every patient gets a head-to-toe, complete musculo-skeletal, neurologic exam.

“Then we'll use imaging—x-rays and possibly an MRI. I'll review your images and come up with a diagnosis and treatment plan.”

Do all of your patients end up having surgery?

“No. I take a very conservative treatment approach. I'm a surgeon and I love my profession, but my absolute last choice for patients is surgery. I will do everything I can to try to treat your condition non-surgically.

“Almost always, my recommendation is a non-operative treatment plan involving physical therapy, injections, chiropractic care, acupuncture and other non-surgical treatments to try before considering surgery. Most people get better with the non-operative treatment plan.

“If non-surgical treatments don't work for you and you need surgery, you can be assured I will use the latest operative techniques and technology to help you.”

Do you think chiropractic care can help?

“Many spine surgeons do not have a favorable view of chiropractic care—but that's not true for me. I feel that all aspects of medicine have some way of potentially helping people. I don't recommend chiropractic care to everybody, but I often do. Some people get relief from chiropractic care. So why would we not give you that option before we consider surgery?

“I personally have interviewed and been to visit the offices of the chiropractors I use and refer patients to, and I feel that they're qualified, honest, intelligent chiropractors who can potentially help my patients. I've also referred patients for acupuncture treatment.”

When do you recommend surgery?

Surgery is almost never indicated for people with isolated neck or back pain. However, patients who also have associated extremity symptoms may ultimately need surgery. We will try all possible non-operative treatments before considering the option of surgery.”

What causes neck and back pain?

“We don't really know what causes neck and back pain, but in general, it's probably caused by arthritis—worn-out discs, worn-out joints, worn-out ligaments. So the neck or back hurts from arthritis; the arms or legs hurt from pinched nerves.

“The causes of neck/back pain and arm/leg pain are often related because the arthritis—the bone spurs from the worn-out joints, the thick, worn-out ligaments, and the bulging, worn-out discs—often pinch the nerves.

“But the reason the neck or back hurts is arthritis. The reason the arm or leg hurts is from a pinched nerve—even though that may have been brought on by arthritis.”

If my leg hurts, how could the problem be in my back?

“If you have pain shooting down your leg, from your butt all the way down to your foot or ankle, that is what is commonly called a pinched nerve. When you pinch a nerve in the back, that does not give you back pain; it gives you leg pain. A pinched nerve could be caused by a herniated disc, spinal stenosis or another spinal condition.

“Nerves are like electrical wires. Whatever you do to the nerve, your body feels it downstream. It's like if you cut the telephone wire at the beginning of a street; the effects are felt all down the street. All the houses down the street lose their phone service.

“So if you pinch a nerve in the back, the problem is coming from the back, but the results are felt down the leg.”

How can osteoporosis affect the neck and back?

“Osteoporosis, a bone disease characterized by decreased bone mineral density, increases the risk of fractures. In the neck and back, osteoporosis commonly leads to compression fractures.”