Choosing a Medical Weight Loss Plan in Atlanta

 

Being overweight or obese is something of a double whammy when it comes to back and neck pain. Carrying excess body weight not only increases your risk of spine problems, it may also mean that you are not a good candidate for back surgery to correct those problems.

Some patients may be surprised to learn that before they can have spine surgery they need to shed some pounds. This is because heavier patients have a greater risk of surgical complications, including problems with anesthesia, breathing, and cardiovascular function, in addition to greater challenges healing from surgery.

Medical weight loss is recommended for many patients with back and neck pain, but what is it exactly?

Let’s start by stressing that medical weight loss is not surgery, diet pills, or another fad diet. Instead, true medical weight loss programs are based on credible scientific research and target the root causes of obesity and overweight. The aim is to lose weight in a healthy fashion so that you can achieve and (crucially!) maintain a healthier body weight going forward.

What are medical weight loss programs?medical weight loss doctor atlanta

Medical weight loss programs are administered by trained doctors or health care providers and are designed to help every individual achieve their personal weight loss goal, be that losing 100 lbs, 200 lbs, or 10 lbs. The greatest benefits are typically seen in those with a body mass index over 30 – where that mass includes a high percentage of body fat (adipose tissue) – because this can significantly reduce the risk of a range of serious medical conditions such as diabetes, cardiovascular disease, sleep apnea and cancer.

True medical weight loss programs use a range of tools to assess metabolism and body composition. This is important as it is possible to have a high calorie diet and a high body mass index and still be healthy, such as in the case of a body builder who eats a lot and weighs more than average, but who carry very little fat and whose metabolism is non-problematic.

For those who are carrying excess body fat and who have or who are at risk of metabolic syndrome, medical weight loss programs can help create structured diet and exercise plans that facilitate gradual weight loss to achieve a target weight. Even losing 10 lbs can significantly reduce a person’s risk of numerous health conditions and may allow them to undergo surgery that is too risky otherwise.

Medical weight loss programs are tailored to the individual, accounting for existing health conditions, family medical history, behavioral considerations such as emotional overeating, and barriers to exercise that necessitate some creativity and additional support.

What to expect from a good medical weight loss program

A good medical weight loss program will begin with a complete medical and lifestyle profile. This profile should include any medications or medical devices currently being used, as well as any supplements or alternative health modalities. This will often be done prior to the first appointment with a clinician.

medical weight loss doctor atlanta

Look for a program that then carries out a full body composition analysis, including blood pressure and blood glucose testing. This will give you and your physician a baseline from which you can track your progress.

Following these assessments, you will likely sit down with a clinician to discuss your results, to clarify any issues, and to establish your desired outcome from the program. They may ask you about specific challenges you have faced when trying to lose weight and keep weight off in the past. This information is then used to create a personalized medical weight loss program just for you. This clinician will also typically serve as your point of contact and support throughout your program, helping you to stay on track for success.

Why are these programs different to regular dieting?

Medical weight loss programs differ substantially from yo-yo diets and weight loss pills largely because these programs aren’t seen as a short-term fix. Instead, these kinds of programs are designed to help create sustainable habits that support good health going for the rest of your life, giving you the skills to manage your weight and your health successfully.

The importance of this is increasingly recognized by the medical establishment, with many physicians all too aware that simply telling a patient to lose weight without providing any guidance and support is often counterproductive. The problem is that obesity and overweight is a complex, multifaceted issue that poses a challenge for medical billing. It is often poorly funded, therefore, resulting in poor availability of evidence-based weight loss programs.

Things are changing, however, and some medical weight loss programs are now fully covered by health insurance, while some insurers cover components such as weight loss screening and behavioral counseling. Check with your insurance provider for more information and look for credible medical weight loss programs that are well-established, transparent about funding and results, and that offer comprehensive ongoing support. A good medical weight loss program will typically provide one-on-one counselling three times a week for up to a year, with many specialists noting that it can take six months to establish healthy habits and a year to make healthy lifestyle changes that stick.

 

If you have neck and back pain and are overweight, a medical weight loss program could be just what you need to help you relieve the stress on your joints and put you in good stead should you need spine surgery.

If you’re interested in a credible Atlanta Medical Weight Loss program, we invite you to visit our friends at Integrative Wellness Atlanta for more details.

Dry Needling – an alternative treatment for chronic back pain

Dry needling

Dry needling is an increasingly popular treatment for relieving chronic back or neck pain caused by muscle tension and nerve dysfunction. This effective therapy is designed to create a local twitch response in the muscle in order to release muscle tension at the root of pain.

Dry needling treatment has very few potential side effects and involves the insertion of very thin needles through the skin into muscles, ligaments, tendons, subcutaneous fascia, and scar tissue. Dry needles may also be inserted near peripheral nerves, neurovascular bundles, or both so as to stimulate a response that can help with the management of neuromusculoskeletal pain.

Dry Needling Atlanta

The needle stimulates nociceptors or sensitive loci in the muscle or tissue to create a response that can disrupt dysfunctional neuromuscular activity. This may then help to relax the muscle and relieve associated pain.

Unlike with wet needling (used for corticosteroid injections, for example), the thin monofilament used for dry needling does not deliver any medication to the tissue.

Dry needling is sometimes defined as an intramuscular procedure targeting myofascial trigger points. However, treatment using dry needling may also target tissues other than muscles.

Trigger points and tender spots

Chronic neck and back pain can be a result of irritation in the muscles that causes tension and radiating pain. These trigger points or tender spots in skeletal muscle may be referred to as a ‘knot’ and can feel hard and uncomfortable.

Over time, chronic tension, muscle spasms, or cramps can cause irritation in other tissues as the body tries to compensate for the structural problem by altering posture or gait, for example. Ongoing muscle tension can cause pain directly, and may also contribute to changes in bones, ligaments, tendons, and spinal discs that also results in pain and other symptoms.

What can I expect from dry needling?

In a typical treatment session, a physical therapist will insert a number of dry needles into muscle and will leave them in place for 10 to 30 minutes. They will take note of any response from the muscle when inserting the needles and this will guide the insertion of additional needles to locate a trigger point or to better target problematic areas.

A number of studies have found evidence of immediate improvements in pain and disability following dry needling targeting myofascial trigger points. Typically, such treatments used ‘sparrow pecking’ or ‘pistoning’ techniques, i.e. rapid in-and-out needling to stimulate the tender point and provoke a neuromuscular response (Dunning et al., 2014). Further long-term trials are still needed to confirm these benefits and to demonstrate extended benefits of dry needling.

What conditions can dry needling treat?

Dry needling is used to address a variety of conditions, including musculoskeletal problems such as:

  • Acute and chronic injuries
  • Neck pain
  • Back pain
  • Sciatica
  • Knee and hip pain
  • Headaches
  • Tendinitis
  • Muscle Spasms and strains
  • Fibromyalgia
  • Tennis/Golfer’s Elbow
  • Repetitive strain injuries.

Dry needling vs. acupuncture

Although the tool of choice for both dry needling and acupuncture is the very thin, solid needle filament, dry needling is distinct from acupuncture.

Physical therapists who practice dry needling do so on the basis of modern knowledge of anatomy and neurology as discovered through scientific research into the nervous system and musculoskeletal system. Acupuncture was developed using a traditional knowledge base, largely the tenets of traditional Chinese medicine, and is underpinned by a particular philosophy.

Does dry needling hurt?

In most cases, patients undergoing dry needling do not feel the needle penetrate the skin and are only aware of the needle if it is inserted into a muscle that is tense. The resulting sensation can feel like an acute cramping of the muscle and it is this twitch response that helps to release the tension in the tissue and stimulate healing.

Dry needling for diagnosis

Dry needling may be a useful diagnostic tool, although further study is needed in this regard. The theory here is that if a patient with chronic back or neck pain has a powerful response to a needle in a particular spot, such as a familiar pain sensation, this can help to identify the location and cause of the pain.

When the needles are inserted into healthy muscle there is usually very little discomfort, helping the practitioner to go on to other areas so as to identify the tender spots.

What side effects can you expect with dry needling?

Dry needling is an effective and relatively safe treatment option for neck and back pain, with minimal risk of side effects. When adverse events do occur related to dry needling these usually take the form of mild soreness in the muscle and some minor bruising.

As always, it is essential to undergo treatment at a well-regarded facility which pays scrupulous attention to health and safety guidelines. The needles used for dry needling, as with acupuncture, are not reused for different patients and should be individually sealed and stored in sterile conditions prior to use, after which they should be disposed of in a safe manner to minimize the risk of infection.

Evidence for the effectiveness of dry needling

There is a growing body of evidence to support the use of Dry Needling Literature Review with Implications for Clinical Practice Guidelines DUNNING ET AL 2014(1)

In a case study reported in the International Journal of Sports and Physical Therapy, the use of dry needling led to significant relief of chronic low back pain in a 30-year-old woman on active military duty (Rainey, 2013). The patient had pain in her lower back and hip that started after a lumbar flexion injury while weight-training. The injury led to instability in her lower back (the lumbar spine) and her right hip and myofascial trigger points were identified in her right gluteus maximus and gluteus medius muscles.

The patient underwent two dry needling sessions to treat these muscles, along with intramuscular electrical stimulation (IES) and a home exercise program focusing on improving core stability.

The result of treatment was complete resolution of symptoms of lower back and hip pain, with the officer reporting no pain or disability at the follow-up appointment. The physical examination found no functional impairments or limitations, and spinal movement was normal. The researchers also noted the absence of myofascial trigger points, indicating no source of regional neuromusculoskeletal pain.

This therapy appears to help with pain management, reduces muscle tension and dysfunction and may help with electrical and biochemical dysfunction of the motor endplates, allowing the musculoskeletal system to function properly.

Dry needling may be particular useful, therefore, in helping patients with chronic neck or back pain to engage in other forms of rehabilitative therapy that are currently difficult because of muscle tension and pain.

Ready to try dry needling in Atlanta? Contact Us to setup your appointment today!

References

Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev, Aug;19(4):252-265.

Rainey, C.E. (2013). The use of trigger point dry needling and intramuscular electrical stimulation for a subject with chronic low back pain: a case report. Int J Sports Phys Ther, Apr;8(2):145-61.

Avoiding Back Surgery Complications

Back surgery complications – how to avoid

As with any surgery, back surgery poses a number of risks and can lead to complications. Fortunately, ongoing refinement of techniques and practices means that the risk of such complications is very low and getting lower year on year.

For most patients, spine surgery has a positive outcome, offering relief from symptoms and resulting in few, if any, complications. However, as spine surgery is often undertaken as a last resort, permanent damage may have already occurred, meaning that a complete resolution of symptoms may no longer be possible.

Anyone who is considering spine surgery should discuss their treatment options with an experienced health care professional. This will help patients weigh the potential risk of back surgery complications against the likely benefits of any procedure. This discussion should also include an assessment of the likely prognosis if surgery is not pursued.

It is generally recommended to pursue conservative therapies for at least six months before considering surgery, unless not having surgery poses a bigger risk of permanent nerve or tissue damage.

back surgery complications

Reducing the risk of complications from spine surgery

In order to minimize potential back surgery complications and enhance the benefits of back surgery patients should be sure to follow pre-surgical guidance, such as:

  • Quitting smoking
  • Minimizing the risk of infections (and alerting the surgical team to any suspected infection)
  • Achieving and maintaining an optimal body weight
  • Stopping or altering medications and supplements in advance of surgery as advised by the surgeon.

Following post-surgical advice is also essential to reduce the potential for complications. This typically means:

  • Keeping the incision site clean and dry
  • Not using any creams or other products on or around the incision site unless told to do so by the surgeon
  • Not smoking
  • Staying hydrated and well nourished
  • Staying active while avoiding straining
  • Taking any medications as instructed
  • Checking with the physician or surgeon prior to using any natural supplements.

Following the advice of the surgical care team before and after surgery means that the risk of complications will be lower. However, there is still a possibility of complications with any back surgery.

Risks and complications of back surgery

Risks associated with back surgery are those typical of any surgery, such as issues with anesthesia; bleeding; respiratory and cardiovascular problems; and circulatory issues including thrombophlebitis which can lead to blood clots blocking blood vessels, leading to stroke or myocardial infarction (heart attack).

Where back surgery complications occur after surgery they usually take the form of:

  • Infection
  • Bruising or edema

In most cases such adverse effects are typically minor and resolve quickly without lasting effects. In more serious cases a patient may experience the following complications of back surgery:

  • Nerve damagefailed back surgery syndrome
  • Dural tear
  • Paralysis
  • Muscle weakness
  • Hardware failure
  • Non-union (arthrodesis) in spinal fusion procedures
  • Slippage of the spine
  • Implant migration

The more complex a spinal surgery the more things there are that can go wrong. Some people may need additional surgery to correct problems with hardware or to fix a dural tear that does not resolve itself.

Candidacy for surgery – who is likely to experience complications?

Advances in surgical technique and in patient care before, during, and after surgery have reduced the likelihood of both risks and complications of spine surgery. If the risks of surgery for a particular patient are considered too high as weighed against the potential benefits, surgery may not be an option unless the patient’s circumstances change significantly, at which point the surgeon may reassess. In other cases, surgery may be considered an immediate necessity in order to halt further nerve damage, for instance.

Each case is assessed on its own merits to ensure suitability for back surgery and to devise a pre- and post-surgical plan tailored to the patient. This means looking at a patient’s symptom history, family and personal medical history, anatomy and physiology, general health and lifestyle, support systems and their expectations for the outcome of surgery.

Perhaps the most likely ‘complication’ of back surgery is simply that the surgery fails to completely resolve symptoms of back pain or neck pain. This is always a risk, especially in longstanding cases where permanent damage has already occurred. Helping all patients to form realistic expectations around surgical outcome is, therefore, a major part of improving satisfaction after back surgery.

Have questions? Contact SpineCenterAtlanta’s patient care team at 404-351-5812 or send us a contact request and we will call you back.