Kraus Back and Neck Institute in Houston, TX spinehealth.com

Relief from Lower Back and Neck Pain

 
surgery optionsavoid surgery
      At the Kraus Back and Neck Institute (KBNI), we specialize
                 in non-surgical as well as surgical treatments
                                of Back and Neck  Pain
     Conservative to Surgical Options: MINIMALLY INVASIVE SPINE SUGERY 
              
 "Applying Science to the Art of Medicine"                                                  
                              .....................................................................
  
                       
                 Dr. Kraus is available for Neurosurgery consultation (surgical and non-surgical) in Houston.
                      Offices:  1) West Houston Medical Center
                                    2) Memorial Hermann Memorial City Hospital
                                    3) Katy
           FILM REVIEW:  send an e mail                                       
                                                         
      To arrange  an appointment, call 281-870-9292,  visit  neurosurgerypa.com
or   send an e mail
              For national and international patients, we can help with  travel arrangements
                                
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                                         top doctors houston texas 2007 top docs united states neurosurgery spine   top doctors houston texas 2008 top docs united states neurosurgery spine  top doctors houston texas 2009 top docs united states neurosurgery spine   best doctors in america, united states neurosurgery spine
                                            Dr. Kraus is honored to be listed in
                                            "Best Doctors in America" (2001-2008) and
                                             "Top Doctors of Houston, Texas" (2007, 2008, 2009)     

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low back pain ache houston texas united states
Low Back Pain, can be very debilitating.  The effects of Low Back Pain in the USA are staggering!!
    
 
   

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   last updated
  June 19, 2009

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expert treatment of low back pain ("back attack")

 

Specialists who treat the pain : An expert in each arena

 

The list of who treats low back and lower extremity pain is exhaustive.  Most people will suffer an occasional episode of low back pain, but when it persists, or when it radiates to the lower extremities, it is time to consult an expert.  Other causes for concern include weakness in the lower extremities, loss of bowel or bladder control,  fevers and unintended weight loss.

Family physicians and internists are usually the first doctors to be consulted when a patient has low back or lower extremity pain.  They are experienced in the treatment of low back pain, and see a good deal of it.  They will be able to rule out serious problems such as cancer and infection.  If these are unlikely, they may elect to treat with conservative care, medications, and physical therapy.  If things do not improve in follow up visits, they will often perform additional tests, and/or consult a specialist.

Chiropractors: Many patients with low back pain will see chiropractors for evaluation and care.  Chiropractic treatment is often beneficial for the treatment of acute low back pain.  It may be less successful for the treatment of radiating pain to the lower extremities.  When one has had a very long history of low back pain, chiropractic care may not be of great benefit.  Chiropractors perform the majority of manipulative treatments given, but their treatment methods also include massage, stretching, electrical stimulation, hot and cold packs, exercise programs, and nutritional counseling.  Chiropractors do not prescribe medications. 

Physiatrists: A medical expert in the rehabilitative treatment of low back pain, also often address issues of prevention.  The comprehensive program they prescribe often includes physical therapy, exercise, hot and cold packs, and TENS (transcutaneous nerve stimulation) units.  They will prescribe medications if needed.  They may also include physical therapists and occupational therapists in the treatment plan.

Neurologists: A physician expert who specializes in the non-surgical approach to treatment of disorders of the nervous system.  They perform detailed neurologic exams, and order tests to diagnosis the causes of pain and weakness.

Pain specialists and Anesthesiologists: The specialty of pain management is a growing one.  Often, patients who don't improve with more conservative approaches, and for whom surgery is not an option (either because of age, bleeding problems, personal preference, or lack of surgical pathology), these specialists may offer significant relief.  The scope of their practices varies greatly.  Some prefer medications while others opt for more aggressive measures.  Trigger point injections involve placing anesthetic into certain muscle points.  Facet joints are the joints which hold one spinal segment to another.  Facet joint injections are injections into these joints with steroids or anesthetics.  Epidural injections involve the placement of steroids around the covering of the nerve roots (called the dura;  thus the term epidural). The are often given in a series of three shots, and can relieve pain and inflammation.  Nerve blocks involve the more selective placement of steroids around individual nerve roots.  Implantable pain therapies (spinal cord stimulation and intraspinal drug infusion therapy) can be  done in conjunction with a neurosurgeon. 

Pain psychologists: An expert who has a specialized degree in psychology, who evaluates and treats the psychological component of low back pain.  Sometimes, surgically repairing a structural problem may be of limited benefit if there is a significant psychological component.  Psychological factors which can potentiate pain, and can inhibit healing, include depression, anxiety, lack of family support or other significant personal or family stresses, and fear of pain and hospitals.  Bad previous surgical outcomes in the patient, or in friends or family members, may have an adverse effect.  Also, "unrealistic expectations" will result in unhappy patients.  Chronic pain syndromes are often difficult to treat.  In addition, when compensation or litigation issues are pending, psychological stresses are created, which may affect surgical outcomes.

Neurosurgery: An expert in neurosurgery  deals with the surgical treatment of low back and lower extremity pain.  Neurosurgery involves diseases of the cervical spine, thoracic spine, and brain, as well.  The spectrum of types of lumbar surgery include

  • discectomies ( neurosurgery to remove lumbar discs)
  • "redo" discectomies ( neurosurgery for recurrent discs)
  • spinal decompressions, for stenosis (narrowing of the spinal canal resulting in pressure on nerve roots)
  • lumbar fusions
    • posterior fusions using pedicle screws, rods, for instability
    • posterior fusions using interbody fusion with cages or bone, for instability
    • posterior fusions using interbody cages or bone, and pedicle screws
    • anterior lumbar interbody fusions (primarily for low back pain)
  • dorsal column stimulator implantation for low back and lower extremity pain
  • intrathecal medication pump implantation (for pain and spasticity)

Spinal neurosurgery  is done with the greatest of care to keep or add stability to the lumbar spine, while decompressing the nerves to relieve pain and enhance function.  The neurosurgeon usually uses a microscope while dissecting around the nerve roots, and often uses nerve root electrical monitoring techniques when nerve root injury is a moderate risk.

Orthopedic spine surgeons:  An expert who is  trained in orthopedic surgery, and then complete additional training in spine surgery.  The scope of their spinal surgery experience is similar to that of neurosurgeons.

 

 

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