Questions & Answers Q: How do I determine if surgery is the proper solution for my lower back and sciatica pain? A: Chronic lower back or leg pain caused by spinal disc problems can be frustrating because it limits your ability to move and do the things you enjoy. Most lower back pain solutions focus on conservative (non-surgical) care - rest, medication, physical therapy, and exercise. If, despite your best efforts, the pain doesn't go away, surgery can help relieve your pain by treating your disc problem. You and your surgeon would discuss your medical history and lifestyle. After diagnostic testing to confirm your diagnosis and locate the source of your pain, your surgeon would determine which surgery is most beneficial to you. Q: When and what kind of testing should I expect? A: During your initial visit to SpineCenterAtlanta, your physician will take your medical history and perform a physical examination. A course of action will be designed and decided upon between you and your doctor. If diagnostic testing is necessary to determine the cause of your particular pain, testing will be ordered. Your physician will discuss the process with you thoroughly. You can normally return to your regular activities within one to three hours. Testing will probably include some or all of the following: X-rays show the bones (vertebrae) of the spine. Vertebrae that are too close together could indicate a degenerated or herniated disk. MRI (magnetic resonance imaging) shows detailed images of discs, the spinal cord, and other soft tissue. Myelograms are special x-rays of the lumbar spine. To take a myelogram, a special dye that highlights your nerves is used. CT (computerized tomography) and MRI (magnetic resonance imaging) are special imaging tests. They confirm which disk is damaged. EMGs (electromyograms) measure the electrical activity of your muscles' contractions. They can show muscle or nerve damage. Q: Can I go out of my insurance network to see a doctor in your group? A. Most insurance plans offer out-of-network benefits to its members. We will be happy to assist you in finding out if your plan has out-of-network benefits. If your plan does not offer out-of-network benefits, the State of Georgia has a new law, the "Consumer Choice Option (CCO)," which requires most managed care plans (HMO, PPO, and POS) to offer its members the option to choose their own doctor. Please contact us for further details. Q: Can I see a doctor in your group if I've been injured on the job? A. If you have been injured on the job and don't have a doctor, SpineCenterAtlanta would be happy to help you. Or, if you are currently receiving medical care, you have the right to a second opinion. Our second opinion can confirm a diagnosis and proposed treatment and provide you with comfort in your decision making process. A new Georgia law, effective July 1, 2001, amends an injured worker's rights, to provide an injured employee the right to an independent medical examination. Access Georgia's State Board of Worker's Compensation Bill of Rights for the Injured Worker at http://www.ganet.org/sbwc/about/forms/wc-bor.pdf) or contact us for further information. Q: What insurance providers do you work with? A. SpineCenterAtlanta (your medical care provider) has contracts with a number of Managed Care (insurance) groups. When you make your first appointment, you'll provide the administrative professional at SpineCenterAtlanta with your insurance information. She will confirm your benefits with your insurance company and discuss them with you. SpineCenterAtlanta is dedicated to providing the best care available within our field and working with patients to keep out-of-pocket expenses manageable. Q: What will be my financial responsibility if I chose to see this doctor? A. If insured, your financial responsibility will vary depending upon your plan coverage. Many times, the insurance plan covers most of the cost of the care provided, even out-of-network. If uninsured, SpineCenterAtlanta will work with you on an individualized patient financial agreement program for your total spine care. Q: What causes low back pain? A. Some causes of low back pain include arthritis, ruptured intervertebral discs, and abnormal curvature. Most of the time, however, a specific cause cannot be pinpointed. Backaches from overuse or heavy lifting are probably the result of muscle spasm and inflammation of the soft tissue (ligaments and muscles) along the spine. Q: How can I prevent low back pain? A. The following strategies may help prevent low back pain: Use proper lifting techniques (e.g., bend at the hips and knees to lift an object off the floor, carry objects close to your body, get help carrying heavy objects) Limit frequent bending and lifting Ensure proper workplace ergonomics (e.g., proper chair-to-desk height and keyboard height) Maintain your ideal body weight Maintain a regular exercise program, including abdominal and back strengthening exercises Do not use tobacco products Q: Can wearing high heels cause spine problems? A. Yes. Studies suggest a correlation between high heel height and the potential for spine problems. If you have a back problem, avoid heels. Q: Why has my physician asked me to have my dental work finished before I have my hip joint replaced? A. It's important to have your dental work finished and to have tooth or gum problems treated before your surgery because the germs in your mouth could enter the bloodstream and infect the new joint. This could delay your recovery. In an extreme case, an infection in the new joint might mean the prosthesis would have to be removed. Q: I have back problems and just the thought of having sex sends a pain spasm up my spine. My wife is concerned that our sex life might be over. A. Back pain doesn't have to put an end to your sex life. There are positions that may help you control back pain during sex. Once you identify which positions might work for you, start to experiment. If you and your partner work together, pain may give way to pleasure sooner than you think. Discuss this with your physician. Get your doctor's approval before returning to sex, especially if you're recovering from back surgery. Also, be sure to follow any special instructions your doctor or physical therapist gives you. To obtain a helpful brochure "Sex and Back Pain," please Contact Us.