Talking Low Back Pain with Dr. Casey Davidson – Facebook Live

Dr. Davidson, Tell Us A Little Bit About Yourself And What Specialties You See Here At Bone And Joint Institute:

Dr. Casey Davidson: I’m Casey Davidson, I’m one of the orthopaedic spine surgeons here at Bone and Joint Institute. We have three spine surgeons here at Bone and Joint Institute and one other spine provider – Dr. Zach Kalb – that also helps us with non-surgical spine management, so we really have all-encompassing care in regards to the spine and we try to accomplish improvement in pain and improvement in functionality via a number of different avenues and a number of different assets and different treatment plans that we utilize and individualize to a patient.

Many people experience low back pain and hip pain and they can often be related. How do you differentiate between the two?

Dr. Davidson: As an oversimplification, a lot of what we do is we’ll say if you’re having front pocket pain – if you can imagine you’re wearing a pair of pants that has front and back pockets – front pocket pain is usually something that’s coming from the actual hip joint itself. So anything radiating into the hip or the groin area, it’s more likely to be coming from your hip joint socket through some arthritis or some irritation there. If you call in, a lot of times the scheduler will ask you if you’re having pain in the back pocket. Usually in the back pocket in the buttocks areas or radiating down the leg is coming from the back and can be something like a pinched nerve.

What do you do for someone that is experiencing that front pocket pain or hip pain?

Dr. Davidson: We have different providers that provide different parts of the body, so radiating pain in either the front pocket or the groin area, we’ll want to get you over to see one of our hip surgeons to help initiate treatment on that.

On the flip side, what about the back pocket?

Dr. Davidson: The back pocket is something that would need to get over to one of our spine providers. As I said before, we have four providers that see patients, but we also have physician extenders. We have three physician assistants that currently can help initiate the treatment of that back pocket pain. When you’re having pain on the leg it can be pretty miserable, so there are a lot of different things – medications and therapy – that we can to treat it and get it feeling better.

Do you have to do any type of imaging such as X-rays or MRI?

Dr. Davidson: Typically we will obtain some X-rays when you get here and what that allows us to do is look at the bones and look at the discs and look at both the hips and the back to assess “Are there any structural abnormalities, is there any arthritis or degenerative changes that may be contributing to some of that pain.” That’s usually where we start is with some X-rays.

For back pocket pain, you mentioned therapy and some medications. Can you talk a little more detail about what that treatment plan may look like?

Dr. Davidson: Usually what we’ll start with, depending on some of the symptoms and factors that may be present, we’ll usually start with some physical therapy. Physical therapy has a lot of great literature to support it taking care of both back pain and nerve pain down into the leg. We usually initiate that at your first visit in order to manage some of the discomfort related to irritation of the nerve route, some of the inflammation. Sometimes we’ll prescribe some anti-inflammatories so some NSAIDs, some Tylenol. Sometimes we’ll use some muscle relaxers if we need to for muscle spasm pain. Sometimes we’ll use some short course and some steroids, which are a strong anti-inflammatory. Really we try to minimize narcotics if we can because they’ve been shown to be problematic and can cause a plethora of other issues but occasionally they can be beneficial. We utilize them sparingly but those usually are kind of medicines that are used to kind of help manage some discomfort to allow you to start moving and doing some of that physical therapy.

Talk a little bit about the technology and some of the new thins coming down the pipe as far as our spine program here.

Dr. Davidson: A couple of different, exciting things we’ve got going on. One is that we’re looking at some new navigation system at the hospital and over at Williamson Medical Center. So what that is is it’s a different way to place some of the hardware that we utilize while we’re doing surgery to allow us to do more minimally invasive techniques and to more safely place some of the hardware that we’re replacing. It’s a really cool technology and it’ll put us on the cutting edge of some of the technological advances of the spine.

The other thing would be outpatient spine. We really have realized that it’s safe and efficient and a very good option to perform outpatient spine surgeries so we’re doing more and more of those and we’re having great results and patients have been very happy.

Is that at both Williamson Medical Center and Bone and Joint Institute?

Dr. Davidson: Both. A lot of the outpatient stuff we’re pushing over here to the surgery center just out of simplicity and efficiency but we do a lot of outpatient surgery over at Williamson Medical Center – and they do a great job too. The outpatient component and getting people back to post-op Day 0, they may be able to go back and sleep in their own bed and be at home in a comfortable environment, that can make a big difference.

How does the spine program and what you’re able to do on a daily basis add to the comprehensiveness of Bone and Joint Institute?

Dr. Davidson: I think it’s a great opportunity. We really cover the gambit of orthopaedic treatment options. On a day-to-day basis, I’m collaborating with my spine partners, my hip surgery partners and I’m collaborating with some of our non-surgical spine specialists. We’re a short walk down the hall to be able to talk with Dr. Zach Kalb doing our injections and ask him about injections. We can check on patients that are getting injections. I can check with and refer over to Dr. Richard Gibson who also does some hip injections and some different ultrasound-guided injections. If we happen to have somebody that ends up in my clinic that thinks that are predominantly having hip pain, a lot of times we’ll even get them over to talk with one of our hip surgeons that day if we can fit them into the schedule. It really just, from a collaborative standpoint, makes things so much more efficient and so much better for the patient overall.

To watch the full segment with Dr. Davidson’s from Facebook Live, click here.

If you have any questions about osteoporosis or want to schedule an appointment, give us a call at (615) 791-2630 or schedule an appointment by clicking here.