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The fact that June 5th was National Running Day was lost on many people. Why? The joints and muscles of most individuals are not flexible or strong enough to take the pounding that running requires. However, almost anyone can walk and this exercise seems to be as effective as running. There’s even recent research that proves this.

In April 2013, Paul Williams of Lawrence Berkeley National Laboratory in California and Paul Thompson of Hartford Hospital in Connecticut compared 33,060 runners to 15,045 walkers and found that it’s how much a person exercises, in terms of energy spent, not how long he or she spends exercising. While it takes longer to walk a mile than to run one, when these two exercises compared in terms of energy expended, they are comparable yielding the same benefit.

The researchers measured blood pressure, blood sugar and cholesterol at the beginning, and then watched for six years to see who got diagnosed with high blood pressure, unhealthy cholesterol or diabetes. Those who exercised equally (in terms of energy output) got the same benefit whether they ran or walked. This study was published in the American Heart Association journal, “Arteriosclerosis, Thrombosis and Vascular Biology.”

In addition to these physical benefits, walking lowers stress levels in most people. A study at the Department of Behavioral Science at the University of Texas M.D. Anderson Cancer Center showed university students who walked had lower stress levels than sedentary people or even those who exercised strenuously. Plus, walking can be done almost anywhere – on the street, in a park or in a shopping center.

Is Back Pain Keeping You From Walking Tall?

With all of these benefits, why isn’t everyone walking every day? Sometimes, back pain precludes this activity. This is where the spine specialists at Texas Back Institute can be of assistance. We spoke with Dr. Stephen Tolhurst, an orthopedic spine surgeon at Texas Back Institute about the benefits and challenges of a regular walking program.

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To watch a video interview of Dr. Tolhurst explaining the benefits of walking for the back, please click here. 

Are there benefits to back health that are derived from a regular regimen of walking? If so, what are these?

Walking improves one’s overall health and this affects the whole body including the back and neck. The back tends to be healthier and less susceptible to injury and/or disease such as arthritis when an individual is active. Additionally, walking can help to keep the core muscles – abdominals, back and legs – stronger and this supports the back and neck.

What are some lower back problems that can keep someone from walking and how does one know when these pains are serious enough to visit the physicians at Texas Back Institute?

There is a condition called spinal stenosis, which is an abnormal narrowing of the spinal canal that can occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. The symptoms of spinal stenosis include pain, numbness and loss of motor control. The location of the stenosis determines which area of the body is affected. This can cause a “rubbery” feeling around the leg when walking. This condition is serious and should be treated by a spine specialist.

There are also situations where pain shoots down one’s leg when standing or walking. This could be caused by a herniated disc or pinched nerve and should also be treated by someone on our staff.

However, mild to moderate back pain or stiffness during or after walking is usually not serious. If the pain is not getting worse, it’s probably safe to work through. In fact, the exercise from walking will likely help this pain and stiffness.

What are the most common factors that can cause lower back pain and keep someone from walking?

The number one factor is a sedentary lifestyle and the lack of regular activity. In this situation, core muscles are weak and walking can cause back pain. Obesity also plays a role in back pain and it’s no surprise regular physical activity can help to reduce obesity. Sleeping on awkward surfaces, such as a cot, floor or even a too-soft mattress, can cause back pain.

Some people experience “side stitches” when they walk. Is this a back problem or not?

Side stiches are not a back issue. While there are lots of theories on what causes them, no one is sure. They are not dangerous but they are annoying. When I’ve gotten them, I’ve used deep breathing techniques – after inhaling, breathing out through pursed lips to force the exhale – and this helps me. Stopping and stretching is also a tactic to use to work out this pain. Under any circumstances, this is not a sign of spinal problem.

How You Can Get Started

Just knowing the physical and psychological benefits of walking is not sufficient to motivate most people to “put on their walking shoes.” Texas Back Institute is involved in the specialized care of neck and back pain, spine trauma, scoliosis, artificial disc replacement and related spine surgery – not fitness counseling. However, we recognize physical fitness can have very positive effects on one’s back health.

With this in mind, here are a few fun suggestions to get you and your entire family involved in a daily walking program.

  • Bring along a walking buddy. This can be friends or family and if they’re excited about feeling better…all the better!
  • Walking has to be fun, otherwise it’s boring. Finding visually interesting places to walk such as trails in parks and greenbelts and then combining natural studies such as bird watching or tree/flower identification activities with your walking buddy.
  • Purchase an inexpensive pedometer, clip it to your waist and keep track of the miles you walk each day. Some of these steps will come from your daily activities. The average person’s stride length is approximately 2.5 feet long and this means it takes just over 2,000 steps to walk one mile, and 10,000 steps is close to 5 miles. Set a reasonable and attainable goal and then log your daily steps in a journal and try to add more steps each day.
  • Take the stairs whenever possible. Climbing stairs is a great aerobic exercise and when you take them, you’re not stuck in an elevator with 5 or 10 other people.
  • Get some tunes for your walk with your mobile device and ear buds. Music is a wonderful addition to any walking program because it not only distracts the walker from fatigue, but sports psychologists have noted that a steady beat can elevate a person’s performance by as much as 20%! In order to get you in the mood, why not download some tunes that have “Walking” in the title. Here are some:

Spring and summer is a great time for you to step up to a walking program. With this advice from Dr. Tolhurst you have some of the medical facts you need to get started. Now all you need is your walking buddy, pedometer and walking tunes and you’re good to go. Are you ready? Start walking.

iron-man-3-730x400The movie smash hit of the summer is Marvel’s Iron Man 3 and its popularity can be explained on several different levels. The “superhero” in this blockbuster flick is both physically and emotionally scarred, so in many ways, he’s just like you and me. Plus, the action and special effects are non-stop. This science fiction, where the lead character’s  human body part is replaced by an artificial part, is science fact at Texas Back Institute.  How so? Read on.

Artificial disc replacement, pioneered by several spine surgeons at Texas Back Institute, including Dr. Scott L. Blumenthal, is in many ways more futuristic than the suit of iron that brash-but-brilliant industrialist Tony Stark wears to heroic advantage in Iron Man 3. Before delving into the reasons for Stark’s angst and ultimate redemption, we asked Dr. Blumenthal to gives us some insights into the ways he and his colleagues are transforming patients in pain to Iron Men and Women.

Artificial Disc Replacement – Medical Fact not FantasyScott L. Blumenthal, M.D

In post-movie interviews fans of Iron Man 3 have said that one of their favorite aspects of the story is the blurring of science fiction and medical fact. Since you have taken a part of the body – the disc that cushions the spinal vertebra – and replaced it with one that is artificial and more durable, what are your thoughts about this advancement?

When I started in medical practice, we talked about the TV show The Six Million Dollar Man. For anyone younger than 30, this was a fictional story about a man who had been critically injured and had many of his organs, muscles and limbs replaced by much stronger artificial ones. At this point in medicine, this replacement of real with artificial body parts is becoming reality, not fantasy. For generations, spine surgeons have been fusing vertebra when the discs wear out or are damaged.  Our patients were constantly asking “Why can’t you just  replace it?” Well, after much development and testing, now we can. In patients who have back pain resulting from damaged disc we can replace it with one that is man-made.  My colleagues and I formed the Center for Disc Replacement and now the fantasy is going to be main stream medicine.

What enabled Texas Back Institute to be at the forefront of this procedure?

Our advantage came from our opportunity to do the FDA testing of this procedure here at our clinic. This procedure had been very popular in Europe for many years (before being considered in the U.S.) and many people with the resources to travel there, were getting the benefit of this technology by going over there. Because we were asked to assist in this testing, we were the first practice to be able develop protocols for the procedure. Our experience here far outweighed other physicians in this country. We started lumbar disc replacement and went on to cervical disc replacement. We discovered extensive evidence that strongly suggested artificial disc replacement speeded recovery, so our patients returned to work sooner. We found this procedure had better outcomes than fusion and the overall costs were less.

What brought about the development of the artificial disc?

It’s a combination of factors. There is substantial patient demand and the technology in the composition of the artificial discs is excellent and continues to get better than it was 12 years ago when we started. Plus, there is a measurable economic benefit to disc replacement as opposed to other procedures.

Do you mean there are economic benefits to patients in the form of cost vs. outcome?

Exactly. This is why the major insurance companies – not known for their investing in medical technology simply because it seems to be good technology – have decided to cover this procedure. They clearly have good data that proves the costs for artificial disc replacement are reasonable when outcomes, long-term recovery and the incidence of future problems are considered.

What other medical advancements – which may seem like science fiction now – do you see becoming medical fact in the immediate future?

I see stem cell therapy becoming an important new frontier for back surgery and specifically disc damage. Patients are looking for different, non-invasive ways to alleviate back pain and these stem cells – some harvested from the patients suffering from the pain – have the potential to change the way we treat damaged tissue.

Watch Dr. Blumenthal comment on technology and spinal care.


What Makes Iron Man 3 So Interesting?

As the advertising blurbs about Iron Man 3 note, “the movie pits brash-but-brilliant industrialist Tony Stark (also known as) Iron Man against an enemy whose reach knows no bounds. When Stark finds his personal world destroyed at his enemy’s hands, he embarks on a harrowing quest to find those responsible. This journey, at more »every turn, will test his mettle.” Whew! All that in about 2 hours!

As fans of the three movies know, the first of the Iron Man films revealed Stark as a clever, resourceful scientist-adventurer-tycoon who launched his super-character and super-suit while trying to escape from a platoon of Middle Eastern terrorists. This film was followed by a sequel called, Avengers , which did not receive the same level of enthusiastic critical review or box office support. However, the third installment – Iron Man 3 – has critics and, more importantly, paying customers, raving.

Part of the reason this current Iron Man saga has been so successful has to do with the evolution of the lead character played brilliantly by Robert Downey Jr. This star has had his own, well-chronicled personal challenges and the Tony Stark character he plays in the movie is experiencing many of these same – all too human – difficulties.

Iron Man 3 is replete with action, special effects and the superhero formula that seems to cure all boredom. However, the lead character spends less time in his iron suit, fighting bad guys and more time contemplating his place in the universe. One reviewer was on the mark when he noted Stark discovers the answer to the question that has been haunting him: Does the man make the suit or does the suit make the man?

Watch the Iron Man 3 trailer here.

Since Dr. Blumenthal and his colleagues at Texas Back Institute  are turning what was medical science fiction a few years ago into medical fact today, we had to ask him if he had a favorite superhero when he was growing up? His answer should give hope to those who don’t particularly care for Iron Man, but do long to go where no man has gone before!

Blumenthal notes, “Actually, I was not a big fan of superheroes. I’m more of a Trekkie. Fortunately, the new Star Trek – Into the Darkness opens tomorrow and I will be there!”

Dr. Scott Blumenthal was the first Orthopedic Spine Surgeon in the US to perform an Artificial Disc Replacement (ADR) surgery. This life changing surgery has now helped over 1,400 Texas Back Institute patients. Recently SpineUniverse.com featured the blog post below about the choosing the right spine surgeon for you.

Choosing the Spine Surgeon Who Is Right for You

Patients often wonder how to choose a spine surgeon to perform their total disc replacement.

The easy answer to this question is simple:  carefully.

The longer answer to this question is:  do your research, both on your surgeon and on the procedure.

Tips for Choosing a Spine Surgeon for Disc Replacement
While thousands of surgeons have been trained in disc replacement techniques, very few have adopted it into their clinical practice with any regularity.

Certainly, the bare minimum requirements for choosing a surgeon would be to ensure he/she is a board certified or board eligible orthopedic or neurosurgical spine surgeon.  “Board certified” means that the doctor has gone through a rigorous testing and peer evaluation process by a specialized medical board.

You can ask your doctor if he/she is board certified, or you can research it online.

Some tips to get a better feel for the expertise of the surgeon are:

  • Ask how long he/she has been performing disc replacement surgery and with what frequency they do this procedure.
  • Make sure your surgeon performs many types of surgery and can tailor your treatment to be most appropriate for your condition. Not every patient is best served with a spinal fusion, nor is every patient best served with disc replacement.
  • Make sure you have open communication with your physician.
  • Make sure you trust and have confidence in your surgeon’s abilities.
  • Look at the surgeon’s academic credentials or published papers.  Find out what they have written on disc replacement and if they are leaders in this specialized area of spine care.

A warning to patients:  Don’t depend on fancy advertising or marketing when choosing a surgeon.  Use all your resources when making a decision this critical. The Internet, medical directories and societies, as well as your regular physician can all be great resources in helping you decide which surgeon to go to.

There are also additional resources such as patient chat rooms and blogs where you can read about other patients’ experiences with surgeons.

Choosing a spine surgeon is a very important decision, and the more facts you can get, the better. Luckily, there are many resources to help you find a spine surgeon who is right for you.

Artificial Disc Replacement

September 25, 2012

Dr. Scott Blumenthal was the first Orthopedic Spine Surgeon in the US to perform an Artificial Disc Replacement (ADR) surgery. This life changing surgery has now helped over 1,400 Texas Back Institute patients. Recently SpineUniverse.com featured a blog post about the history of artificial disc replacement.

The History of Artificial Disc Replacement

How Long Has This Spine Procedure Been Used?

          Submitted by on September 10th, 2012

Artificial disc replacement (ADR) or total disc  replacement (TDR) is a surgical procedure which replaces a degenerated disc in  the spinal column with an artificial motion device. It has been used in the  United States since the year 2000, but it originated in Europe almost 30 years  ago.

Before performing the first ADR in the United  States in March 2000, I did a lot of research on the procedure, including  visiting with a number of surgeons in Europe as well as the inventor of the  first FDA-approved ADR, Karin Buttner-Janz. Besides inventing the artificial  disc, she is well-known for being an Olympic and world champion gymnast from  East Germany.

With 12 years of experience, we have now  performed more than 1,400 disc replacements in our private practice alone.  Patients now have access to spine surgeons with extensive experience in disc replacement right here in the in the United  States.

Total disc replacement is an alternative to  spinal fusion. It is an innovative process of surgically removing a damaged  disc from the spinal column and replacing it with an artificial disc. This procedure can significantly benefit patients who suffer from herniated discs or degenerative disc disease with or without leg or arm pain.

Artificial disc replacement gives patients an opportunity to retain  mobility in both the neck (cervical spine) and lower back (lumbar spine). By  replicating the movement of a normal disc, ADR helps to alleviate adjacent disc  degeneration minimizing the need for additional spine surgery due to disc  degeneration or herniation.

Since 2000, a number of FDA studies of other  artificial discs began enrolling patients in the United States. Over a dozen  studies have been completed in the United States and currently there are four  discs approved for use in the United States.

The FDA-approved disc available for the low back  (lumbar spine) is the ProDisc-L.  For the  neck (cervical spine), the Bryan, Prestige, and ProDisc-C are available.

Looking forward to the future of artificial discs  in America: at least a dozen or so discs are either currently in-trial or have  completed the trials for FDA approval and will hopefully be available in the US  soon.

Artificial Disc Replacement

Texas Back Institute is a global leader and pioneer in spine care, having performed more than 1,400 artificial disc replacement procedures with 14 different types of ADR devices, beginning in 2000 with the first ever performed in the United States. One of the latest advancements in spine surgery, artificial disc replacement gives our patients an opportunity to retain mobility and resume their lives with minimal pain or discomfort. Led by the world-renowned spine surgeons at our Center for Disc Replacement, we perform this motion-preserving, life-changing procedure on patients from around the globe each year. If you’re suffering from chronic back or neck pain, our concierge services team will help you coordinate all aspects of your visit to TBI so you can receive treatment from some of the best spine surgeons in the world. It’s your time to get back to life.

BW Beasley…Back to Racquetball!  

BW Beasley came to the Texas Back Institute after suffering from chronic back pain symptoms for years. Ten years earlier, Mr. Beasley had undergone a microdiscectomy with a different physician which only temporarily relieved his pain. He was anxious for a chance to get back to an unrestricted and active lifestyle, as he had been an active golfer and racquetball player before his pain had become too severe. Additionally, he was required to travel for work as a sales manager, and this was becoming increasingly difficult due to his back pain symptoms.

After conservative treatments proved unsuccessful, BW decided to go through with disc replacement surgery with Dr. Jack Zigler at TBI.  Shortly after surgery, the hospital staff had him up walking and into the artificial disc replacement physical therapy program.  BW progressed rapidly and by his 6 month follow-up visit, he was scuba diving and golfing again. Travel was no longer an issue, which made work much more manageable.  At his 12 month follow-up visit, he arrived at TBI with a copy of the Summer 2009 Racquetball magazine that featured an article he had written about playing the perfect game. He had just played in the US Open for Racquetball in his age group—an amazing feat, for someone who was seeking back pain treatment had undergone back surgery less than a year before. He stated that people were amazed to hear that he had an artificial disc and asked many questions about it, his surgeon, and where he had his surgery. “I refer patients to TBI and Dr. Zigler all the time!” he says.

Three years later, he won a national Racquetball tournament for his age group. “I have some trouble with my shoulder and my elbow at times, but not really my back,” he said. He can’t believe that three years have passed and that he continues to do so well after back surgery and feels so good.

“I never thought I’d be able to get my life back,” he says, “but if I can do it, I know others can too.” When asked what BW would tell others worried about undergoing spine surgery, he says, “If you do nothing else, just go see the spine surgeons at Texas Back Institute.  You owe yourself at least that!”

Here are a few things our medical receptionist would like you to know, to make every medical visit as easy as possible for you.

Call to schedule an appointment during mid-day hours.  Avoiding the rush hours is always a good idea.

Know your own schedule before calling to make an appointment. This will make the process move more quickly for you and the office manager and avoid any accidental double-booking that you might have to correct later.

Fill out new patient paperwork before you come to your appointment. Many practices provide paperwork online, via email or will mail it to you. You’ll avoid having to call someone from the doctor’s office to get information you might not have handy or remember.  In some cases, you may also be more accurate and thorough in answering some questions. You’ll also spend less time in the waiting room.

Have all of your insurance information with you. Be prepared to present your insurance cards and all applicable policy numbers. Most doctors’ offices also require some form of identification, such as a driver’s license.

Prepare, in advance, your questions for the doctor, timeline and notes for your medical condition and medications you are taking. If possible, keep a journal of your medical condition that records symptoms, medications taken, any side effects, etc. that will help you present your situation more accurately to the doctor. Also come with your questions so that you won’t leave your appointment and then remember you forgot to ask a question that is important to you.

Call the doctor’s office from the road if you’re running late. Make sure you have the office contact information with you so that you can let them know if you’re lost, stuck in a traffic jam or something else causing you to be late. The receptionist may then be able to move other patients ahead of you and work you in. (And please pull your vehicle over to a safe place to make your call.)

If going to a specialist, bring all of your diagnostic results with you. Make sure you gather up all diagnostic test results, such as imaging procedures and blood work, with you. The specialist will need them and not having them can delay your treatment. Also, bringing your files with you in person is better so as to avoid any problems such as transfer of files that aren’t identified properly.

Inform the office manager of any special circumstances associated with your condition and office visit. Be sure to let the doctor’s office know if your situation involves a worker’s compensation claim, accident or previous surgery.


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