Obesity and Back Pain – Dr. John Roberts

by Dr. John Roberts V, MD15. July 2011 12:32

dr. john roberts

The data released by the America Health and Robert Wood Johnson Foundation Obesity Study is sobering: 38 states have obesity rates over 25%, and only one state, Colorado, has an obesity rate below 20%. As recently as 20 years ago not a single state had an obesity rate over 15%.

To frame it slightly differently, the 2010 Census indicated the U.S. population has reached 308,000,000 souls. Let’s assume 25%, or 77 million people are obese, and the average height of a person is 5 feet seven inches. The difference between overweight and obese for a 67inch tall person is approximately 32 pounds. This equates to Americans unnecessarily carrying around 246,000,000 pounds, or roughly the equivalent of two aircraft carriers, on their backs, every day!

It is like carrying a medium –sized suitcase with you everywhere you go. How this affects the human spine is quite simple.

The spine is comprised of several complimentary curves that hold us in balance. This accounts for the normally seen gentle curve of the neck and of the lumbar spine. Placing a large part of the body mass in front of this natural line of balance throws balance out of place and recruits muscles to secondarily support the weight. It doesn’t take much of an insult to injure the already overburdened and unbalanced spine.

Consequently, 87% of all spine care providers agree that obesity is potentially the number causative factor in developing low back pain. It’s simple math: lose the weight or likely join the ranks of those with chronic low back pain.


Beware Weekend Warriors – Dr. John Roberts

by Dr. John Roberts V, MD22. June 2011 07:00


You wash the cars, mow the lawn, perhaps spend a little recreation time at the pool with the kids. If the kids are in luck, you might even spend a few minutes launching them through the air into the water. Monday morning arrives, you drag yourself out of bed and head to work. You bend over to pick up a wrench or that slip of paper on the floor, and instantly your back goes out.

It feels like someone has thrust a hot dagger into your back. You wince, stagger to a chair and realize you have just ruined the next week. This is an all too real scenario. In fact, work-related injuries occur more commonly on Monday than on any other day. But this need not be the case.

Heightened physical activities, such as occur over the weekend, often push muscles to their limit, causing a buildup of lactic acid which leads to muscular soreness and tightness. It is this exact stiffness that renders the muscles more susceptible to sprains and strains. On a microscopic level, a sprain or strain occurs when the muscle fibers literally tear themselves apart.

Obviously, the greater force applied, the greater the resultant injury. This can be largely avoided by one simple bit of advice: stretch your hamstrings. As a muscle group, the muscles in the back of the thighs, the hamstrings, constitute the most powerful muscles in the body and they easily dwarf the lumbar muscles in power. As you bend over, it becomes a tug of war between the hams and the lumbar muscles, and the lumbar muscles usually lose out, resulting in a muscle injury.

My simple advice: spend a few minutes every morning, and particularly on Mondays, stretching your hamstrings. There are several ways to do this. Lie on your back and pull your knee up to your chest. Alternatively, put your foot on a chair or low bench and lean your torso forward. You feel the stretch. Do it every day and you will see a remarkable difference.


Look Before You Leap – Dr. John Roberts

by Dr. John Roberts V, MD15. June 2011 13:00


It’s that season again. Pools are open, ponds and lakes are warming up; it’s time for a swim. But the age worn adage is more important than ever. Never, and I mean never dive into murky water. You must know how deep it is and what lurks below the surface.

Neck injuries make up 2% of spine injuries in children, and the real tragedy is that the majority of these are avoidable. Children are particularly vulnerable to neck injuries following impacts to the head because their heads are proportionately larger than the rest of their bodies and their relatively undeveloped neck musculature cannot protect their spinal cord from a sudden bending force. Also, children have such ligamentous laxity in their necks that spinal cord injuries often occur without any apparent boney trauma to the neck.

So when it says “NO DIVING’ in the shallow end of a pool, respect it. It is not written to make the lifeguard’s job easier; it is there so a life is not tragically altered. Also, that rope swing may seem inviting, but check it out first. It is a frequent refrain from the devastated quadriplegic, lying in spinal traction, ‘I didn’t know the water was only six inches deep’, or ‘I can’t believe there was a tree trunk just under the surface.’

Do yourself a favor, look before you leap!


Patient Heal Thyself

by Dr. John Roberts V, MD13. June 2011 08:53

 The supersizing of America is no laughing matter. In fact, nothing is as sobering as when one sees their true Body Mass Index (BMI) written down in their medical record. As a spine surgeon, I believe obesity may now be the single greatest causative factor in the chronic back pain that bothers so many Americans.

It is a common story: ‘I work too many hours to exercise when I get home, don’t have time to cook a good meal, and  somehow… the weight just piled on.’ Obesity is at the very root of the problem. The human skeleton and supporting structures aren’t strong enough to carry the three and four hundred pound loads we, as Americans, have loaded onto our frames.

In fact, the cartilaginous discs we all have between our lumbar vertebrae are virtually inert due to the absence of an internal blood supply. Consequently, our discs have a finite life span and once you go over that limit, you are left with a collapsed disc and a very painful situation.

Studies show that fully 40% of all back pain suffers can eliminate their problem through weight loss alone if they can get the weight off before the damage is done. If the damage has been done, you are between a rock and a hard place because obese patients do not usually obtain good results from corrective spine surgery.

My advice is simple: skip the donuts and fast food, find time to exercise. An elliptical stair climber or an aquatic program is a good place to start. Set up a schedule and weigh yourself daily. Otherwise, you might end up with pain that controls your every moment.


The Unsung Hero of the Back

by Dr. John Roberts V, MD13. May 2011 06:05


Nestled between our vertebrae is the unsung hero of the vertebrate spine: the disc. Much is known about the disc but there is little discussion about it. It is primarily a cartilaginous structure with a soft, pulpy center that is surrounded by bands of tissue that become progressively stiffer as you near the outer rim. It is a very effective shock absorber and actually resembles a run-flat tire with its stiff outer fibers.

The disc quietly goes about its business as it allows us to bend routinely up to 200,000 times per year. It protects the spine from shock as we take up to 2 million steps in a normal year. Imagine what we put it through as a marathon runner or as a football player? What is even more remarkable is that the disc has a tenuous blood supply at best. In fact, it has the metabolic activity of a snail. Consequently, the disc we have through life is pretty much the same disc you were born with. This is an impressive feat when you consider what we put our discs through.

But there are a few simple words of advice to actually help preserve our discs: stop smoking because the combined carbon-monoxide and nicotine strangle the discs tenuous blood supply, lose those extra holiday pounds for the obvious added stress they cause, avoid awkward or excessively heavy lifting and use mechanical aids where possible, always use the best ergonomics when possible. More to follow on the ergonomic recommendations…