Dr. Paula Walker

People go to yoga to stress out their physical body and to de-stress their minds, explains Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga.
The specialist advises taking the yoga out off the mat and get it to real life. After a lot of practice, people have to take a deep breath. It just calms them down physically, mentally and emotionally. Yoga is a moving meditation and it’s a practice connecting breath and movements. It’s so popular and it’s very inclusive for everybody, says Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga.
People don’t have to sit still to do it. Yoga movements takes their minds off of what may be going on in their lives, explains Allison Gollner, Yoga Instructor & Studio Manager at greenmonkey® yoga. Yoga is for all body shapes and sizes and everybody can practice it, according to Allison Gollner, Yoga Instructor & Studio Manager at greenmonkey® yoga, and Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga.
They say the whole body is involved in yoga practice. The specialists also affirm people can do yoga in wherever they can find a little space, to breathe and stretch. Yoga shifts people energy and they leave the studio more positive and friendlier, says Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga.
Allison Gollner, Yoga Instructor & Studio Manager at greenmonkey® yoga, teaches some poses to help with balance, especially for elderly people. Heat makes easier to practice yoga, explains Allison Gollner, Yoga Instructor & Studio Manager at greenmonkey® yoga, Heat makes it easier to be flexible and to get into a deeper posture.
She advises people trying to find a good yoga instructor. If you don’t resonate with a certain teacher, try another teacher, recommends Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga. Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga, says yoga is a motivator for her, because she believes yoga is the Fountain of Youth. She explains she enjoys looking and feeling as young as she can be.
She describes more people practice yoga, take those motivations and tend to eat healthier, tend to socialize more healthily and people feel fit and vital. She affirms people who do yoga look at least 10 years younger. Yoga helps people to relate with each other, especially when it is performed in open areas, explains Allison Gollner, Yoga Instructor & Studio Manager at greenmonkey® yoga.
For other people, yoga is their second home. A lot of people develop strong relationships through yoga. Also friendships and business relationships are developed, too, says Paula Walker, Yoga Instructor & Director of Marketing and Events at greenmonkey® yoga. Dr. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Orthopedics and Sports Medicine Institute, explains conservative care consists on physical therapy, oftentimes injection therapy, lifestyle modifications and other ergonomic changes that patients are going to make in their lives in order to ease the pain or any other health problem.

Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, says most of the patients will get conservative care, unless they present red flags, like weakness, bladder problems and sexual dysfunction. Dr. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Orthopedics and Sports Medicine Institute, explains the recovery after a back pain surgery will focus on a core strengthening in a way that you are not bending, lifting and twisting your back.

She recommends avoiding crunches or sit-ups, but doing planks. “Planks are fantastic as sort of a light Pilates and low impact activities,” she highlights. Dr. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Orthopedics and Sports Medicine Institute, says surgery for back pain is necessary when patients have tried conservative management, injections and lifestyle modifications and they still have back pain.

“Things that necessitate surgery are things like instability, so if your vertebral bodies are moving back and forth on each other, that can actually damage your nerve roots,” she says. There are different types of back surgery, such as diskectomy, laminectomy, fusion and artificial disks. Dr. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Orthopedics and Sports Medicine Institute, says those ones would happen for patients who presented with a herniated disk and with either back pain or leg pain.

“The type of surgery selected depends on the patient’s symptom. So, if you have back pain, that more pushes us towards a fusion because it comes from either the disks or the facet joints,” she explains. It is time to see a doctor because of back pain if the pain started after you fell or were struck, if you feel weakness, numbness or tingling in legs, if you have bladder or bowel problems and if the pain is getting worse or it is not going away.

Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, recommends going to the doctor to make sure there is no fracture or if the alignment of the spine is being kept, for example. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, explains sciatica means there is a compression of a nerve in the lower back, and normally people will feel it down in the leg.

“You might feel a jolt of pain going on the leg and depending on which nerve is being affected, you might feel it in a specific distribution running on leg,” he says. Age related changes in spine, obesity, occupation, prolonged sitting, and diabetes are some of the sciatica risk factors. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says as we age the structures are not the same.

“They start getting the wear and tear and that can cause you have some degeneration and eventually the weakness from the muscles that can lead you into having back problems,” he points out. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, says the risks of spinal cord stimulation will be infection, and bleeding. “For bleeding, we ask the patient to stop several medications prior to the procedure, and for infection everything is sterile and we give antibiotics during the procedure and during the last of the trial so they don’t get infected, and they don’t develop an infection that can be detrimental,” he points out.

The doctor says the success rate is anywhere around 60, 65% on patients and it can be brought up to about a 90% if they improve the selection of the patients to this procedure. Arthur Whitelaw is a patient of Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute. Whitelaw had so much pain for many years, and after the spinal cord stimulation, he feels very good.

“The procedure with him went well, we did a trial portion, and after the trial he responded exceptionally well. He was that perfect fit for getting the device implanted,” the doctor says. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains acute is the pain for the first 30 days, and chronic is when the pain persists more than three months, and the more chronic it becomes, the more difficult it is to treat.

Back pain can occur with scoliosis, spondylolisthesis, arthritis, and spinal stenosis. “Scoliosis will be more of a chronic condition that normally occurs when the bones are fusing and they are forming. When you get into 18 years old, you’re done with puberty, the bones fuse and pretty much that’s when you develop scoliosis,” he says. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says when you have an acute injury, doctors will recommend a cold pack. “They are good for the first 48 hours.”

Hot packs, stretching and over-the-counter medication are other home remedies. “Stretching decreases the tension that you’re putting into the different segments or elements in the lower back. It should be in to the point that you’re not straining or making your symptoms worse, it actually should be the opposite.” For having a healthy spine, try to avoid heavy lifting, slouching, poor work postures, inactivity, sleeping flat on your back, smoking and ignoring back problems.

For example, Dr. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Orthopedics and Sports Medicine Institute, recommends when exercising to ensure your weight lifting with a healthy form which is with the legs and also well engaging the core is important. There are some good advices for self-care for low back pain, such as short rest period, activity modification, heat or ice therapy and over-the-counter pain medications.

Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, explains when we are doing an activity for so long, we have back problems and we want to rest. “If you’re doing a certain activity and you feel that you’re starting to have back problems, just change that activity, do something else,” he says. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, says normally spinal cord stimulation can be put anywhere throughout the spine, but for the most part it is for lower back conditions.

“Someone who might be suffering from chronic sciatica, or chronic pinched nerve in the back, that already has surgery and they still persist with pain is one of the most common indications for spinal cord stimulation as far as we don’t have any order cause that might be causing those symptoms”, he explains. He highlights the procedure is getting a needle in place and putting wires in the spine to send electricity or signal to the spinal cord. Anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and anti-seizure medications are some of the options to treat sciatica. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says doctors will typically treat an acute injury with a steroid pack.

He also explains there is no evidence that muscle relaxers help the patient in the long-term, because it does not treat the source of the problem. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, explains some people may have instability of the spine. “The bones are supposed to be stack on top of each one, if there’s a malalignment that can actually cause some of the compression or touch a nerve that can injure or cause a sciatica.”

He also says cysts in the spine can be another trigger, because they are structures filled with water that touch the nerve and that can cause sciatica. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, says sitting down for long periods can affect your lower back. He recommends every now and then standing up and walking, at least half an hour.

“When you sit down, you’re putting some strain on the discs, which are between the bones of the back. The discs will degenerate, then it will start affecting some of the joints that we have in the back which are called the facet joints and we start putting some pressure on the nerves,” he explains. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, explains you need to see a doctor when the sciatica pain follows a violent injury, when you have a severe pain in the low back or leg, and when you have trouble controlling bowels or bladder.

He recommends making sure there is no fracture on the spine with X-rays. “If there’s a fracture, we can treat those, if it’s not, then your are most likely to have some muscle completion and you can rest free.” Loss of feeling in affected leg, weakness in affected leg, and loss of bowel or bladder function are some of the complications of sciatica.

Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says numbness and tingling are not the main concern of doctors, but it is weakness. “If you’re dragging your foot that can become a permanent issue and those are things that we want to be more prompt into taking care of that, and most of the time might become surgical.” Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains the key before offering a procedure for someone is to know what is causing the pain, by getting X-rays and doing physical therapy first.

“Before getting into stimulator, sometimes we do spinal injections, and if they don’t have significant improvement, we send the patient for surgical intervention, but if they still are in pain there are options and that is when a stimulator might come into play”, he says. The vertebral column has four sections: cervical vertebrae, thoracic vertebrae, lumbar vertebrae, and sacrum and coccyx. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, says one of the areas that normally is injured is the lumbar spine, the lower back.

There are some factors that can increase your pain risks, such as getting older, poor physical fitness, being overweight, heredity, other diseases, job, and smoking. The doctor says some people with genetic conditions or who have a family history of back pain have another key component of risk of having back problems. About 700,000 cases of spinal compression fractures occur every year due to osteoporosis. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, says sometimes people in their 80 years old all of the sudden develop back pain.

He also explains x-rays are the best way to know if you have a fracture and sometimes during an x-ray the doctor captures a fracture and the patient does not have any pain. Neck cracking or cracking neck is a sign of nitrogen bubbles being developed in the joints and it’s nothing to worry about, affirms Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute.
However the specialist says it’s different when someone has an incident an then the neck cracks, because it can mean the ligaments are injured and they can develop a chronic condition.
Dr. Mena describes when a car accident occurs, the most common things that get affected are two joints in the neck: between the 5th and 6th and between the 2nd and 3rd. Osteoporosis can cause bones to break, so it is very important to get this diagnosis because it could be detrimental. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, explains when the hip bone has more porous areas, it means the bone is not as strong, so it can become fragile and eventually can break up and people can develop fractures.

If the injury is not treated, people can have a hip fracture, that can be debilitating, they can suffer with pain and that can impact their mobility. “I’ll see both patients with benign and malignant spine conditions. So, patients with benign spine conditions will come in from just vague back aches or more severe pain that is keeping them up at night,” says Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute.

According to Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, some people will become early patients, because they suddenly develop back problems and other people can suffer from traumatic fractures, for example, from sports. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, explains Kyphosis is when the spine is a little more wedged towards the front. According to him, Kyphosis just stands for a different type of curvature. “So, if the curvature is more pronounced then we say it is an exaggerated Kyphosis or Kyphosis,” he says.

Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute, points out Kyphosis is not necessarily a bad word, because it is something that everyone has. Compression fractures can cause severe back pain. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute, says fractures above T5 can be a risk factor for having an underlying cause for your fracture, like osteoporosis or a tumor.

The pain from compression fracture is most commonly felt in the middle or lower spine, can also be felt on the sides or in the front of the spine. The pain is sharp and “knife-like”, can be disabling and takes weeks or months to go away. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, says women are a little more susceptible of suffering from compression fracture, because of the hormonal factors. The bones are being fed up by the hormones, so if those hormones or those chemicals are low in the body they can become a little more susceptible into developing fractures.

Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute, points out smoking is terrible and goes along with malnutrition, so patients who smoke are more prone to be osteoporotic. The opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs as a solution to manage pain.

José Mena, Interventional Spine Specialist at Baptist Health South Florida, says opioids are not intended into treating the source of the pain, they are just masking the pain.

Doctors should be proactive in dealing with the symptoms where the pain is coming out from to prevent patients from escalating the use of this type of narcotics. Brian Betancourt, Exercise Physiologist with Baptist Health South Florida, and Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute describe the muscles that make up the neck area and how they keep it strong and stable.

They describe the muscles that make up the neck area and how they keep it strong and stable. Osteoporis is one of the causes of back pain. Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute, says the majority of fractures are due to osteoporosis and especially as the population ages, more patients are diagnosed with osteoporotic vertebral compression fractures.

Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, points out trauma and cancer as other causes of spinal compression fracture.

Pazionis highlights women generally up to 40 years old decline in bone density and that can be due to a number of factors, like vitamin D deficiency. Some of the things that you look for in a physical exam are humpback or kyphosis or tenderness over the affected spinal bone or bones. Jose Mena, Interventional Spine Specialist at Miami Orthopedics and Sports Medicine Institute, says normally for people with compression fracture the most common one will be the tenderness in the spine. They have to make sure that there is no neurological deficit, weakness or foot drop.

Theresa Pazionis, Orthopedic and Spine Surgeon at Miami Cancer Institute, explains she will conduct a gate exam to look at how the patients are walking and if they are able to stand and to sit. There are some things that increase back pain risks: getting older, poor physical fitness, being overweight, heredity, job and smoking.

Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains each one of those conditions and advises stop smoking and get a healthy lifestyle. There are several reasons for M.R.I: weakness or progressive neurological deficits, suspicious for malignancy or infection and trauma.
Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, adds another reasons at this least: progressive symptoms of pain.
The specialist affirms around 70 to 80 % of the patients just with an exercise program, they’re going to respond and they’re going to get better and not require a MRI. There are specific types of exercises to ease back pain and that all people can do regardless if they are fit or not.

Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says it is important to combine an aerobic program with another one related to strength.

It is recommended to have 30 to 45 minutes every day of aerobic program about five times a week to keep you in a good weight, and strength program is to address your back pain problem. Some athletes, as NFL players, can develop chronic back problems over time, because they get injured and just want to go back to the field very quickly.

José Mena, Interventional Spine Specialist at Baptist Health South Florida, says athletes have to be treated in short-term, but doctors have to be looking for long-term treatments to prevent irreversible damage.

Coaches’ role is very important, because they have to be aware of spinal injuries and do their best to make sure the player is safe. Lower back pain is a common problem that can also affect teenagers. Some of the causes of back pain in teens are poor posture, continuously sitting in front of a computer or watching TV and obesity.

Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says he sees teens that have football injuries over time. Because of being more sedentary they develop some back problems. He highlights he also has patients with back issues, because they text on their phone with a very bad posture.

Carrying heavy school bags and having injuries caused during sports activities are also causes of back pain. Exercising could help treat back problems but also could be bad for your health if you don’t do it appropriately.

José Mena, Interventional Spine Specialist at Baptist Health South Florida, recommends to make sure you have a good posture when you are lifting any weight.

It is important to listen to your body, because no pain is good. He also says it is better if you take a couple sessions with a physical trainer that teaches you how to do exercises without consequences. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, gives some tips to teens so they can protect themselves from lower back pain.

One of them is trying to not carry heavy backpacks for school, because it is bad for posture. Instead they can try using rolling suitcases. They also have to improve their posture, because posture is the key for preventing back issues.

Women that carry heavy purses in only one side of the body should search a better way to carry the purses or try not to take so many things with them. If you are already dealing with lower back pain, there are some things you can do to deal with it. José Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says the most important thing is having an exercise program.

Doing exercises is right now the evidence doctors have to deal with it, it is the key. “Also acupuncture, chiropractor care, medications and injections are the things that we have to help patients”, he points out.

Losing some pounds could help people that are overweight, because weight shifted the center of gravity. Even though people do not sleep the proper amount of hours, they spend a lot of time in bed, reading or watching TV, among others.

Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, recommends to change the mattress every ten years, because it starts to wear out.

About the ideal mattress, Mena says it has to be firm enough and comfortable as well, at the same time, because it is going to keep the line of the spinal in a good position when you are sleeping. We all can make changes to improve our posture and prevent back pain. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says if you are in a chair at work, you have to make sure the chair is ergonomic.

Another important thing is to have an orthopedic mattress, because we are spending a third of the day sleeping there and you have to avoid putting some of the strain over the lower back.

Healthy eating and exercising are going to help you to have less risk of suffering from back pain. People spend a lot of time every day on the computer and that can lead to a lot of back problems. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says there are options to make it a little bit better for them.

He points out it is important to have the computer up to a more 90 degree angle and the monitor should be at the eye level to avoid stress on the different segments of neck and back.

About standing desk, he says it will be for people that have a disk problem; however, it is not good either to be standing up for eight hours. Any injury has to be treated, but the length of the treatment would depend on several factors.

José Mena, Interventional Spine Specialist at Baptist Health South Florida, says the short-term treatment is for people that most of the times seek care when they have a back injury. They want the medication, get better and establish themselves.

Although 90% of patients treated with short-term treatments will get better, the long-term ones are used to prevent patients from having another episode of the same injury within the next year. Pain can cause depression. Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, explains chronic pain can be treated with medications that are also antidepressants.

Brian Betancourt, Exercise Physiologist at Baptist Health South Florida, says exercise helps chronic pain and depression, because adrenaline is generated and will create a better feeling in the patient with pain and also in their mood. Some of the benefits of exercise are it prevents chronic diseases, it improves mood, it helps you to have better sleep and it also improves brain health.

Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, says exercise will help us to strengthen the body and the heart, to avoid and also treat chronic conditions. “The exercise program is a key point for every single condition,” he highlights. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, affirms physicians want to make sure the patient doesn’t have a neurological deficit.

He also insists when the patient doesn’t respond to an exercise program, injections or other treatment, It’s important to consider a surgery.

Dr. Georgiy Brosuvanik, Spine Surgeon with Baptist Health South Florida, describes a motion-preserving operation called a disk replacement. He affirms this operation is the best option for younger patients with neck pain. Anytime that patient is not keeping the neck in a neutral position, he’s messing around with nerves and they can cause pain, explains Brian Betancourt, Exercise Physiologist with Baptist Health South Florida.

Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, advises trying to maintain a good posture during the day, with the intention of building the back muscles and having a good posture. With a 3-D imaging, Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains anatomy of the cervical spine.
He describes cervical cord, joints, vertebrae and nerves. The doctor says these can be injured by falls, car accidents or a lot of pressure over them.
The most common symptoms of neck pain are pain in the neck, along the arm, headache, muscles weakness and difficult to walk, the specialist explains. According to the Journal of Orthopaedic and Sports Therapy, the rate of low back MRIs in the United States is growing at an alarming rate, despite evidence that it does not improve patient outcomes.
Claudia Hogdson, Advanced Registered Nurse Practitioner with Miami Orthopedics & Sports Medicine Institute, explains acute pain means that the body is having inflammatory processes but it’s not an emergency.
Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains once physicians have a history and physical exams, they match what’s going on the patient with M.R.I. and tailor the treatment accordingly. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, affirms people who put more pressure on the neck, apply more stress on those muscles as well in the discs and the joints in the neck.
He explains these people, over time, can become painful related to cellphone use and they develop cervical problems, or neck problems.
In order to avoid this, Brian Betancourt, Exercise Physiologist with Baptist Health South Florida, advises taking breaks, trying to do things at eye level and stretching. With a digital imaging of a spine, Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains where back pain happens.
He describes the disc itself is the number one cause of having back problems. He says normally people age start becoming a little weaker, they start losing some water content and becoming more prevalent into developing symptoms.
The doctor explains what sources can cause an acute pain. Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute, explains steroids injections are an option to relieve pain caused by exercising. “It is used for medical purposes to bring the inflammation down, it’s a medication that we inject into the body part aiming to try to relieve the symptoms,” he says.

He also points out the injection is not a cure of the symptoms, it is a tool they use to supplement the exercise program. During exercising, the most important thing is focusing on the muscles of the upper back for improving posture, affirms Brian Betancourt, Exercise Physiologist with Baptist Health South Florida.

The expert affirms those exercises will help the muscles get the endurance they require.

Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, agree with Betancourt and says buttocks should be close to the edge of the chair when someone is seating. It’s essential to have a good alignment in order to not stressing the back when someone is in that position, he says. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics and Sports Medicine Institute, says when the disc starts slipping out of the bone, the patient has a herniated disc. This happens as people age and a herniated disc can become painful, and the nerves are compressed, giving the patient symptoms.

Claudia Hogdson, Advanced Registered Nurse Practitioner with Miami Orthopedics and Sports Medicine Institute, points out the cervical spine carries the brunt of the weight of our body, and when people cannot turn their head to the right or the left, it is because of pressure of our neck supporting the head. Exercise can help deal with arthritis. “People with arthritis or medical conditions try to be more sedentary, because they are thinking about their pain. But it has to be the opposite, we want to lubricate those joints,” says Dr. Jose Mena, Interventional Spine Specialist at Miami Orthopedics & Sports Medicine Institute.

Brian Betancourt, Exercise Physiologist at Baptist Health South Florida, explains it is important to consult with your doctor, because you want to have an understanding of any conditions you have. Brian Betancourt, Exercise Physiologist with Baptist Health South Florida, advises never to put the neck in an extreme position such as extreme forms of flexion or lateral deviations.
Also, Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, recommends being the neck as neutral as possible at the time of sleep and keeping the alignment of the spine. Besides M.R.I there are other imaging tests that physician might need such as x-Ray, CT scan and electromyography. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, explains each one of them.
Claudia Hogdson, Advanced Registered
Nurse Practitioner with Miami Orthopedics & Sports Medicine, affirms in her
office she tries to do a good history of the patient. She also says when patients
have an acute pain and treatment does not improve it, they address for advance
imaging.
With those results, physicians consider what the best treatment is. Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute, advises to see a physician if patients in the morning have any symptoms of lower back pain.

He considers the best thing to do is refer patients with a physical therapist for a better morning exercise program.

He also talks about osteoarthritis and affirms it is going to happen at as people age.

He says there are statistics to confirm 34% of patients from age of 20 to 39 they will have bone degeneration or arthritic changes on the spine. Bone density test shows if the bone is brittle or not affirms Dr. Jose Mena, Interventional Spine Specialist with Miami Orthopedics & Sports Medicine Institute.
The specialists explains the more brittle the bone is, the bigger number of the curve will come and increase the risk for having osteopenia or developing fractures.
Claudia Hogdson, Advanced Registered Nurse Practitioner with Miami Orthopedics & Sports Medicine, talks about how she can diagnose a back pain.

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