In this article published by Stephen H. Hochschuler, MD on Spine-Health.com, the importance of exercise and fitness on your back is discussed. Keeping strong and active, keeps the muscle from becoming stiff, which can lead to more pain. However, make sure before you do ANY activity, especially after surgery or an injury, be sure to consult with your doctor to make sure it’s safe.
Exercise and Fitness to Help Your Back
A common (and harmful) misconception is that exercise should be avoided when a patient is experiencing back pain. Understandably, many patients are reluctant to exercise out of the fear that any exercises or stretching will aggravate their existing back pain. This may make them rely too heavily on medical treatments and underemphasize the importance of exercise for healing and long term back pain relief.
For most back problems, exercise and movement are the natural stimuli for the healing process. Controlled, gradual and progressive exercise, rather than inactivity and bed rest, most often provides the best long-term solution for reducing back pain and preventing (or lessening) future episodes of pain.
Most experts recommend no more than one or two days rest at the onset of most episodes of back pain. Prolonged inactivity can actually increase back pain as the back becomes stiff, weak, and deconditioned. As the pain increases, many patients reduce their activity and exercise levels, resulting in even more back pain and aggravating the cycle of inactivity and back pain recurrence.
Exercise plays the dual role of both treating back pain and helping prevent future episodes of pain.
- By nourishing and repairing spinal structures, exercise helps alleviate existing back problems.
- Movement and exercise keep the anatomy of the back healthy, flexible and strong in order to reduce the chances of further injury and back pain.
It is always advisable for patients to first consult with a health professional before beginning any exercise or fitness program. Working with a physician or experienced spine specialist will ensure that patients’ activities are safe for their back and for their overall health. With back pain, it’s particularly important to get an accurate diagnosis for the cause of the patient’s pain from a physician or chiropractor in order to rule out possible types of back pain that may be aggravated by exercise (such as spinal instability).
How Exercise Helps the Back
Engaging in exercise and fitness activities helps keep the back healthy by allowing discs to exchange fluids which is how the disc receives its nutrition. A healthy disc will swell with water and squeeze it out, similar to the action of a sponge. This sponge action distributes nutrients to the disc.
In addition, fluid exchange helps to reduce the swelling in the other soft tissues that naturally occurs surrounding injured discs. When there is a lack of exercise, swelling increases and discs become malnourished and degenerated.
Exercising the back reduces stiffness by keeping the connective fibers of ligaments and tendons flexible. Improved mobility through back exercise helps to prevent the connective fibers from tearing under stress, which in turn prevents injury and back pain.
Another important effect of exercise is that it stretches, strengthens, and repairs muscles that help to support the back. The back and abdominal muscles act as an internal corset supporting the vertebrae discs, facet joints, and ligaments. When back and abdominal muscles are weak they cannot support the back properly. Back strengthening exercises help to strengthen these supporting muscles in order to prevent straining soft tissues (e.g. muscles, ligaments, and tendons) and provide sufficient support for the structures in the spine.
Additionally, stretching is good for the back. For example, stretching hamstring muscles helps to relieve stress on the low back. Another benefit of back exercise is that the motion helps lubricate the facet joints, which are synovial joints that require appropriate motion.
Integrating Exercise with Medical Treatment
Exercise and fitness are necessary for healing existing back problems, recovering from back surgery, and especially for keeping the back healthy to help prevent (or at least lessen) future episodes of back pain.
Ideally, an exercise and fitness program should be integrated during most phases of treatment for pain relief and to improve the overall health of patients. If the pain is severe, however, patients may first need to be treated for the pain prior to starting a back exercise program.
Specific Exercise Strategies
The following guidelines and insights are designed to help patients plan and follow through with a safe and effective exercise program to condition the back. The key goals of engaging in exercise and fitness activities are to aid the healing process for an injured back and alleviate existing back pain while helping to prevent (or at least minimize) future problems.
- Find the right type of professional to help with the exercise and fitness program. Patients should always consult with a physician prior to beginning any exercise or fitness program. A healthcare professional can assist with the development of an appropriate list ofback exercises and activities in which to engage or avoid. Health professionals such as physical therapists, chiropractors, and physical medicine and rehabilitation physicians (physiatrists) often have specific training and expertise with exercise and fitness programs for pain relief. It’s particularly important to see a health professional with expertise in spinal conditions and back pain, as different back conditions often require very different exercise programs.
- Expect some initial discomfort when beginning a new exercise and fitness program. However, start slowly, because the results of back exercise, such as soreness, may not be felt for 24 to 48 hours after the exercise session. Beginning an exercise program after an episode of back pain will likely cause some increase in pain in the beginning. However, the back pain experienced during exercise should be “good pain.” This pain is to be expected as a natural part of increasing activity and stretching tissues that have become stiff and deconditioned.
- Set a careful pace when starting to exercise. When returning to activity after an episode of pain or following surgery, ease into back exercise and physical activity. Be careful not to overwork or strain muscles that may have become deconditioned after a period of inactivity. Taking into account that there may be some initial discomfort, a cautious approach to back exercise can help keep back pain under control and prevent a flare-up.
Include a combination of stretching, strengthening, and low-impact aerobic conditioning exercise. Utilizing these three components of exercise will help heal existing problems, avoid injury and prevent future problems. Muscles will become strengthened and more flexible, repairing strained muscles that cause back pain. Low-impact aerobic conditioning helps to stretch and strengthen the back as well as the abdominals and hamstrings, two muscles that help to support the back.
Engage in gentle forms of exercise, such as water therapy or walking. For patients experiencing higher levels of back pain, exercise may be more comfortable in the water than on land. Water therapy provides the therapeutic effect of relieving pain and also can help prepare the body for more extensive exercise. Another form of gentle physical activity is exercise walking, a good option for patients in less pain who are ready to move onto more intensive exercises on land.
Consider alternative forms of exercise, such as Pilates, yoga, or Tai Chi. Pilates, yoga, and Tai Chi provide gentle strengthening and stretching exercise that can help alleviate present back pain. They help improve overall fitness and posture, which in turn prevents future episodes of back pain. Other benefits of alternative therapies like Pilates, yoga, and Tai Chi are stress relief and relaxation, which can also assist with back pain relief.
- Know when to reassess the exercise and fitness program. If back pain during exercise becomes severe, it is important to redesign the back exercise program with the help of a professional. The individual patient is the best judge of whether the pain during exercise is normal discomfort or if the level of pain is signaling that the patient should discontinue the specific exercise.
- Build a motivating support system during the course of the exercise program. Friends and family may often encourage patients to rest and avoid physical activity because of the common misconception that exercise causes back pain. However, the opposite is true when patients perform the appropriate back exercises. The patient may need to educate others about the importance of back exercise and fitness for back pain relief. Telling friends and family about plans to increase start exercising and asking for their encouragement may help the program’s success.
- Keep a written record of progress made during the exercise and fitness program. Tracking progress is useful for the patient as well as for health professionals who are helping with the exercise program. Records could include a list of the specific back exercises performed, number of sets and repetitions, duration of exercise, and pain and sensations experienced during exercise. This helps both the patient and the exercise professional track progress toward fitness goals and ensures that information is accurately communicated among different professionals and to the patient. Monitoring progress may also help keep the patient motivated to continue with the exercise and fitness program.
- Many people will experience some kind of lower back pain at some point in their lives. An ounce of prevention by doing a few simple exercises daily to keep the back nice and healthy will go a long way to alleviate lower back pain problems. Learn why exercise is so important for a pain-free, healthy back in this video.
Article courtesy of Spine-Health.com and Stephen H. Hochschuler, MD
Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540.347.9220 or our Gainesville office at 703.743.2814. Or Click here to make an appointment.
What is Acupuncture?
Acupuncture is a form of Chinese medicine that has been practiced for centuries. It’s based on the theory that energy, called chi (say “chee”), flows through and around your body along pathways called meridians.
Acupuncturists believe that illness occurs when something blocks or unbalances your chi. Acupuncture is a way to unblock or influence chi and help it flow back into balance. It is done by putting very thin needles into your skin, at certain points, on your body. This influences the energy flow. Sometimes heat, pressure, or mild electrical current is used along with needles.
What happens during acupuncture?
Your acupuncture provider will give you an exam and ask questions about your pain and how well you are functioning. He or she will also ask about your overall health.
Then your provider will look for the places (called points) on your body to access the chi that is blocked or not flowing right. Each of the points relates to certain health problems or body functions.
Your provider will look for landmarks on your body—using certain muscles or bones, for example—to find the points so that he or she can place the needles.
After the provider finds the points, he or she will quickly tap very thin needles into your skin. He or she will probably place several needles. Some may be placed deeper than others, depending on what the provider believes is needed to restore the flow of chi.
Every provider is different, but in most cases treatment lasts for 15 minutes to an hour. You may have several visits to complete your treatment. Some people have ongoing visits.
What does it feel like?
You may feel slight pressure when a needle goes in. Most people find that it doesn’t hurt. The area may tingle, feel numb, itch, or be a little sore. Providers believe that this is a sign that the energy flow, or chi, has been accessed.
After the needle is placed, your provider may roll the needle slightly back and forth. Or he or she may use heat or electrical current on the needle.
What is acupuncture used for?
People use acupuncture to relieve pain and treat certain health conditions. You can use it by itself or as part of a treatment program. Studies have found promising results for the use of acupuncture to treat nausea and vomiting related to pregnancy, chemotherapy, and postsurgery pain. Acupuncture also may be useful for:
- Stroke rehabilitation, which involves relearning skills that a person lost because of brain damage from a stroke.
- Headache. A study shows that adding acupuncture to standard treatment leads to significant, long-lasting relief from chronic headaches, especially migraines.
- Menstrual cramps.
- Tennis elbow.
- Fibromyalgia, or widespread pain and tenderness of muscle and soft tissue.
- Myofascial pain, caused by spasm in the muscles.
- Osteoarthritis, or the breakdown of the tissue (cartilage) that protects and cushions joints. A study found that acupuncture can reduce knee pain and increase movement of the knee in people with osteoarthritis.
- Low back pain. For people who have low back pain, acupuncture may help decrease pain and increase activity. Some studies show that acupuncture reduced pain and disability related to back problems more than usual treatment. Another summary of several studies showed that acupuncture reduced pain and increased the ability to be active, but not any more than other treatments.
- Carpal tunnel syndrome, or pressure on a nerve in the wrist that results in tingling, numbness, weakness, or pain of the fingers and hand.
- Asthma, or inflammation in the tubes that carry air to the lungs, resulting in periodic episodes of difficulty breathing, wheezing, chest tightness, and coughing.
- Drug addiction. Acupuncture may help reduce symptoms of withdrawal after a person stops taking a drug he or she is addicted to. It may also help prevent a relapse. More studies are needed to learn about the benefits of acupuncture.
- Dental pain
- Labor pain
Is Acupuncture safe?
In general, acupuncture is safe when done by a certified provider. A state license ensures that the provider has a certain level of training and follows certain guidelines. But there are still a few states where acupuncture is not licensed.
In very rare cases, problems may occur after acupuncture. You could get an infection, especially if the needles aren’t sterile. But licensed providers throw away their needles after one use. Make sure your provider uses a new pack of sterile needles every time.
Talk with your doctor if you have other questions about the safety of acupuncture.
Always tell your doctor if you are using a treatment like acupuncture.
Choosing an acupuncturist
Check to see if your state licenses providers. Many providers also may have a certificate from the National Certification Commission for Acupuncture and Oriental Medicine. This is a non-profit group that promotes standards in acupuncture and Oriental medicine. Ask your doctor and friends for recommendations.
You also may want to pick a provider who:
- Will work on a treatment plan with you, your doctor, and other health professionals
- Clearly explains what he or she is doing during treatment
- Explains how often you may need treatment and how much it will cost
Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both of our offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at (540-347-9220) or our Gainesville office at (703-743-2814). Or Click here to make an appointment.
This weekend is looking to be stellar, weather-wise, and if you can get outside and enjoy it, please do! However, if you’re recovering from back surgery, getting around might be a bit tough, so here are 56 things to do to help you pass the time, courtesy of spine-health.com. Remember though, staying sedentary for too long can have negative effects on everyone, especially those recovering, so unless instructed by a doctor to stay in bed, please make sure to get up and move around a bit.
- Discover new music from the Internet: Fill up your iPod from iTunes, or join Spotify and Pandora to discover thousands of new tunes.
- Search Spine-health.com for articles relating to your condition.
- Sharpen your thinking skills with online games from luminosity.com. You can sign up for the free version to see if you like it.
- Read a great classic: To Kill a Mocking Bird, A Catcher in the Rye, The Grapes of Wrath, The Old Man and the Sea, The Great Gatsby, The Call of the Wild, or War and Peace. Invest in a tablet reader such as a Nook, an eReader, or a Kindle to have instant access to almost any book in the world. If you have a smart phone or tablet, download the Kindle or iBooks app. Be sure to check Bookbub.com for free or discounted ebooks.
- Listen to books on CD or your iPod. Sometimes it’s easier to listen to a book than to read.
- Ask your kids to read to you.
- Play classic board games with your kids like Monopoly, Chess,Scrabble or Uno.
- Subscribe to Netflix, Amazon Videos, or Hulu to watch a season of a TV series that you had always wanted to see. Game of Thrones is an R-rated epic, Breaking Bad is intense and addicting, Chicago Fire is a drama with a fierce following. Or watch an older series, like 24, Cheersor The Dick Van Dyke Show.
- Do crossword puzzles. Or try a numbers version of crosswords like Sudoku or kakuro puzzles. You can find free kakuro puzzles atKakuro.com and free Sodoku puzzles at Livewire Puzzles.
- Play the guitar (or learn to), or ask someone to play an instrument or sing for you.
- Watch old movies. These are great if you are feeling fuzzy from the pain medications . The classic old movies are slow-moving, so it’s easy to follow the plot. The library is a good source for free or very inexpensive rentals.
- Enjoy Xbox or Nintendo, Gameboy, Sony PSP, or any handheld electronic games. Try some of the new games on your smart phone or tablet. Download the Touch Arcade App to keep up to date with the hottest new games.
- Try Simon, a classic memory test game. It’s not too difficult, so it’s good if the pain medications are affecting your concentration. You can get a small version of it from Amazon.com.
- Get wrapped up in a long, complicated novel series. Here’s a great listto get you started.
- If you prefer, read the original magical book series, The Chronicles of Narnia by C.S. Lewis.
- Give yourself a manicure or a facial, or look through magazines to find a new hair style you’d like to try.
- Open up a Pinterest account and start pinning away. Pinterest allows you to create collections of your favorite ideas on different boards. VisitSpine-health’s boards while you’re at it.
- Read the entire New York Times – that will take at least a half a day!
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- Sit out on your deck or porch for awhile each day and get some fresh air and sunshine. The Vitamin D from the sun will help get your endorphins flowing.
- Get free therapy online and make friends with other people who are in similar situations on theSpine-health.com Discussion Forum: “…finding this site and spending time here was a great help during recuperation – both in regard to having something to do but also for learning and understanding about our surgeries and recovery, and also being able to help and assist others here – that’s why I am still active here 7 months after surgery.”
- Start a blog: an online diary that allows you to chronicle your recovery and automatically notifies your network of friends and family each time you update it. WordPress.com offers free blog sites.
- E-mail a loved one who is having difficulty empathizing with your condition and invite him or her to view the Message Board so they can see what you and others in your condition have to go through.
- Connect with an old friend with whom you’ve lost touch. Try sending a card or letter to him or her via old fashioned mail. Or find your friend on Facebook and reconnect.
- Learn to meditate and practice, practice, practice. Meditation is great for reducing stress and producing an overall feeling of calm and well-being, all of which contributes to healing.
- Start to plan your rehabilitation by visiting Spine-health’s wellnesssections. Pick out exercises you think you’d like to try, and spend time mapping out your exercise plan.
- Take this time to put all those old pictures in an album, or to turn your digital prints into real photos. Consider learning how to scrapbook or create online photo albums of all your digital prints with Shutterfly.com, Snapfish.com, or any other online photo service.
- Research and plan ahead for your next vacation.
- Become an expert on a specific subject: rent documentaries, read books, and use Google Scholar to do free online research on a certain subject. Ancient Greece? Bird watching? History of golf? Research and learn all about whatever interests you.
- Sort out the pile of mail, bills, catalogs etc.,that has been piling up on kitchen counter since before your surgery.
- Put your financials online with Quickbooks or a similar financial management program.
- Make some gifts the old fashioned way. Knit or crochet a baby blanket for someone who’s expecting a baby soon, needlepoint something to decorate the baby’s nursery, or make advance holiday gifts.
- Learn the almost-lost art of lace making.
- Learn to write left handed (or right handed, if you’re a lefty) to exercise a new part of your brain.
- Inventory all the stuff you want to get rid of around the house and garage, and sell it on eBay or Craigslist.
- Get started on that novel you’ve always wanted to write.
- Make a Honey-do (or handyman) list for all those odd jobs that need to get done around the house.
- Help build the online encyclopedia Wikipedia by editing or starting any topic where you have expertise.
- Learn origami and create beautiful origami gift boxes or figures.
- Learn calligraphy and make your handwritten notes gorgeous! This is especially valuable if you have horrible handwriting like mine…
- Create a list of recipes that are easy to prepare that you can make once you’re up and around but still recovering. Keep track of them online with Pinterest.
- Learn a new language using Rosetta Stone. Many libraries carry the Rosetta Stone program. Or, learn sign language.
- Research the health professionals you plan to see once you are ready to leave your home:massage therapists, physical therapists, personal trainers, etc.
- Order personalized stationery or address stamps or stickers. Or, if you send out an annual card, get to work designing it and updating your address list.
Feeling better by doing good
- Every day write a short thank you (or love note) to the person who is caring for you and put it in the same place for them to find each day.
- Write thank you notes to everyone in the hospital who was helpful to you. Go on the hospital’s social media sites and comment on the positive experiences you had.
- Help a homeless animal find a home by sharing their stories and pictures from rescue groups on Facebook. Start here.
- Pray in your own way. Research new prayers and devotionals.
- Read online verses from the Bible about healing and related topics.
- E-mail thank you notes to all the websites you found especially helpful (hint, hint!)…it makes all the hard work worth it! Contact us.
- Anytime you reach out to help someone else in need, you will feel less lonely and less depressed. Volunteer with an organization that allows you to call and talk to people who are lonely, such as people in nursing homes or people confined to their house.
- See Depression Guide
- If you don’t yet have a cause that you’re passionate about, research one online (start here) and make a plan to start donating your time and energy to something you care about once you can get around.
- Be an excellent host or hostess. Send out invitations to your friends and family, schedule visits, greet your visitors enthusiastically even when you’re in pain, and encourage them to talk about themselves and their lives. It will go a long way to help take your mind off your situation, and will make it a pleasant visit all around.
Getting mobile again
- If you can’t walk much yet, have someone drive you to Wal-Mart or Target and ride one of the scooters.
- Schedule appointments with the professionals you researched from #42. Put the appointments in your calendar, and mentally prepare for them.
- Just walk, walk, walk. Try to gradually work up to 10,000 steps a day.
- See Exercise Walking for Better Back Health
- Get comfortable shoes for walking that are easy to get on and off. Crocs are a favorite – they’re lightweight, slip on so you don’t have to bend over to get them on or off, and have some traction to help avoid slipping.
- Walk on a treadmill and set a progressive goal (e.g. go for 2 minutes longer each day) that is OK’d by your doctor. Chart your progress each day so you have a visual confirmation of how far you’ve come!
- Sign up for a water therapy - it’s very gentle on your back, as the water supports you while you exercise and prevents any jarring motion.
Of course, check with your doctor first before doing any of the above. Many of these ideas do require a laptop and Internet access. If you don’t have a laptop, you can buy an inexpensive one (starting at $600) or try to borrow one from a friend or family member. Wireless Internet access is a good idea so you can access the Internet from your bed, a recliner, or wherever you’re most comfortable. Courtesy of spine-health.com.
Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both our Warrenton and Gainesville offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it’s also convenient for patients who may be experiencing pain or disability at the time of their visit.
To schedule an appointment with one of our board-certified/ fellowship trained physicians, call our Warrenton office at 540.347.9220, or our
Gainesville office at 703.743.2814, or, click here to make an appointment. Don’t forget to visit us at www.broava.com for a complete list of all comprehensive musculoskeletal services offered at Blue Ridge Orthopaedic & Spine Center.
You’ve heard the dreaded words from your doctor – “You need surgery”. If non-surgical treatments such as pain management and or physical therapy are not improving your orthopaedic condition, surgery may be the course of treatment for you. Here are some important questions to ask your physician prior to surgery from the American Academy of Orthopaedic Surgeons.
- Why do I need surgery and are there any other options other than surgery?
- What are the advantages of this procedure?
- What are the dis-advantages of this procedure?
- What is the success rate of this procedure?
- If I don’t have surgery now, what will happen in the future?
- Is this surgery going to alleviate my condition?
- How many of these procedures have you performed at the hospital?
- Are there any tests or evaluations prior to the procedure?
- What kind of implant or prosthesis will be used and how long will it last?
- Are there any risks in the use of anesthesia and will I meet with the anesthesiologist prior to my surgery?
- If I am in pain after surgery, what are my pain relief/control options?
- What is my recovery time and what will my limitations be?
- Will I have any disability after the procedure and will I need physical therapy?
- When can I return to work and resume normal everyday activities?
- Will informative materials/information be provided prior to my surgery?
Blue Ridge Orthopaedic & Spine Center offers up-to-date surgical outpatient facilities devoted exclusively to our patients. Our Surgical Suite meets the highest standards of care and fully complies with the rigorous requirements of the Accreditation Association for Ambulatory Health Care, Inc., a nationally recognized credentialing agency.
Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. For your convenience, both our Warrenton and Gainesville offices are equipped with in-office radiology departments. Not only does this facilitate rapid diagnosis but it’s also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified/ fellowship trained physicians, call our Warrenton office @ 540.347.9220, or our Gainesville office at 703.743.2814, or, click here to make an appointment. Don’t forget to visit us @ www.broava.com for a complete list of all comprehensive musculoskeletal services offered at Blue Ridge Orthopaedic & Spine Center.
Osteoporosis is a disease of the bones in which there is a loss of bone density and destruction of bone tissue. Even though you may not notice a difference in your bones, over time they will lose many important proteins that are vital to keeping your bones strong. As a result, your bones will have less strength and you will be much more susceptible to fractures, especially if you fall.
According to this article from Krames Staywell http://ssov3.staywellsolutionsonline.com/Conditions/Orthopedics/Osteoporosis/85,P00932 Osteoporosis affects over 10 million Americans over the age of 50, with women four times more likely to develop osteoporosis than men.
34 million Americans over the age of 50 have low bone mass which increases the threat for osteoporosis. Loss of Estrogen is the number one cause of bone loss in women during and after menopause. Woman can lose up to 20% of their bone mass in the five to seven years following menopause.
Other risk factors for osteoporosis –
- Age – Bones will become less dense and lose strength with age
- Overall poor health
- Tobacco Smoking
- Race – White and Asian women are most at risk, even though all races may develop the disease
- Low body weight
- Poor vision
- Thyroid disease
- Low levels of testosterone
- Early menopause
- Certain medications – Most associated medication risks are steroids and anticonvulsants, but there is evidence emerging with regard to other medications
- Low calcium intake
- Having a fracture occur as an adult
Many people are not affected with symptoms of osteoporosis and the disease is often referred to as the “silent disease.” Some people may have pain in their bones and muscles, particularly in their back. On occasion, a collapsed vertebra may cause severe pain, decrease in height, or deformity in the spine. Osteoporosis most often occurs in the hips, spine and wrists.
Blue Ridge Orthopaedic and Spine Center’s physicians, physical therapists, and pain management specialists have extensive experience treating nearly every kind of condition including osteoporosis. We offer a range of non-operative treatment options as well as many minimally invasive options that are treated in our surgical center on an outpatient basis. Please contact us today @ 540.347.9220 (Warrenton office) or 703.743.2814 (Gainesville office) for more information or visit us @ www.broava.com. Our number one goal – Get YOU back to GOOD health.