A.   An orthopedic surgeon is trained to deal primarily with the bones and joints - the residency training period after internship is 3 or 4 years - then a fellowship in spine may be an additional year.

A neurosurgeon is trained to deal primarily with the nervous system (brain, spinal cord, nerve roots and nerves) these are delicate tissues and neurosurgeons are known for delicate work and specifically for protecting the nervous system and avoiding injury to these critical structures. - the residency training period is a minimum of 5 years - some programs are 6 to 8 years long. - there are only about 3500 board certified neurosurgeons world-wide.

Typically, if an orthopedic surgeon is doing a substantial spine operation, a neurosurgeon will be there as well. If a neurosurgeon is doing an operation that extensively involves bone, joint or the possibility of fusion, then an orthopedist may be involved as well.

Basically, for major spine operations you may wish to have both fields represented.

A.   Regular exercise is your most potent weapon against back problems. Activity can increase your aerobic capacity, improve your overall fitness, increase the muscle tone and help shed excess pounds that stress your back.

Stretching and toning your back and other supporting muscles can help reduce wear and tear on your back. It reduces your risk of injury by warming up muscles, and it also increases your long-term flexibility.

Strength training can make your arms, legs and lower body stronger. In turn, your risk for falls and other injuries decreases. Strong arms, legs, and especially abdominal muscles also help relieve back strain.

Always ask your doctor or physical therapist for advise before beginning an exercise program, especially if you've hurt your back before or you have other health problems, such as osteoporosis.

A.   There are many different causes to back pain. Sometimes back pain can occur for no apparent reason, but the two main reasons are either due to an injury, or just the fact that a weakness exist in that region.

Lack of muscle tone and excess weight, especially around your middle, commonly cause and aggravate back pain. Poor posture can add stress to the muscles and joints, causing fatigue and injury. Add to that the daily stresses and strains you put on your back, such as carrying out the trash, sitting in your car or truck for long periods of time, lifting something heavy and incorrectly or just applying the brakes in your car.

Even minor damage to any one component of your back's structure can upset the delicate balance and make movement painful. Your body will then try to protect this area by contracting the muscles surrounding the area. The contracted muscles not only causes the pain you experience, but they also slow down circulation to the area, which ultimately diminishes the necessary oxygen flow and prevents the body to heal itself.

Damage and associated pain can occur at any point of your spine. However, the most common site for pain is in your lower back because it bears the majority of your weight, and is therefore exposed to the most pressure.