Five Questions With: Dr. Alexios Carayannopoulos

" Low back pain is the single leading cause of disability worldwide."

Dr. Alexios Carayannopoulos is the director of the Comprehensive Spine Center and division director of pain and rehabilitation medicine at Rhode Island Hospital. He is a clinical assistant professor of neurosurgery at The Warren Alpert Medical School of Brown University. He is board certified in both physical medicine and rehabilitation, as well as in pain medicine.

PBN: What lessons did you learn in starting and growing the Lahey Clinic spine center that you are applying to the comprehensive spine center at Rhode Island Hospital?
CARAYANNOPOULOS:
I learned how to grow the practice, while maintaining efficiency. Since Americans spend at least $50 billion each year on back pain, and as many as 80 percent of the population will experience a back problem, back pain is a serious business. It is critically important that centers that focus on the treatment of back pain are efficient so that patients can make a timely appointment for appropriate evaluation, diagnosis, and treatment in order to minimize pain and to maximize function. As I expanded the practice from one to three sites in one year, our efficiency also improved appointment wait times and overall patient satisfaction.

PBN: What is the single most frequent spine injury or condition that leads to the loss of days of work?
CARAYANNOPOULOS:
Sciatica, from herniated lumbar disc, is the most common painful spine condition. Fortunately, most patients with sciatica do not require surgery, as most episodes are self-limiting if treated appropriately. At the Comprehensive Spine Center, we offer a complete array of non-surgical pain management options to decrease pain and to minimize lost days from work.

PBN: Do people exercise their backs enough? What leads to such a high number of spine injuries?
CARAYANNOPOULOS:
No. Most injuries occur because of poor posture or body mechanics leading to improper bending, twisting, or lifting, often times at work. Most episodes are non-organic, meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture, or cancer. At the Comprehensive Spine Center, we offer a team-based approach including medical, surgical, psychological, and alternative options. Furthermore, we offer on-site spine-specific rehabilitation, which focuses on appropriate exercise and helps to educate back pain patients on how to maintain a healthy spine and prevent recurrent back pain or further injury.

PBN: What portion of people whom you treat end up requiring surgery, and what is the most common spinal surgery that is performed?
CARAYANNOPOULOS:
Generally, 90 percent of patients are successful with the Comprehensive Spine Center’s non-surgical pain management treatment paradigm. However, if surgery is required, our expert surgeons offer a variety of options, ranging from minimally to maximally invasive surgeries. Most commonly, a minimally invasive discectomy is performed using a surgical microscope, which is only offered at select specialty centers throughout the United States. This procedure offers a short recovery time. Most patients are discharged to home the same day, can resume work within days, and have minimal post-surgical discomfort.

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PBN: What is the demographic breakdown of people who need spine treatment – do you see more men than women, for instance?
CARAYANNOPOULOS:
Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease in 2010, in both men and women. There are many risk factors for back pain, including age, genetics, occupational hazards, lifestyle, weight, posture, pregnancy, and smoking. With that said, back pain is so prevalent that it can strike even if you have no risk factors at all. Most working Americans admit to having some level of back pain each year. Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

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