‘Healthy Living’ educational seminars: Treatment options for back pain

Published on: March 26, 2014

Neurosurgeon Dr. Larry Fishman gives a health-education seminar. Photo Lia Martin

Neurosurgeon Dr. Larry Fishman gives a health-education seminar. Photo Lia Martin


Acute pain causes many adults to ask questions and seek answers. They describe it as a stabbing, burning, twisting, tearing or squeezing sensation. They will do most anything not to have it. Spinal and joint pain is common in seniors as part of aging. If you have been diagnosed with arthritis, you are one of the 46 million adults in the United States who have it.

Osteoarthritis (OA) is the most common form of arthritis. About 23 million adults have been diagnosed with OA by their doctor, accounting for 50 percent of all arthritic cases. One in two people will experience some form of OA in their life. It is more common in women than in men.

To complicate pain issues, there are more acute diagnoses that will impact some. For instance, what does it mean if you have a “bulging disc,” or a “herniated disc”? When do you get surgery for carpal tunnel syndrome? What about “Band-Aid” surgery?

So when Dr. Larry Fishman, a neurosurgeon, came to speak on back pain as part of the “Healthy Living” series sponsored by South Bay Hospital, quite a few in Sun City Center came to listen. 

Vonda Kloke, a Sun City Center resident, said she came with her husband Virgil to hear Dr. Fishman speak on joint and spine pain because her primary physician recommended him to her for treatment of a bulging disc.

“I came because my doctor referred me to him, and I wanted to hear him before I went,” Vonda said.

The Klokes were very pleased with Fishman’s presentation, and Vonda will go and see him as a patient, she said.

“And it was educational,” Virgil said, indicating that he had not expected to learn so much.

The Klokes were two of more than 50 people who registered for the seminar. Attendees asked intelligent questions and received informational answers.

When someone asked Fishman about reasons for the pain associated with degenerative disc disease, he explained how some pain in the back is just part of the normal aging process.

“Young people have nice, fat, juicy discs,” Fishman explained. He showed how our discs dry up when we get older, and that arthritis is normal wear and tear of the spine and joints. 

He also stressed there were three ways to treat degenerative disc disease: conservative therapy, microdiscectomy or discectomy and fusion.

Fishman advised against surgery as a general rule. Before he would recommend surgery, he said, he would advise a more conservative therapy, including exercise and pain medicine, where indicated. He said if the pain is occasional and not interfering with your life, you can alleviate the pain and live a normal life without turning to surgery.

In fact, Fishman said, insurance companies require a proper diagnosis to pay for an operation ordered by a surgeon. As an example, he said, osteoarthritis would not be approved by insurance companies as a good reason to have surgery because it is a condition and cannot be corrected by an operation.

However, Fishman said he is a proponent of outpatient surgery, which requires shorter anesthesia times and is also a solution for a patient on blood-thinning medication. Often called Band-Aid surgery, microdiscectomy can be used to remove a portion of the bulging or herniated disc. Using a microscope, the surgeon can see what he is doing, said Fishman,  and remove only the part of the disc that is pressing on a nerve.

“Microdiscectomy is the gold standard,” Fishman said.

He also said that using a technology called balloon kyphoplasty for vertebral compression fractures was effective, especially in treating post-menopausal women.

VCF leads to sudden, severe back pain, loss of height and deformity of the spine, causing a curved “hunchback” shape.

“Patients are miserable,” Fishman said. He recommended that his own mother have the balloon kyphoplasty outpatient procedure because she had been suffering with VCF. He said his mother was able to drive back home to Delray Beach that same day, after the procedure was done.

What makes this technique work, Fishman said, is that it actually corrects the spinal deformity and strengthens the bone. The patient no longer has to wear a brace.

According to Fishman, after the balloon is inserted, cement fills the cavity and the balloon is removed.

“The stent stays and is stronger than the bone surrounding it,” Fishman said. “It changes people’s lives.”

Dr. Larry Fishman practices at 4031 Upper Creek Drive, Ste. 100, Sun City Center and at 427 S. Parsons Ave., Ste. 110, Brandon. Dr. Fishman is on staff at South Bay Hospital, Brandon Regional, Tampa General and South Florida Baptist, and has practiced for 25 years in Sun City Center.

South Bay Hospital is located at 4016 Sun City Center Blvd., Sun City Center, FL 33573. See other “Healthy Living” education events at or call 1-888-685-1595 to register for a seminar. Dr. Ashok Dhaduvai, gastroenterologist, will give a colorectal cancer-prevention seminar at 11 a.m. on Thursday. The seminars are held at 1210 W. Del Webb Blvd. in Sun City Center.