Presenter: Katherine Lodge
Guest: Richard Parkinson
Guest Bio: Dr. Richard Parkinson, a spinal and neurointerventional neurosurgeon at ispine Neurosurgery. Richard completed his training in neurosurgery in Sydney, then continued his training in the United States with a fellowship at the prestigious Northwestern Memorial Hospital in Chicago.
Richard is here to talk to us about spinal injuries that have been sustained at work or during sport.
Health Professional Radio – Spinal Injuries
Katherine Lodge: Thank you for listening to Health Professional Radio. I’m Katherine, and today our guest is Dr. Richard Parkinson, a spinal and neurointerventional neurosurgeon at ispine Neurosurgery. Richard completed his training in neurosurgery in Sydney, then continued his training in the United States with a fellowship at the prestigious Northwestern Memorial Hospital in Chicago.
Dr. Parkinson is the first neurosurgeon in Australia to be trained in neurointervention and he’s here to talk to us about spinal injuries that have been sustained at work or during sport. Welcome to our show, Richard.
Richard Parkinson: Thanks, Katherine.
Katherine: Now, you have a particular interest in sport injuries, and some of your patients are, or have been in the past, professional athletes. What are some of the common spinal injuries that you see?
Richard: A lot of spinal injuries are simple disc injuries or simple disc and ligament injuries, which can settle down with conservative or non-operative treatment. Professional athletes put a lot more stress on their bodies, and quite commonly, I see people with disc herniations or slipped discs in their neck or back. Occasionally, those require surgery. Most of them, however, do settle down without surgery.
Katherine: Yeah, that’s good to hear. And as you said, some of these professional athletes, after years and years of wear and tear on their body – also, not just athletes, but people with work that involves maybe strain on their spine – what are some of the long-term effects for people who put a lot of strain on their spine?
Richard: Now, most people seem to … the aging process in the spine can go one of two ways: either you can age gracefully, if you want to put it that way, and not develop any nerve compression or discogenic type pain; or you can have a few bumps along the way, and occasionally with dropping of the disc, it can cause compression or crunching of the nerve roots, which again occasionally require surgery.
Now, that’s quite a large part of any spinal specialist’s practice, because as you know, the population is getting older. Most people, however, do have an occasional bout of back pain, and things settle down with time, and thankfully, most people don’t require spinal intervention.
Richard: It’s pretty common though.
Katherine: Right. I understand that you’ve been involved in some research looking at chronic infections, in particular, disc injuries, as part of a research team at the Prince of Wales Hospital. Can you tell us about this research?
Richard: I’m a co-investigator, but I’m not the primary investigator. But it’s a very interesting study looking at disc herniations that have been removed surgically. So, the piece of disc that’s compressing the nerve is removed, and then we send it and a couple of other samples of tissues for culture. And there’s been some interest in whether or not disc degeneration might be related to chronic infection in the disc, and that might be the reason why some people’s discs deteriorate and other people’s don’t.
And I think it’s a really interesting study, because if that was the case, then, potentially, there’s something that could be done about it treatment-wise, with antibiotics.
Richard: So, it’s really an interesting area.
Katherine: Yeah, it does sound interesting. And as you’ve mentioned, back pain or spinal injury is caused by years … and it is more of an aging population that does complain of back ache, things like that. Can you tell us or give us some advice, some of our listeners, maybe the work that they do, how could they prevent, take preventative measures to reduce the likeliness of spinal injury?
Richard: It’s always good to have an occupational health & safety person if you’re involved in an activity that involves heavy lifting, bending or twisting. It’s always good to have an OH&S person come and give you some information and some training on how to lift properly and effectively.
I think adhering to proper lifting guidelines is probably the best thing you can do to avoid hurting your back. So, bend your knees, and try and lift within your own centre of gravity, or within your own sort of vector of force. In other words, for example, bend your knees, lift on the side, and lift up towards you, rather than bending over and trying to lift like a crane, which will always hurt your back.
Richard: It’s also good, if you do hurt your back, to seek attention and not ignore it. Again, most people settle down with appropriate physiotherapy, but you’ve got to make sure that you don’t let something go.
Katherine: Exactly. That’s great advice actually, yeah. Some people just take an aspirin, and then they kind of [indecipherable 05:03]
Richard: Yeah. And then they turn up a year later with a disc herniation, and unfortunately, there’s not much more that can be done other than surgery.
Katherine: Right, yeah. It doesn’t have to get to that point, actually.
Katherine: And I’m glad you mentioned the bend-the-knee thing, because some of our listeners are not in occupations where they’re lifting patients or whatever, but you hear of stories – family and friends, went shopping one day and just lifted something awkwardly, or even moving around the furniture, just very unexpectedly, they put their back out, and yeah.
Richard: The physios have a very good term that they call “turning on the core,” and I’m sure a physiotherapist could tell you more about it than I do. But the basics of it is that you increase the tone in your abdominal muscles to splint your back, which does allow the back to be prepared to take the weight. And it tends to work quite well as well.
But the important thing is to have some appreciation and preparation before you lift anything, and not to lift anything more than about 20 to 25 kilos – anything more than that is probably going to hurt you no matter what you do.
Katherine: Right. Before we wrap up, I understand that you sometimes do some work up in Darwin with the indigenous community?
Richard: That’s correct, yeah.
Katherine: Can you tell us a bit about what you do up there?
Richard: Well, I work at a consultation clinic in Darwin once a month, and I’ve also just commenced operating up there. So, it’s a very exciting time. I’m mainly operating at Darwin Private Hospital, but there’s an offer on the table and we’re talking about doing a public clinic [indecipherable 06:48] as well. This will be the first neurosurgical care offered to territorians, and you know, I think it’s very exciting.
Katherine: Yeah, it is. It does sound very exciting. And thank you so much for your time today and giving us some information about spinal health. Thanks for that.
Richard: No worries, Katherine.