Cantor Spine Institute is a renowned South Florida-based medical practice specializing in a holistic approach to spinal care through minimally-invasive surgery, cutting-edge technology, methodical research and analysis, and exceptional patient experiences. Every case is different, but all patients are the same in receiving the most thoughtful, personalized plan for treatment and recovery. Dr. Anthony Giuffrida of Cantor Spine believes treating pain should also be approached holistically and spoke with Haute Beauty about preventing pain, the latest treatments, and how minimally invasive is the best option if treatment is needed.
HL: What are your thoughts on preventing pain?
Dr. Anthony Giuffrida – The number one thing people take for granted is not having pain. Doing things when you don’t have pain can go a long way from keeping you from developing pain. Two easy things you can do are staying away from certain foods and exercising regularly. It is well known that smoking, alcohol, red/smoked meats, bleached flour, processed sugars all cause inflammation, so keep all of these things in moderation. Secondly, keep exercising and keep moving, try not to stay sedentary at your desk all day. I think prevention is very important to remain cognizant of. If you’re not having pain, let’s keep it that way.
HL: What are the latest treatments for back pain?
AG – The latest treatments are geared towards minimally invasive techniques and follow a “less is more” approach. We’ve realized that with bigger surgeries patients have bigger problems in the long term. They may feel fine a few years after the surgery, but with the big surgeries we’re actually creating more harm down the road. New treatments like Intracept and have given us the option to do minimally invasive procedures that aren’t full-blown surgeries, patients don’t have to stay in the hospital overnight, and their recovery time is very minimal if any. They are giving patients relief from pain without the long-term consequences of big procedures.
HL: How many treatments are necessary before relief?
AG – Yeah, so the newer procedures are a one-time thing. That’s the other thing we’re looking for nowadays. With the older methods, like injections, everyone knows that with epidurals sometimes you need many of them or the relief can wear off after a few months. With these new procedures, one and done. One and it works. Patients don’t have to worry about wondering when their pain is gonna come back, which is nice that they always have that worry looming over them. They can get back to what they love like boating, going to the gym, you know, really living their life and not worrying about the pain coming back.
HL: What are things you recommend to alleviate pain that are not procedural?
AG – Patients, I don’t think, realize that most aches and pains can be taken care of with simple conservative measures, like good physical therapy, daily stretching, maintaining your diet and weight. Those things can take care of a lot of neck and back pains, especially in the younger populations. If patients really do the exercise programs we recommend and stick to it, their pain stays away without any procedures. At Cantor Spine Institute, that’s what we really strive for, “less is more,” it would be great if we could do no procedures and you could just get yourself better through diet, an anti-inflammatory diet to be exact, and exercise, that’s even better. What I try to drive home during with my patients is that we don’t have to do anything to make you better, you have the capability to do it yourself. I think everyone comes to us looking for a magic solution, and in the world of the spine especially, there is no magic solution, there’s no spine replacement, you’re born with the spine you have and that’s what you’ve got. When we start manipulating the spine, it can cause problems down the road, so we’d rather do nothing and have you get better naturally. A lot of people come to us and say ‘Ok, so what are you gonna do to make me better?’ And I say, ‘You can make yourself better!’ But unfortunately, a lot of people don’t have time or don’t want to put in the work, which is sad to see, but the people that really put in the effort see amazing results and are very well off. We’re ultra-specialized in what we do, but if we don’t have to do anything, then that’s better. The body heals itself pretty well if you do the right things, so the push now for regenerative medicine (PRP and stem cells) is better than all the medications. I think we’ll see a rise in those treatments in the coming years because they are your own body’s cells just put into the injured area.
HL: What are your thoughts on stem cell treatments?
AG – Unfortunately they’re not covered by insurance, so they can be expensive, but they are a better first-line treatment than steroids because they are your cells, they’re natural. I take the stem cells out of your body and inject them into where it hurts, your shoulder joint, your knee joint, etc. I’d like to do more of these procedures, but insurance doesn’t like to cover them…yet. Research is revealing that stem cell and PRP treatments have their place in spine care as well. My treatment algorithm is ideally trying conservative care with physical therapy, ice, and heat, and if there is no improvement then use stem cells/PRP. If those don’t work, then try steroids. If those don’t work, then we’d go to a bigger procedure, but a minimally invasive procedure, not a big surgery because, again, “less is more” is the philosophy. Less is definitely more for the body.
HL: Do you feel patients are open to stem cell treatments?
AG – Yes, definitely, a lot of patients want to do them, but it can be a big financial burden. The patients that do these treatments are extremely happy with the results.
HL: How do you recommend patients manage average daily pain?
AG – My job is for my patients to enjoy their life. But I want patients to have realistic expectations, too. If you’re 45, you’re not gonna feel the same as an 18-year-old playing football, you know? You’re a unique person, your pain is yours, and I think everyone beyond their mid-twenties wakes up every now and then with a little bit of pain somewhere, so it’s more about understanding what's normal and not everything is something to “treat” exactly. It’s tough to live with any amount of pain, so of course, most want someone to fix anything with a magic treatment, but part of my job is developing a relationship with the patient and setting realistic expectations about their pain and what is best for them in the long run. Yes, I can do an injection, but is that the best choice? I ask, should we try stem cell/PRP treatments first, you know, treatments with little to no side effects.
HL: Do you provide meal and exercise plans for your patients?
AG – Yes, we have a special diet we put people on. Mainly because they do really well after surgeries on it, and they do really well because their body is in a prime position to heal itself. I put my patients all on the same diet even if they’re not getting surgery because it’s good if they really want to lose weight and if they really want to heal, even if they’re just healing from pain, not surgery. It’s basically an anti-inflammation diet, high in protein, high leafy greens, and low in processed foods. Protein is really good for healing. Also, you have to watch your caloric intake if you want to lose weight. It’s much more complicated than just intake versus what you expend, so there are different ways to achieve realistic goals for people, and I process that with them. We have to give our patients exactly what they need to eat every meal because they don’t prefer guidelines of what they should eat, so it’s a lot of eggs, this green drink called Vibrance for breakfast, a lot of fish, small portions, and good choices on your vegetables, not potatoes every day. Research has shown us that our patients do better after surgery and feel better generally due to this diet, so if it helps someone heal from surgery, why not prescribe it to all patients to help them feel better when healing from injuries? Diet is huge in preventing pain and inflammation is directly correlated to what we eat. You definitely have to be realistic with diet and exercise goals for yourself, though I know it can be difficult even as a specialist in the field I struggle to follow what I’m meant to eat and do at the gym. Never beat yourself up if you fall off the wagon, just get back on and listen to your body.
AG – A final note is that if you need something done, go minimally invasive, there’s no reason to scar your body. It doesn’t need to be a huge procedure.
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