SpineCare Program Patient Story: Joe Lopiparo

Suffering with back pain, restaurateur Joe Lopiparo found relief through Froedtert & the Medical College of Wisconsin’s SpineCare Program. The experience left Joe doing activities he has shied away from for years and singing the program’s praises.

Joe Lopiparo of Franklin, Wis., had suffered from back trouble for more than 25 years, so it was no surprise when back pain struck in 2010 during a golfing vacation. His back pain flare-ups usually lasted just a few days. This time, however, it was different.

“When I returned from the trip, my back pain got worse and worse,” Joe said. “I couldn’t stand up straight. I pretty much lay on the floor at home, and I was out of work for almost a month.”

For Joe, owner of an Italian restaurant, missing that much work was unacceptable. Joe went to see a Medical College of Wisconsin family medicine physician who suggested he seek help with the SpineCare Program of Froedtert & the Medical College of Wisconsin.

Back pain

“Back pain and neck pain are extremely common, with more than four out of five people experiencing spine related problems during their lifetime,” said Diane Braza, MD, a Medical College of Wisconsin physiatrist (a physician specializing in musculoskeletal disorders). Dr. Braza explained that the main causes of spinal pain are poor posture, poor body mechanics and muscle strain.

“There are many approaches to treating spinal pain, Dr. Braza said. “The challenge is fitting them all together in the most effective way. SpineCare is unique because it brings together all the different caregivers that patients need for back pain. The team includes physical medicine specialists, chiropractors, physical and occupational therapists, spine and orthopaedic surgeons, neurosurgeons, and other spinal pain experts. Patients often find the team approach results in better outcomes and fewer visits for their back issues.”

Getting moving

Joe met with Andrew Nelson, MD, a Medical College of Wisconsin physiatrist. An MRI scan confirmed Joe had two herniated discs.

“Right from the get-go, Dr. Nelson explained all the options, what he was planning to do and how it all worked together,” Joe said.

“We always educate the patient on what the medical evidence shows so they can take part in decisions about their care,” Dr. Nelson said. “In Joe’s case, our decision was based on good evidence that disc herniation can often be managed and improved with non-operative care.”

Joe’s care plan included a combination of therapies to get his pain under control, get him moving and strengthen his back. One of the first steps was beginning work with Boyd Peterson, DC, a Medical College of Wisconsin chiropractor. Chiropractors physically, gently push through joints that have restricted movement in order to restore normal movement patterns. The adjustment reduces the patient’s back pain and sets the stage for other therapies. Joe saw Dr. Peterson fewer than half a dozen times before he could get out of the house and back to work.

Joe also began physical therapy to stabilize the spine by strengthening key muscles, and worked with SpineCare’s occupational therapy team. “We start by finding out which day-to-day activities the patient is having problems performing,” said Carol Fitzgerald, OT, a Medical College of Wisconsin occupational therapist. Patients learn basic body mechanics for moving, bending and lifting, and then find out how to apply the principles to job tasks and home activities like vacuuming, shoveling snow — even getting out of bed and putting on their socks. The therapists also empower their patients by helping them self manage their problem if their back pain comes up again.

Approach to back surgery

The goal of SpineCare is to treat patients non-invasively whenever possible. Some patients, however, do require surgical intervention. According to Marjorie Wang, MD, MPH, a Medical College of Wisconsin neurosurgeon, identifying surgery candidates requires careful evaluation.

“One major issue is making sure the patient’s symptoms match their diagnostic workup,” Dr. Wang said. “Finding a problem on an MRI is not the same as locating the source of a patient’s pain.”

The most common surgical procedure for spinal pain is discectomy, the removal of the displaced portion of a herniated disc. Discectomy may sometimes be accompanied by a fusion procedure that stabilizes the spine by joining vertebrae. Both procedures can often be performed using minimally invasive techniques.

Patients watched closely

As Joe was going through therapy, his care team monitored his progress closely. They quickly realized that although he had been prescribed a pain medication, he needed extra help. One option for a disc herniation is injection of a steroid medication around the disc and irritated nerve, under X-ray guidance, to reduce inflammation and pain.

“Joe was having problems participating in therapy because of pain, and we were able to bring down the pain significantly with one injection,” said David K. deDianous, MD, a Medical College of Wisconsin physiatrist. “Joe later received a second injection when his progress slowed.”

Excellent outcomes

Data shows that patients in the program experience significant improvement in pain and function. Dr. Braza believes one reason for SpineCare’s excellent outcomes is the team’s long-term approach to back and neck pain.

“If you treat a spine disorder as something that is not coming back, you are missing the boat,” she said. “We look at back and neck pain as a recurring event in our lives, so we emphasize developing a wellness approach for the future that includes a personal exercise program.”

Joe completed his SpineCare treatment plan, now works out regularly, focusing on his core strength, and is back to working and golfing four rounds a week.

“Everybody at SpineCare is very thorough, friendly and helpful,” Joe said. He was also impressed by the program’s efficiency.

“I run a restaurant, and I wish we could take care of people in as timely a manner as they do at SpineCare,” Joe said.

The Froedtert & the Medical College of Wisconsin SpineCare Program is an outpatient program specializing in the treatment of neck and back pain caused by injury or illness. SpineCare has been recognized by the National Committee for Quality Assurance (NCQA) in its Back Pain Recognition Program (BPRP). SpineCare is one of only two clinics in southeastern Wisconsin whose physicians and chiropractors have been recognized for delivering superior care for people suffering from low back pain.

For more information or to make an appointment, call 414-955-7199.