Alpha blockers treat conditions such as high blood pressure and benign prostatic hyperplasia.
Alpha blockers relax certain muscles and help small blood vessels remain open. They work by keeping the hormone norepinephrine (noradrenaline) from stimulating the muscles in the walls of smaller arteries and veins. This stimulation makes the vessel walls constrict. Blocking that effect causes the vessels to remain open and relaxed. This improves blood flow and lowers blood pressure.
Because alpha blockers also relax smooth muscle cells throughout the body, these medications help improve urine flow in older men with prostate problems.
Side effects and cautions
Alpha blockers may have what's called a "first-dose effect." When you first start taking an alpha blocker, you may develop pronounced low blood pressure and dizziness, which can make you suddenly faint when you rise from a sitting or lying position.
Other side effects include headache, pounding heartbeat, nausea, weakness, weight gain and small decreases in low-density lipoprotein cholesterol (the "bad" cholesterol).
Of concern are the results of a major high blood pressure study referred to as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). It indicated that some alpha blockers can increase the risk of heart failure with long-term use. Talk to your doctor about your situation.
Do you need back surgery?
Most people will have back pain sometime during life. And 90 percent of these people will get better, without treatment or with conservative therapies, within four to six weeks. Only 5 percent remain disabled longer than three months.
In most situations, an operation won't be considered unless conservative measures have failed, and even then it's not often indicated. Back surgery is usually reserved for times when a nerve is pinched, the spinal cord is compressed or there's too much movement between the spinal bones.
Your doctor may recommend back surgery if you have neck or back pain accompanied by symptoms of nerve damage. Signs and symptoms include:
- Pain that radiates down your legs (sciatica) or arms
- Numbness, weakness or tingling in your arms or legs
- Loss of bladder or bowel control
Squeezed disks and pinched nerves
Your vertebrae are separated by soft, flexible disks that have a tough outer shell and a soft, gel-like center. They act as cushions between the vertebrae. Your spinal cord runs down through your vertebrae, and nerves pass through gaps in the spinal column.
Many types of problems can reduce the amount of space in the spine, so nerves become pinched. As people age, it's common for spinal disks to dry out and shrink, reducing their effectiveness as shock absorbers. Disks can also bulge or rupture (herniate), which can irritate nearby nerves. However, many people with bulging disks have no pain.
To relieve pressure on the spinal cord or nerves, surgeons can remove portions of bone to widen the narrowed area in the vertebrae. Removing the gel-like interior of ruptured disks also helps relieve pressure on pinched nerves. Sometimes the entire disk must be removed, with the adjoining vertebral bodies fused together surgically. One alternative to fusion may be a new procedure that replaces the damaged disk with an artificial one.
Types of back surgery
Different types of back surgery include:
- Diskectomy. This involves removal of the herniated portion of a disk to relieve pressure on a nerve. It's done as an open surgery, and typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
- Laminectomy. This procedure involves the removal of the lamina that overlays the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
- Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture or when there's excessive motion between vertebrae. It may also be used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
- Intradiscal electrothermal therapy (IDET). In this treatment, doctors insert a needle through a catheter into the disk. The needle is heated to a high temperature for up to 20 minutes. The heat thickens and seals the disk wall, reducing disk bulge and the related spinal nerve irritation.
- Vertebroplasty. During this procedure, your surgeon injects bone cement into compressed vertebrae. For fractured and compressed vertebrae, this procedure can help stabilize fractures and relieve pain. With a similar procedure — called kyphoplasty — a balloon-like device is inserted to expand compressed vertebrae before bone cement is injected.
- Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. These relatively new devices are still being studied, however, so it's not yet clear what role they might play as a back surgery option.
Last Updated: 12/22/2006
