Spinal Pain

Spinal Pain

Spinal pain in the lumbar region (low back) and cervical region (neck) is quite common and is often the cause of many lost work days. Lumbar muscle strains and sprains are the most common causes of low back pain (spinal pain). The thoracic spine can also be a site of spinal pain, but because it is much stiffer, the thoracic spinal region is much less injured than the lumbar and cervical spine. The lumbar and cervical spine are prone to stretching due to their weight-bearing function and involvement in movement, bending, and twisting. A lumbar muscle strain occurs when muscle fibers are abnormally stretched or torn. A lumbar sprain is caused by unusual stretching of the ligaments (bands of tough tissue that hold bones together). Both of these can result from a sudden injury or from gradual overuse. Most pain is temporary, but it can reoccur. Less often, pain comes from damage to part of your spine, or from a condition you were born with.

Clinic- 21st Century Pain Management By Dr.Junaid at Sugarland Area, 1628 Crabb River Road, Suite A Richmond, Texas 77469

The Spinal pain may accompany other symptoms such as stiffness, numbness, or weakness in your arms and legs. Spine problems can even affect your bowels and bladder.

When the lumbar spine is stretched or sprained, the soft tissues become inflamed. This inflammation causes pain and can cause muscle spasms. Although a lumbar strain or sprain can be very debilitating, it usually does not require neurosurgical intervention.

Spine pain can be caused by more severe things that may require surgical intervention. These usually include spinal pain that radiates from the back to the anterior chest, into the arms, legs, or around the rib cage.

About your Spine-

There are three types of muscles that support the spine:

  • Extensors (back and gluteal muscles)
  • Flexors (abdominal and iliopsoas muscles)
  • Obliques or rotators (lateral muscles)

Your spine consists of 33 vertebrae, discs, spinal cord and nerves, ligaments and muscles. The spine is divided into four regions and the vertebrae in each region are numbered.

The spinal column is divided into four regions:

  • Cervical: Neck region
  • Thoracic: Upper and middle back
  • Lumbar: lower back
  • Sacral: Tailbone region

Spine pain can be caused by several different conditions:-

Abnormal curvature. The natural curves of your spine help stabilize your body. But if the curves become too pronounced or your spine develops a twist or extra curvature, it puts extra pressure on the vertebrae and discs.

Fractures. Causes of a spinal fracture include an injury, repeated stress, or a condition such as osteoporosis, which can make bones weak and brittle.

Degenerate disc. Disc degeneration can result from normal aging or wear and tear, but can sometimes begin or accelerate due to injury, illness, or unusual stress. Degenerated discs can irritate the spinal nerves and cause instability. They can be painful.

Bulging disc. If the outer wall of the spinal disc weakens, it may push outward (swollen) against the nerves. This can cause painful nerve irritation.

Lumbar hernia. If the outer wall of the spinal disc ruptures (ruptures), the soft material inside the disc can become compressed and press on nearby nerves. This can cause Spinal pain, numbness, or weakness in your legs or back.

Instability. Spinal instability is when adjacent vertebrae slide back and forth or permanently shift out of position.

stenosis. Stenosis is the narrowing of the spinal canal. Stenosis can put pressure on the spinal cord and nerves and cause pain and other symptoms.

Nerve Problems. This can cause Spinal pain, numbness, weakness, and other problems in your body.

Clinic- 21st Century Pain Management By Dr.Junaid at Sugarland Area, 1628 Crabb River Road, Suite A Richmond, Texas 77469

Symptoms of Spinal Pain

Non-surgical low back, neck, and chest pain usually affects the central or para-spinal soft tissue without spreading to the arms, chest, or legs. In contrast, pain radiating from the spine to the extremities or chest wall indicates structural compression of the nerves in the spine, which may require a surgical view if the condition does not improve within days or weeks with non-surgical symptomatic treatment.

Symptoms include:

  • Stiffness in the lumbar region that limits the range of motion
  • Inability to maintain normal posture due to stiffness and/or pain
  • muscle spasms with activity or rest
  • Spinal Pain that lasts for a maximum of 10-14 days
  • Significant loss of motor function, such as the ability to walk on toes or heels.

In addition tospianl pain, symptoms of a spine condition may include:

  • Numbness, tingling, “pins and needles”
  • Bowel or bladder problems
  • Stress or emotional issues
  • Fever, chills, sweating
  • Weakness, slow reflexes
  • Dizziness, headaches
  • Sexual dysfunction
  • Unusual weight gain or loss

Causes of Spinal Pain

Anyone can experience back or neck pain. Still, some things increase your chances of suffering, such as:

  • Get old. The older you get, the more likely you are to experience back or neck pain.
  • Poor physical fitness. Lack of exercise and poor posture increases your risk of back pain.
  • Being overweight. Extra weight puts extra stress on your spine.
  • Your job or hobby. A job or activity that requires you to lift, push, or pull can be risky. But desk work can also be hard on your back—especially if you don’t sit upright or get up very often.
  • To smoke. Studies show that smokers have more back pain than non-smokers.
  • previous injury. An injury you had months or years ago can put you at risk for back problems later on.
  • Arthritis, osteoporosis, and other diseases can increase your chances of experiencing back pain.
  • Family history and genetics. Some conditions run in families.

Physical exam of Spinal Pain

In a physical exam, your doctor will check your body and its movement. Below are some things your doctor may note.

  • Simple exercises can help test your strength.
  • Range of motion. Your doctor may check your flexibility or watch you bend and twist.
  • Your doctor may assess areas of soreness by touching parts of your body.
  • Sensation and sensitivity. Your doctor may check to see if you can feel the heat, cold, or a pinprick on parts of your body.
  • Reflexes and motor skills. Your doctor may ask you to walk on your heels or toes, or do tests to check your body’s reactions.
  • Shape, tone, and position of the spinal bones, muscles, and so on.

Diagnostic Test

Diagnostic testing is usually only required if the spinal pain has been present for more than two weeks and has not improved as expected. Similarly, if the pain radiates to the extremities or around the chest far beyond the spinal epicenter of the focus of pain, it is important to exclude underlying causes, such as an undetected spinal disc injury. If symptoms persist, the following tests may be ordered by your doctor. It is important to note that a clinical picture that improves regardless of the diagnosis supports continuing with non-surgical methods. If improvement does not reach a satisfactory steady point, additional diagnostic studies should be performed. Similarly, diagnostic evaluation needs to be extended if clinical symptoms worsen.

  • X-ray — The application of radiation to create a film or picture of a part of the body can show the structure of the vertebrae and the contours of the joints. X-rays of the spine are taken to look for other possible causes of pain; i.e. spinal disorder, tumors, infections, fractures etc.
  • Magnetic resonance imaging (MRI) — A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology. MRIs can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and tumors. Add contrast to the study and it can be made sensitive enough to detect inflammatory processes such as infections and new compression fractures without spinal misalignment.
  • CT scan with 3D reconstruction — It shows bone detail better than any other imaging test and can still show soft tissue and nerves.
  • Bone density scan. This scan uses x-ray or ultrasound to measure the amount of bone in a particular area. It can detect and assess osteoporosis (thinning bones). Electrodiagnostic testing The term “electrodiagnostic testing” covers a range of tests that measure electrical activity in nerves and muscles. Two common electrodiagnostic tests are the electromyogram (EMG) and the nerve conduction study (NCS). Results from these tests help your doctor assess nerve and muscle function and locate any damage. Other procedures Other procedures—like spinal injections and discography—may also be useful in finding sources of back pain that may not show up in common imaging studies. Your care team will provide information on these procedures as needed.

Spinal Pain Treatment

Your care may include one or more of the Spinal pain treatments described below-

Education and activity. Your care team can teach you what you can do on your own to relieve pain, regain strength, and increase flexibility. For example, they can advise you on proper body mechanics (how to sit, sleep, lift, etc.) or how to use ice and heat to relieve inflammation. Much of this important education can help you prevent spinal pain in the future and treat it today.

Oral medications (pills). Your doctor may prescribe medication to reduce inflammation, relax muscles, and relieve pain. Take the medicine exactly as prescribed by your doctor or pharmacist and tell your doctor about any other medicines, herbs, or supplements you are taking.

Physiotherapy. Physical therapy encompasses a variety of treatments to promote healing, relieve pain, build strength and flexibility, and help prevent future injury. For example, your physical therapist can create and oversee an exercise program and make recommendations to help improve body mechanics (how to sit, sleep, lift, and move). Other physical therapies include spinal manipulation (applying force on a spinal joint) and traction.

Traction. Traction is a non-surgical method to open the vertebrae. It is done manually by a specially trained provider or mechanically with braces or devices that gently lengthen the spine.

Spine injection. Your doctor may recommend a spinal injection to treat inflammation or relieve pain. An injection can deliver medication directly to the source of your symptoms. Common injections include:

Epidural steroid (cortisone) injections. Injections near specific nerves or directly into the epidural space (the area around the nerves within the spinal canal) can help diagnose and treat pain.

Facet joint injections and nerve branch blocks. Injections into or near the facet joints can treat arthritic joint pain.

Sacroiliac (SI) joint injections. Injections in the SI joint, where the spine and pelvis meet, can diagnose and treat pain in that area.

Trigger point injections. Injections into tight, irritated muscle areas (trigger points) can help relax the muscle and relieve pain.

Other non-surgical procedures. Other procedures, such as neurotomy and radiofrequency ablation, use heat, cold, chemicals, or radiofrequency energy to destroy nerves near a problem joint. This relieves symptoms by preventing pain signals from traveling to the brain. Additional treatments for chronic pain include spinal pumps and stimulants implanted under the skin. A pump can put the drug directly into the spinal fluid, in just the right place on your spine. A spinal stimulator sends a small electrical pulse to the surface of the spinal cord to help mask pain.

Operation. Most spinal problems can be treated without surgery. But in some cases, your spine care team may recommend surgery as a good option to relieve your symptoms. Surgical options include those listed below.

Microdiscectomy. Removal of a portion of a damaged spinal disc using microscopically improved techniques.

Laminotomy, laminectomy (decompression). Cutting part of a vertebra to open the spinal canal and relieve pressure on a nerve or spinal cord.

Spinal fusion. Joining (fusing) two vertebrae so that there is no movement between them.

Anterior Cervical Discectomy and Fusion (ACDF). To remove a disc in the neck (cervical) region of your spine and fuse the vertebrae above and below it.

Vertebroplasty. Injecting special cement into a collapsed vertebra to stabilize and support the damaged bone.

Kyphoplasty. Injecting a special balloon and cement into a collapsed vertebra. The balloon is inflated inside the vertebrae to restore the original height of the bone, and the cement helps maintain that shape after the balloon is removed.

Total disc replacement (arthroplasty). Removing an entire damaged spinal disc and replacing it with an artificial disc to help maintain motion between the two vertebrae.

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