Pain Management – Are you Candidate?

Spine conditions that can be diagnosed and treated:

Compression Fractures

The spinal column consists of 34 individual bones called vertebrae. Separating the vertebrae from each other are intervertebral discs that cushion and absorb the stress and shock that the body incurs during movement and give the spine its flexibility. A compression fracture occurs when a vertebrae collapses. People with osteoporosis are at higher risk for fracture, which may result from a minor fall or simple daily activities such as bending or lifting.

Symptoms

• Loss of height
• Kyphosis (humpback)
• Loss of balance and increased risk of falling
• Neurological symptoms such as numbness, tingling, or weakness (which increases the risks of falling and breaking other bones)

Degenerative Disc Disease

Degenerative disc disease (DDD) is a common condition in aging adults. Our intervertebral discs serve as shock absorbers for the spine, and as we age they gradually dry out, losing strength and resiliency. These changes are gradual in most people. In fact, most people do not know they have degenerative disc disease. Only a portion of the general population actually becomes symptomatic from their degenerated discs.

Symptoms

• Chronic, mechanical low back pain originating
• Back pain that is aggravated by sitting, prolonged standing, bending forward, lifting and twisting
• Partial relief is often found with lying down on your back and the use of adequate lumbar support
• Other patients will describe the sensation of weakening of their abdominal and lumbar musculature despite efforts to maintain their “core” strength through exercise.
• Driving and flying can become intolerable.

Herniated Disc

Discs, which act as shock absorbers for the spine, are located in between each of the vertebral body in the spine. Each disc contains a tire-like outer band (called the annulus fibrosus) that surrounds a gel-like substance (called the nucleus pulposus). A herniation occurs when the outer band of the disc partially or fully cracks and the gel-like substance from the inside of the disc leaks out, placing pressure on the spinal canal or nerve roots. In addition, the nucleus releases chemicals that can irritate the surrounding nerves causing inflammation and pain. A herniated disc is also known as “slipped disc” or “ruptured disc.”

Facet Joint Pain

Traditionally, lumbar pain has been attributed to lumbar disc herniation or degenerative disc disease. However, there are other anatomical structures that may cause low back pain, including the facet joints, the sacroiliac joints, spinal nerve roots, muscles and ligaments, and other non-spinal causes. In the thoracic spine, each vertebra attaches to a rib on either side. Because of the inherent stability of the rib cage, symptomatic facet joint pain is less common in the thoracic spine compared with the lumbar and cervical regions. Facet joint related mid back pain usually follows surgery or trauma to that spinal segment. In the cervical spine, the facet joints are actually the most common source of pain. Neck pain is attributed to facet joint dysfunction more often than a disc herniation or to a dysfunctional intervertebral disc, combined!

Sciatica

Most patients have heard the phrase “sciatica”. The term sciatica is used for descriptive purposes only. What most patients are unaware of is that the sciatic nerve is the least likely anatomical structure involved in causing their low back and leg pain. The term radiculopathy (dysfunctional nerve root) is much more accurate. Radiculopathy refers to compression or irritation of a spinal nerve, as it leaves your spinal canal, resulting in low back pain radiating into the buttock and/or leg.

Spinal Stenosis

The word stenosis refers to abnormal condition characterized by the constriction or narrowing of an opening or passageway in a body structure. The term stenosis is widely used in medicine for different parts of the body, including blood vessels, the GI tract and the spinal column. Typically, the term spinal stenosis refers to the central canal of the spinal column, although stenosis (narrowing) may affect other parts of the spine as well (foramenal stenosis, lateral recess stenosis).

Spondylolisthesis

The word spondylolisthesis comes from the Greek words spondylos, which means “spine” or “vertebra,” and listhesis, which means “to slip or slide.”

A spondylolisthesis happens when one of the spine’s vertebrae (bones) slips forward over the vertebra beneath it. Spondylolisthesis occurs most often in the lumbar spine (low back).

Sacro-iliac Joint Dysfunction

Dysfunction of the sacroiliac joint may cause low back and/or leg pain. The sacroiliac joint is the “chameleon” of the spine; SIJ dysfunction can mimic the pain caused by a number of other spinal structures (lumbar disc, nerve root, facet joint, or hip). The pain is typically felt on one side of the low back or buttocks, and can radiate down the leg. The pain usually remains above the knee, but at times pain can extend to the ankle or foot.

Whiplash

Whiplash, although not technically a medical term, is very real and can be very painful. We call it whiplash because, in an accident, your neck really can whip back and forth—first backward (hyperextension) and then forward (hyperflexion). In reality, the specific biomechanics of this injury are far more complex than this, but these details are beyond the scope of this discussion.