|
  Back & Neck Pain
Myofascial Pain
Complex Regional Pain Syndrome
Spasticity and Dystonia
Cancer Pain
Diabetes-Related Pain
Shingles Pain
Compression Fractures (Spine)
Spinal Stenosis
|
|
Back and Neck Pain
The spine consists of 32 or 33 bones with the first 24 or 25 circular in shape and called vertebrae. Vertebrae generally have a large flat round bone section on the inside with thinner bones on the back-side creating an opening. With all 24 or 25 vertebrae stacked one on top of another the opening called the vertebral canal contains and protects the spinal column, which is a critical component of the central nervous system (CNS). In between each vertebrae is a structure called a disc which contains a gel like substance. These discs act as shock absorbers for the spine.
The joints where the vertebrae come together are known as facet joints. Due to the shape of the vertebrae and where the joints are, smaller openings exist all along the right and left sides of the spine. These smaller openings allow for the nerves going to and from your entire body to exit and enter the spinal column.
Inside the vertebral canal, the spinal cord is surrounded by several protective layers together known as the meninges. The outermost area is known as the epidural space.
The spine is responsible for allowing the body to move and protecting the spinal cord. It is also the site where many muscles and ligaments attach. The CNS consists of the spinal cord and the brain. The peripheral nervous system (PNS) consists of all the nerves going to and from the entire body. It is helpful to think of the spine as the super highway that transmits all nerve impulses from the body to the brain and then sends the responding message from the brain to the body. In this way you can look at the nerves as all other roads, which go to a particular destination or part of the body. The areas where the roads (nerves) enter and exit the super highway (spinal cord) are known as nerve roots (kind of like intersections).
The spinal column itself has 5 regions including the cervical spine; the thoracic spine, the lumbar spine, the sacrum and coccyx.
- The cervical spine is commonly referred to as the neck and contains 7 vertebrae (C1 – C7).
- The thoracic spine is associated with the chest and rib cage and contains 12 vertebrae (T1 – T12).
- The lumbar spine is commonly referred to as the low back and contains 5 or 6 vertebrae (L1 – L5/6).
- The sacrum contains 5 bones that are fused together (S1-S5).
- Finally, the coccyx, also known as the tailbone, has 3 bones.
As you can see the spine is a complex structure of critical importance to the human body. When we experience back or neck pain there can be a number of causes involving any of the components mentioned above. Pain is a symptom, not a diagnosis. Its purpose is to let us know there is a problem. Typically back or neck pain is caused by one of the following:
- Bone and Joint problems such as degeneration, arthritis or fracture.
- Muscle and soft tissue problems such as sprain, strain or spasm.
- Disc problems such as herniated discs.
- Nerve problems such as compression or entrapment of a nerve.
Common causes of injuries include:
- Improper lifting technique
- Poor ergonomics
- Poor posture
- Trauma, such as whiplash
- Degeneration due to aging or disease such as spinal stenosis and compression fractures
Regardless of the cause, neck or back pain either can be a temporary nuisance or severely debilitating. Either way it undoubtly will impact the individuals quality of life. Neck and back pain sometimes resolves itself with little or no treatment. However, treatment can help individuals tolerate the pain better and decrease the time it takes to heal the underlying issue. In many cases treatment is necessary. Treatment options include:
Disabling pain or pain accompanied by numbness, weakness, balance problems, and/or loss of control of bowels/bladder should be reported to your health care provider immediately.
Due to advancements in medicine and medical technology there are many more less-invasive options available to treat back and neck pain regardless of the cause. The ultimate goal with any treatment is to alleviate the symptom, correct the underlying problem if possible and improve the patient’s quality of life.
Back to Top
Neck Pain
It is estimated that 12 – 34% of the normal population suffers from some type of neck pain. Neck pain is the second most common musculoskeletal (involving both bone and muscle) disorder after low back pain, usually causing disability and high amount of health care costs. For approximately 20 million American workers with non-work related neck pain, 70% note that it influences their job performance while 2/3 rd's note that it influences their on-the-job morale.
n
Neck pain commonly is caused by muscle strain, tension or facet joint disorders. If the neck pain source involves a nerve, the pain can radiate to the shoulder and down the arm.
Back to Top
Back Pain
Low back pain (LBP) is one of the leading causes of lost work time, second only to the common cold. Statistics show that approximately $20 billion is lost each year in employee productivity due to back pain. It affects 65%-85% of the population of the United States at some point in their lives.
Image © SpineUniverse.com. Used by permission
Back pain frequently results from herniated (bulging) discs. A herniated disc results when some type of trauma or injury causes the disc to protrude beyond the spinal column. When this happens it can place pressure on the spinal cord or canal or irritate one of the nerves leading from the spinal cord to the body. In this case it is common for the individual to feel pain radiating down their leg.
Back to Top
Spinal Stenosis
Spinal Stenosis refers to a narrowing of the vertebral canal. Some individuals may be born with this condition but the majority of cases develop over time. Along with the wear and tear that occurs over time, bone spurs build up on the joints where one vertebra meets another (facet joint). These bone spurs then encroach on the vertebral canal and pinch the nerve roots that exit/enter the spinal cord. In combination with, or independent of, the bone spurs, a degenerated disc can cause the narrowing and pressure on the spinal cord and/or nerve roots. Although spinal stenosis can affect the entire spine, including the cervical, thoracic or lumbar regions, it is predominately found in the lumbar region
Image © SpineUniverse.com
Used by permission
Image © SpineUniverse.com. Used by permission
The pressure these dysfunctions can cause on the spinal cord and/or nerve root can cause pain, sometimes severe, and/or difficulty standing or walking for distances. Patients sometimes describe the sensation as having very "heavy" legs.
There are many treatment options of spinal stenosis including medications, blocks/injections or surgery.
Back to Top
Spinal Compression Fractures
A spinal compression fracture occurs when an injury to, or weakness of, a vertebra causes it to fracture (break) and collapse (compress). Weakness of the vertebra is commonly caused by osteoporosis. Compression fractures occur in more than 700,000 patients per year in the United States. They are more frequent than hip fractures and often result in prolonged disability.
Until recently, doctors were limited in how they could treat osteoporosis-related spine fractures. Pain medications, bed rest, bracing and invasive spinal surgery were the only options available. Today, epidural steroid injections can help with the majority of the pain. There are two promising therapeutic treatments for compression fractures. They are called vertebroplasty and kyphoplasty and are performed by spine specialists, usually in the hospital setting.
Back to Top
|
|
|
