The spinal column provides the main support for your body, allowing you to stand upright, bend, and twist. Protected deep inside the bones, the spinal cord connects your body to the brain, allowing movement of your arms and legs.
The spine is made of 33 individual bones called vertebrae stacked one on top of the other. Ligaments and muscles connect the bones together and keep them aligned. When viewed from the side, an adult spine has a natural S-shaped curve. The curves work like a coiled spring to absorb shock, maintain balance, and allow range of motion throughout the spinal column.
Keeping your spine healthy is vital if you want to live an active life without back pain. Developing the habits of exercising, sustaining a healthy weight, avoiding smoking and proper posture are all good behaviors to incorporate into our daily lives for increasing our spine health.
Acute, Mechanical Neck Pain
Many structures of the spine can produce pain, including ligaments, bones, joints, discs and muscles. Most episodes of acute, mechanical neck pain, defined as pain lasting less than three months, and not associated with a neurological injury, will or can go away on its own within three months.
If pain becomes significant to the point it impacts your ability to function, and is not improved with limited rest and over-the-counter medications, many non-surgical treatment options, including physical therapy, chiropractics, acupuncture, prescription medications and injections exist to treat the condition.
Fracture of the Cervical Spine
There are seven bones in your neck that support your head. These are your cervical vertebrae. Any break in your cervical spine is serious, especially if it damages your spinal cord which is the conductor of nerve signals between the brain and body. If the spinal cord is compromised at the neck, it can result in paralysis from the neck down.
Cervical fractures are normally the result of traumatic injury, accidents that commonly occur while driving, diving, or playing high-impact sports. Wearing your seat belt, avoiding diving into shallow areas, and wearing the proper equipment for your sport are all important safety precautions when it comes to protecting your cervical vertebrae.
Should you experience a break in one or more cervical vertebrae, surgical intervention may be required. One common procedure is known as the Anterior Cervical Discectomy & Fusion.
Fracture of the Thoracic and Lumbar Spine
In addition to the cervical vertebrae in the neck, there are twelve thoracic vertebrae which span from your shoulders to the end of your rib cage. Below these vertebrae are the five lumbar vertebrae of your lower back.
Any fracture in the thoracic or lumbar spine is significant due to the fact that it could jeopardize the spinal cord’s ability to conduct nerve signals from the brain to the rest of the body. When you experience a traumatic injury to your back, especially if you notice numbness, muscle weakness, or that your can’t control your bowels and bladder, you should seek immediate medical attention.
Vertebral Compression Fractures and Osteoporosis
Osteoporosis is a common condition that weakens your bones. Unfortunately, there are no actual symptoms. There are only outward signs such as the classic “dowager’s hump” where the back becomes rounded due to weakened vertebrae, and sometimes becoming shorter over time.
Osteoporosis-weakened vertebrae are at a high risk for vertebral compression fractures, because as the bone mineral density decreases, bones become brittle. When pressure is placed on a brittle vertebra, it cracks and collapses, becoming compressed. Vertebral compression fractures can occur when you are doing everyday activities, such as bending, reaching, and even sneezing.
Fortunately, many treatment options exist for relieving the pain related to a compression fracture. You should see your physician for a full evaluation.
Spondylolysis and Spondylolisthesis
These tongue-twisting names are two of the most common causes of lower back pain in the adolescent athlete. Spondylolysis (spon-dee-low-lye-sis) is a deformity in a vertebra caused by a stress fracture. As opposed to fractures brought on by a distinct traumatic event, a stress fracture is caused by repeated and unusual pressure on a bone.
If the stress fracture weakens the bone so that it shifts out of its proper position, a related condition called spondylolisthesis (spon-dee-low-lis-thee-sis) occurs. Spondylolisthesis can eventually cause nerve impingement so severe that surgery may be required to alleviate the pain.
Taking a break from activities that aggravate the pain can sometimes help, as can anti-inflammatories. Sometimes, a back brace can assist in resting the spine enough to alleviate the pain.
If the vertebral slippage worsens over time, or if back pain does not respond to nonsurgical treatment, spinal fusion surgery may be needed.
The intervertebral discs separate each of the vertebrae in the spinal column. These discs act both as a joint to allow movement and as a ligament to hold the adjacent vertebrae together. Discs are made up of a ring of fibrous tissue surrounding a nucleus that is the consistency of jelly. The primary job of the nucleus is to absorb the shock of our activity, cushioning the bony vertebrae as they are stacked on top of each other.
Sometimes, your disc can become herniated. In other words, the nucleus of cushioning jelly presses through a tear in the outer ring of fibrous tissue and begins to press on the extremely sensitive spinal nerves. Depending on the area where the disc lies, you may experience pain in your back, or it may travel sharply down your leg or arm. It can also cause muscle weakness or interfere with your bladder and bowel control.
Depending on the severity of the herniation, you may be able to recover without surgical intervention. Professional physical and occupational therapy can be a key not only to healing, but to preventing recurrence of the injury. Epidural injections may also be used to lessen nerve irritation and allow more effective participation in physical therapy. This type of injection is usually administered at an outpatient surgery center using x-ray guidance.
The spinal canal is the empty space (foramen) in the center of each vertebra. The spinal cord passes through this space as the main trunk of nerve activity, with nerves branching through the vertebrae to pass information to and from the body and brain.
Changes in the shape and size of the spinal canal can happen over time as a part of the natural aging process. When the canal narrows, it can put pressure on your spinal nerves, or even the spinal cord itself. This condition is called lumbar spinal stenosis. When your spinal nervous system is compromised, many painful symptoms can occur:
- burning pain in the buttocks and legs
- numbness and tingling in the buttocks and legs
- weakness in the legs
- inability to lift the front part of the foot, sometimes called “drop foot”
Although nonsurgical methods do not improve the actual narrowing of the spinal canal, many people report that physical therapy, anti-inflammatory medications and steroid injections are effective in relieving pain.
There are two main surgical options to treat lumbar spinal stenosis: Laminectomy and Spinal Fusion. Be sure to discuss the advantages and disadvantages of both procedures with your doctor.
Everyone’s spine has a natural s-shaped curve, rounding our shoulders and bending slightly inward at the waist. When that arc is distorted by a side to side curve, it is called scoliosis. Unlike slumping or sway-back, these curves cannot be corrected with attention to posture.
Though the cause of scoliosis is not usually known, it does tend to run in families. Generally it develops in childhood. If it is allowed to progress uncorrected, it can lead to chronic and severe back pain in adults.
Parents should keep an eye out for proper development in their children, looking for indications of unevenness in the shoulders or waist, prominence in the shoulder blades, or leaning to one side. Any one of these signs warrant an examination by your family physician, a pediatrician, or an orthopaedist.
You may need a brace to keep the condition from progressing. Your orthopaedist will recommend the best type of brace for you.
Cervical Radiculopathy (Pinched Nerve)
Pain that radiates from the neck and shoulder down the arm is often due to an injury at the root of a nerve. Commonly called a “pinched” nerve, the term for this condition is called cervical radiculopathy.
Most patients with cervical radiculopathy get better with time. Treatment options depend upon the severity of your pain, presence of weakness or any evidence of spinal cord compression. The procedure that is right for you will depend on many factors, and is best determined after a thorough medical evaluation.
Cervical Spondylosis (Arthritis of the Neck)
Arthritis of the neck is referred to as cervical spondylosis. Although it is a form of arthritis, which is painful, cervical spondylosis rarely results in disability.
Typically, treatment for cervical spondylosis is not surgical. Physical therapy, rest from aggravating activities, and medications can often help alleviate your pain. For some, physician-administered injections such as an epidural block or facet joint block can bring relief.
Although less invasive than surgery, steroid-based injections are prescribed only after a complete evaluation by your doctor. Before considering these injections, discuss with your doctor the risks and benefits of these procedures for your specific condition.
Cervical Spondylotic Myelopathy (Spinal Cord Compression)
As you age, normal wear-and-tear on the vertebrae in your neck can lead to a narrowing of the spinal canal, which in turn presses upon the spinal cord. Several conditions can cause CSM. Rheumatoid arthritis, cervical disc degeneration, and injury are typical sources of spinal cord compression. Less common causes of CSM include tumors, infections, or congenital abnormalities of the vertebrae.
In CSM, as the spinal cord is slowly compressed, the cable of nerves that send and receive signals from the body to the brain is interrupted. This may cause disconcerting symptoms such as: tingling and numbness, trouble lifting objects, a tendency to drop things, difficulty walking, balance and coordination problems, and clumsiness.
Surgery is often required to relieve CSM. However, many conditions can mimic those of CSM. A thorough evaluation by your physician should be done to accurately diagnose CSM and determine the need for surgery.