Over 80% of the population will experience some form of back pain during their lives. Most episodes will resolve on their own when the etiology is a bruise, or muscle strain. Ligamentous strain (the connective tissue between bones), might cause a more protracted course of pain and require some form of medical intervention to attain relief.
Pain that lasts greater than 3 months is considered to be chronic in nature. Chronic pain has an etiology and treatment with opioids only masks the pain by confusing the brain.
Continued pursuit of the pain generator is essential to correct the problem and avoid the complications of opioid use such as drug dependence, drug tolerance, constipation, muscle wasting from lack of exercise, depression, sleep disturbance, hormone imbalance including lowering of testosterone.
Any time the pain is associated with numbness, weakness, fever, or immobility, the assistance of a trained physician should be sought. The nature of the presentation of the injury may dictate the urgency for medical or surgical assistance.
Our approach takes into consideration the missions of the patient. Narcotics are used only when necessary. Cessation of pain, not masking the symptoms or confusing the brain, is our methodology.
— Dr. Gregory T. Flynn, M.D.
A pinched nerve from the spinal cord may occur as the result of a disc bulging or herniated disc pressing against the nerve. As we age, the spine will degenerate and form osteophytes (bone spurs) (spondylolysis) which may press against the nerves exiting the spinal canal.
The pain may result due to the stimulation of the nerve, or loss of blood supply causing ischemic changes and atrophy of the nerve. Cysts or scarring from laminectomy surgery may result in pressure against the spinal nerves. Instability of the spinal column, spondylolisthesis, due to trauma, cancer, or congenital deformity may result in movement that puts pressure on the spinal cord. Lastly, spinal stenosis may occur from any of the above resulting in spinal cord or nerve root damage,numbness or burning sensation, muscle atrophy, and possible loss of function.
Spinal Stenosis is the narrowing of the spinal canal which applies pressure on the nerve root or the spinal cord. The most common cause is the aging process which causes calcification of the ligaments in the spine, overgrowth of facet joints, bone spurs and disc degeneration and bulging. Other causes include trauma, cancer, and post surgical scarring.
Spinal Disc Pathology may originate from injury, disease, or the aging process.
Discs are the material lying between each vertebral body. A normal disc consists of an annulus, made up of a thick matrix of fibers that surrounds the nucleus which is soft and spongy in a normal disc. This nucleus may rupture through the annulus, or herniate. When the herniation occurs in the spinal canal, the nerves may be pressed upon or be exposed to the irritating fluid causing inflammation and pain. Treatment may consist of exercise, non-steroidal anti-inflammatory medication, therapy, steroid injections, or endoscopic discectomy. Herniated discs may occur at any level of the spinal column, cervical, thoracic or lumbar. When the pain follows the nerve root it is called radiculopathy. Radicular pain from a cervical disc herniation will be felt in the arms or hands. Radicular pain from a lumbar disc herniation will radiate down the legs. This is also called sciatica, when it appears down the back of the leg.
Lumbago is pain felt across the back as a result of damage or disease to any of the components of the lumbar spine such as the vertebrae, facet joint, ligaments or muscles.
Facet Syndrome occurs when the parts of the vertebrae, the facet joint, which restricts posterior movement, such as leaning backward, become damaged or degenerative from arthritis. This joint is composed of a capsule, ligaments, cartilage, and fat pads that cushion the individual vertebrae. Once damaged, the nerve may be irritated causing back muscle spasm, or the joint may degenerate, restricting movement.
Arthritis is the degenerative process of all bones occurring at the sites of joint movement. Exercise is the best means to combat the effects of arthritis. All forms of modalities are utilized to control the pain from arthritis. Injections with anesthetics, steroids, medications and therapy have all been utilized. The most promising therapy lies in the reversal of the degenerative process by the use of Protein Rich Plasma and Stem cell therapy. Stem cells are available from your own body via your fat or bone marrow, or purchased from Stem Cell banks harvested from the discarded placentas amniotic membranes.
Science has proven the benefits of core and back muscle strength building may be used as an alternative to surgery for herniated discs. Exercise of core muscles, back muscles and gluteus muscle groups have many benefits including endorphin release, testosterone production, pain reduction, improvement in emotions and sleep patterns.