Pain Procedures & Conditions
Common Conditions Described
Disc degeneration or degenerative disc disease refers to the changes in the spinal discs resulting from chronic wear and tear, injury, or simply aging. These changes include loss of fluid in the discs (a condition called disc desiccation), tears of the disc annulus (the outer layer of the disc), and growth of nerve fibers in the damaged discs.
Spinal disc degeneration is most common in the lower back (lumbar region of the spine) and the neck (cervical region of the spine), but it can happen anywhere in the spine.
Disc tear, or torn disc, generally refers to a tearing of the discs annular tissue, the outer layer of the spinal disc. Disc tear is typically caused by a combination of disc degeneration and trauma. The central disc material (nucleus) often moves into the torn area of the outer layer of the disc, forming an interpositional disc herniation.
Facet Joint Disease
Facet syndrome or facet disease, is a condition that affects the facet joints as they degenerate from years of wear and tear. They are part of the connection between two adjacent vertebras. Because they are almost constantly in motion, they simply degenerate from wear and tear over time as we age. This is why facet disease is more commonly found in the elderly.
Neural foraminal stenosis is when the discs in the spine begin to degenerate and make the foramen narrower. A narrow foramen puts pressure on the nerve and causes pain. This can also happen when the disc herniates and causes the foramen to narrow.
The bones that form the spine in your back are cushioned by small, discs. When the discs are healthy, they act as shock absorbers and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc. It can happen in any part of your spine. But usually herniated discs affect the lower back. Some happen in the neck and in the upper back.
Compressed (Pinched) Nerve
This injury could result from compression, constriction, or stretching. Symptoms include numbness, “pins and needles” or burning sensations, and pain radiating outward from the injured area. Compressed nerves can sometimes lead to other conditions such as peripheral neuropathy, carpal tunnel syndrome, and tennis elbow. The extent of such injuries could vary from minor, temporary damage to a more permanent condition.
Radicular pain, or radiculitis, is pain “radiated” along the dermatome of a nerve due to inflammation or other irritation of the nerve root at its connection to the spinal column. A common form of radiculitis is sciatica – pain that radiates along the sciatic nerve from the lower spine to the lower back, gluteal muscles, back of the upper thigh, calf, and foot as often secondary to nerve root irritation from a spinal disc herniation or from osteophytes in the lumbar region of the spine.
Radiculopathy is a description of a problem in which one or more nerves are affected and do not work properly. The emphasis is on the nerve root. This can result in pain , weakness, numbness, or difficulty controlling specific muscles. In a radiculopathy, the problem is at or near the root of the nerve, along the spine. The pain or other symptoms could manifest in an extremity through referred pain.
Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of another medical problem, not a medical condition on its own. Sciatica occurs when there is pressure or damage to the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg, and the sole of the foot.
Spinal Bone Spurs
Cervical, thoracic, or lumbar, bone spurs can occur anywhere along your spine and cause a number of painful problems. These excess bone growths can form due to a number of reasons, including aging, arthritis, disc degeneration, traumatic injury, poor posture, overuse, or other factors. Bone spurs can cause serious side effects if they grow to the point where they impinge on a nerve or another bone.
Spinal stenosis is narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings (called neural foramina) where spinal nerves leave the spinal column. It usually occurs as a person ages and the disks become drier and start to shrink. At the same time, the bones and ligaments of the spine swell or grow larger due to arthritis or long-term swelling (inflammation).
Spinal stenosis may also be caused by arthritis of the spine, bone diseases, defect or growth in the spine that was present from birth, herniated or slipped disk, injury that causes pressure on the nerve roots or the spinal cord, tumors in the spine. Symptoms include, numbness, cramping, or pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms, weakness of part of a leg or arm and are more likely to be present or get worse when you stand or walk. Most people with spinal stenosis cannot walk for a long period of time.
Spondylolisthesis is a condition in which a bone (vertebra) in the lower part of the spine slips out of the proper position onto the bone below it. In children, spondylolisthesis usually occurs between the fifth bone in the lower back and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine or sudden injury. In adults, the most common cause is degenerative disease. The slip usually occurs between the fourth and fifth lumbar vertebrae. Other causes of spondylolisthesis include bone diseases, traumatic fractures, and stress fractures.