Pain Conditions Treated
Spine Pain & Radiculopathy
Spine Pain & Radiculopathy Treatment West Bridgewater & Norfolk, MA
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Spine Pain & Radiculopathy
Spine pain is the most common benign pain seen in pain clinics. It can happen secondary to multiple factors such as herniated disc disease, spinal stenosis, sacroiliac disease, facet joint disease, and various other conditions. Treatment is usually in the form of medications, injections, physical therapy, and surgery.
There are different classes of medications used for pain. Also there are different techniques and injections that can be performed, some injections include steroids and some do not. If medications, physical therapy, and injections fail, then the patient could be a candidate for surgery or other minimally invasive techniques such as neuromodulation.
Spinal pain in the lumbar region (lower back) and cervical region (neck) are highly prevalent and are often the causes for many lost work days. Lumbar muscle strains and sprains are the most common causes of low back pain. The thoracic spine can also be a site of spinal pain, but because it is much more rigid, the thoracic spinal area is much less frequently injured than the lumbar and cervical spine.
The lumbar and cervical spine are prone to strain because of its weight-bearing function and involvement in moving, twisting and bending. Lumbar muscle strain is caused when muscle fibers are abnormally stretched or torn. Lumbar sprain is caused when ligaments — the tough bands of tissue that hold bones together — are unusually stretched. Both of these can result from a sudden injury or from gradual overuse.
When the lumbar spine is strained or sprained, the soft tissues become inflamed. This inflammation causes pain and may cause muscle spasms. Even though lumbar strain or sprain can be very debilitating, neither usually requires neurosurgical attention.
Spinal pain can be caused by things more severe that might require surgical consideration. These usually involve spinal pain that radiates into arms, legs or around the rib cage from back toward the anterior chest.
Three types of muscles support the spine:
- Extensors (back muscles and gluteal muscles)
- Flexors (abdominal muscles and iliopsoas muscles)
- Oblique or rotators (side muscles)
Non-surgical low back, cervical and thoracic pain usually affects the central or para-spinal soft tissue without radiating into the arms, around the chest or down the legs. On the contrary, pain radiating from the spine into the extremities or chest wall implies structural pinching of the nerves in the spine that might require a surgical opinion if the situation fails to improve within days to weeks with non-surgical symptomatic treatment.
Other symptoms include:
- Stiffness in the low back area, restricting range of motion
- Inability to maintain normal posture due to stiffness and/or pain
- Muscle spasms either with activity or at rest
- Pain that persists for a maximum of 10-14 days
- Notable loss of motor function such as the ability to tiptoe or heel walk.
Lumbar Radiculopathy Causes
Lumbar radiculopathy may occur when the spinal nerve roots are irritated or compressed by one of many conditions, including lumbar disc herniation, spinal stenosis, osteophyte formation, spondylolithesis, foraminal stenosis, or other degenerative disorders.
Lumbar Radiculopathy Diagnoses
Your spine doctor will consider your medical history and symptoms and give you a physical examination, during which the doctor will look for limitations of movement in the spine, problems with balance, as well as any loss of extremity reflexes, muscle weakness, sensory loss, or abnormal reflexes that may suggest spinal cord involvement.
Plain X-ray and an MRI are the typical imaging tests used to evaluate lumbar radiculopathy. However, a CT myelogram may be used when an MRI is contraindicated due to a pacemaker or spinal cord stimulator, etc.
Diagnosis of Lumbar Radiculopathy
A radiculopathy is caused by compression, inflammation and/or injury to a spinal nerve root in the low back. Causes of this type of pain, in the order of prevalence, include:
- Herniated disc with nerve compression – by far the most common cause of radiculopathy
- Foraminal stenosis (narrowing of the hole through which the spinal nerve exits due to bone spurs or arthritis) – more common in elderly adults
- Nerve root injuries
- Scar tissue from previous spinal surgery that is affecting the nerve root