Neck, Back and Spine Pain

Back pain affects 8 out of 10 individuals at some point in their lifetime and is one of the leading causes of job-related disability and missed work.1,2 A survey by the Centers for Disease Control and Prevention reports that nearly 30% of adults have experienced back pain in the prior 3 months.3 Stress on the spine resulting from nerve or muscle irritation or bone lesions can lead to a myriad of painful, and sometimes debilitating, symptoms. Acute neck, back and spine pain, lasting days or weeks, usually results from a trauma, injury or can be due to arthritis or disc disease. Chronic neck, back and spine pain, defined as persistent pain lasting more than 3 months, presents with similar symptoms to acute pain, however it can be severely limiting due to its chronic nature. Symptoms of pain, whether it is due to sports injury, work strain, an accident, or an underlying medical condition, can range from muscle aches or tingling to shooting or stabbing pains in the neck or back, often resulting in limited mobility or range-of-motion. Under some circumstances, people may experience radiating pain, leading to pain in limbs or other parts of the body. Back pain, the number one cause of disability globally, is diverse in nature; each patient can experience a range of severity in his or her symptoms.4 The American Medical Association recommends that patients experiencing back pain for a few days or weeks, or if nerve involvement is suspected, seek medical consultation to perform a medical history and physical exam so that a doctor can make appropriate recommendations for treatment.5  

Sources of Neck, Back and Spinal Pain

  • Radicular Pain (Sciatica) 
    • Disc bulges, degeneration, herniation, and protrusions
    • Spinal Canal Stenosis
    • Foraminal Stenosis or Narrowing 
    • Ligamentum Flavum Hypertrophy
    • Disc Osteophyte Complexes, Osteophytes
    • Epidural Lipomatosis
  • Facet (Zygapophyseal Joint) degeneration, arthrosis, hypertrophy and synovial cysts
  • Pars Defects (Pars Interarticularis Fractures)
  • Discogenic Pain
  • Sponylolysis
  • Spondylolisthesis, Anterolisthesis, Retrolisthesis
  • Spondylosis
  • Schmorl’s Nodes
  • Modic Changes
  • Sacroiliac Joint Dysfunction/Injury
  • Pelvic, Sacral and Coccygeal Fractures
  • Vertebral Burst and Compression Fractures
  • Spinal Cord Injury
  • Myleomalacia
  • Multiple Sclerosis
  • Cluneal Nerve Neuralgia/Entrapment
  • Amyotrophic lateral sclerosis (ALS)
  • Autoimmune or Inflammatory Spondyloarthopathy (Spondyloarthritis)
    • Ankylosing Spondylitis
    • Psoriatic Arthritis
    • Rheumatoid Arthritis

Treating Your Pain Starts with a Proper Diagnosis

Dr. Urban, a physician anesthesiologist and fellowship trained interventional pain specialist will start by reviewing your pain symptoms and medical history.  He will LISTEN to YOU about your pain and complete a comprehensive hands-on physical examination to help locate the origin of your pain. Frequently he tells patients that there may be three sources which could cause similar type pain in the neck, back and spine and sometimes more than one may be the cause.  Diagnostic tests such as an X-ray, CT scan or MRI may be needed to confirm the cause of your pain.  Past treatments with success or failure will be taken into consideration.

Treatment Recommendations May Include:

  • Facet Injections with cyst aspiration/rupture
  • Provocation Discography (Discogram)
  • Neuromodulation (Spinal Cord Stimulator)
    • Dorsal Column Stimulation
    • Percutaneous Trial
    • Permanent Percutaneous Implantation
    • Rechargeable and Non-rechargeable
      Implanted Pulse Generator (IPG)
Contact URBAN PAIN INSTITUTE for help, a neck, back and spine specialist in Alaska!

References:

1 Medline Plus. Back Pain. http://www.nlm.nih.gov/medlineplus/backpain.html. Accessed July 22, 2014
2 National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed July 21, 2014
3 Centers for Disease Control and Prevention. Health, United States, 2012. http://www.cdc.gov/nchs/hus/contents2012.htm#047. Accessed July 21, 2014
4 Buchbinder, R. et al. Placing the global burden of low back pain in context. Best Practice & Research Clinical Rheumatology 27, 575589 (2013).
5 Goodman, D. M., Burke, A. E. & Livingston, E. H. JAMA patient page. Low back pain. JAMA : the journal of the American Medical Association 309, 1738 (2013).