This is often referred to as a slipped, ruptured, or torn disc. It’s the type of injury that occurs when you lift a heavy object — and is a common source of pain in the neck, lower back, arms, or legs. The discs in the spinal column each have a hard outer shell and a gel-like inner core. The discs become weak from improper lifting, the stress of obesity, repeated strenuous activities, and other injuries.
When there is trauma to the disc, the disc herniates (ruptures). This means that the disc’s core pushes through its outer edge — putting pressure on the spinal canal and on spinal nerves. If the disc is in the lower back, the result is pain, tingling, numbness, or weakness in one leg. If the disc is close to the neck, the result is pain in muscles between the neck and shoulders, pain and tingling in the arm, headaches, and other symptoms.
Epidural injections can help lessen the nerve irritation and help patients get better results from physical therapy. These injections may be given in a series over several weeks.
An injury near the root of a nerve can cause pain in a different distant site. A herniated neck disc, for example, can create pain and loss of sensation in the shoulder, arm, or hand — because that is the nerve pathway from the neck discs. This same process can occur at any point on the spinal column — as damaged discs put pressure on nerves, they trigger a chain-reaction along those nerves that results in pain in arms, hands, legs, feet. This condition is called radiculopathy. It is treated with a nerve block, which involves an injection of total anesthetic and/or steroids around the nerve root.
When degeneration occurs in one of the vertebral joints or bones in the spine, the condition is called spondylosis. This degeneration usually occurs in the lower back, and is caused by trauma to the back — over-extending or twisting back muscles. They also can result from osteoporosis, when bones become brittle with age — or from arthritis. In all these conditions, back pain is triggered by arthritis in the joints, pinched nerves in the spinal column, and/or by muscle disturbances in the back.
In treating spondylosis, we start with facet injections to determine which joints are involved. We then perform radiofrequency ablation to reduce the nerves’ conductivity surrounding those joints — which stops the pain cycle. Since spondylosis or “back arthritis” is not curable, these procedures help to control the pain and reduce the medication needed for daily functioning.
Vertebral Fractures & Osteoporosis
With age, bones can gradually weaken and become brittle — called osteoporosis. If not treated, osteoporosis can progress painlessly until a bone breaks. These breaks can occur in the hip and wrist. They can also occur in the spine — when the bones in the spinal column weaken and collapse (called a compression fracture). Compression fractures can be extremely painful, and lead to deformity and loss of height.
Until recently, doctors were limited in treatments for these osteoporosis-related spine fractures. Today, physicians have much more to offer. Two procedures — vertebroplasty and kyphoplasty — can be used to both prevent and treat compression fractures. These procedures are very successful in stabilizing bone, relieving back pain, restoring height, and reducing deformity.