Back Pain has many causes. Many of our patients suffer from pain located in the upper or lower back, between the shoulders, hips or even running down the back of the legs. No matter where it’s located, we want to help treat it. Isn’t it time you were out of pain?
The Office of Sean Gray offers a comprehensive approach to finding the cause or causes of your back pain. You get to discuss with our doctors all of the symptoms you are experiencing, the frequency, the pain level, and we design a treatment plan just for you.
The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. You will find many causes for chronic and acute neck and back pain listed below. Some of them include:
Symptoms - The first symptom of a compression fracture may be sudden and severe back pain that remains in one local area. Some persons may experience numbness/tingling, or weakness in the arms or legs if the spinal cord or nerves leading away from the fracture have been compressed. If multiple fractures occur in an area of the back, the person will develop a forward hump-like curvature to the back.
Causes - There are many possible causes of compression fractures. Car accidents, falls, and weakening of the bone due to pathology (i.e. cancer), or Osteoporosis are common.
Diagnosis - The diagnosis is based on observation of the aforementioned symptoms and x-rays of the spine. Additional tests (i.e. bone scan, blood tests) may be needed to diagnose the actual cause of the compression fracture.
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If you have severe back pain, it is natural to wonder whether or not the pain might be a sign of cancer. Tumors in the spinal column may cause pain from expansion of the bone or from weakening the bone, which in turn can result in spinal fractures, compression (pinching) of the nerves, or spinal instability.
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Discitis, or disc space infection, is an inflammatory lesion of the intervertebral disc that occurs in adults but more commonly in children. Its cause has been the subject of debate, although most authors believe it to be infectious. The infection probably begins in one of the continguous end plates, and the disc is infected secondarily. Severe back pain that begins insidiously is characteristic of the disease.
Discitis in Children
Although most children will continue to walk in spite of the pain, young children may refuse to ambulate. The characteristic finding is extension of the spine and the child's complete refusal to flex the spine. Children with discitis usually are not systemically ill. They rarely have an elevated temperature and their white blood cell count is frequently normal. However the erythrocyte sedimentation rate is usually increased. Lateral radiographs of the spine usually will reveal disc space narrowing with erosion of the vertebral end plates of the contiguous vertebrae. bone scanning may be helpful in localizing a lesion that is difficult to diagnose clinically. Some bone scans are falsely negative, so the diagnosis of disc space infection should not be excluded simply because the bone scan is normal. Magnetic resonance imaging (MRI) seems to be helpful in identifying a disc space infection.
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What is going on in the body?
The normal spine rounds slightly in the chest area, with arching in the lower back and neck regions. Excessive kyphosis can occur mainly in the chest area of the spine, causing the roundness of the back to appear exaggerated.
What are the signs and symptoms of the condition?
Symptoms are usually minimal, unless the deformity is severe. In that case, the back may ache or, rarely, nerve problems may arise. The hamstrings, or muscles at the back of the thigh, may also be tight.
What are the causes and risks of the condition?
Kyphosis is generally caused by an abnormal posture. Other possible causes include: · a significant fracture of the vertebra, which can cause the back to angle forward · spinal surgery · Scheuermann's disease, which results in wedging of the vertebrae. This disease is usually seen in teenage boys, and its cause is unknown. Pott's disease, which refers to kyphosis due to collapse of the vertebra when tuberculosis infects the spine · osteoporosis in elderly women, which causes a type of kyphosis known as dowager's hump · spinal tumors, or surgery to remove them · nerve disorders
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Lordosis is a disorder defined by an excessive inward curve of the spine. It differs from the spine's normal curves at the cervical, thoracic, and lumbar regions, which are, to a degree, either kyphotic or lordotic. The spine's natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.
Lordosis can be found in all age groups. It primarily affects the lumbar spine, but does occur in the neck (cervical). When found in the lumbar spine, the patient may appear swayback, the buttocks more prominent, and in general an exaggerated posture. A lumbar lordosis can be painful sometimes affecting movement.
Certain disease processes can adversely affect the structural integrity of the spine and contribute to lordosis. Some common causes include achondroplasia, discitis, kyphosis, obesity, osteoporosis, and spondylolisthesis.
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Ligaments run up and down the spinal column. Hypertrophy of the ligaments in the vertebral canal (the posterior longitudinal ligament -- runs up and down along the back side of the vertebral bodies, and the ligamentum flavum -- runs up and down under the posterior bone ring made up of the lamina and spinous process) can increase their mass enough that they narrow the canal (stenosis) sometimes to the point that the spinal cord and/or nerve roots running through the canal are compressed. When the posterior longitudinal ligament in front and ligamentum flavum behind the spinal cord hypertrophy the cord is almost "circumferentially" surrounded and compressed).
According to the American Obesity Association (AOA) 64.5 percent of adult Americans (about 127 million) are categorized as being overweight or obese (1). The unfortunate truth is that obesity is becoming a global epidemic affecting adults and children.
Connection to Back Pain
Most people know that obesity contributes to the development of coronary heart disease, diabetes, high blood pressure, and colon cancer. However, did you know that obesity is a contributing factor to back pain? It is true. Being overweight or obese can significantly contribute to symptoms associated with osteoporosis, osteoarthritis (OA), rheumatoid arthritis (RA), degenerative disc disease (DDD), spinal stenosis, and spondylolisthesis.
The spine is designed to carry the body's weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to assimilate the burden, which may lead to structural compromise and damage (e.g. injury, sciatica).
One region of the spine that is most vulnerable to the effects of obesity is the low back; the lumbar spine. Lack of exercise and bodily conditioning leads to poor flexibility and weak muscles in the back, pelvis, and thighs. This can increase the curve of the lower back causing the pelvis to tilt too far forward. Further, this is detrimental to proper posture and as posture weakens, other regions of the spine (neck) may become painful.
You may try to dismiss the cause of some of these spinal disorders to the process of normal aging. It is true that with age body tissues can cause changes to spinal anatomy (2). However, if you are overweight or obese, chances are you have, or will have, back pain.
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Trauma to the spine refers to injury that has occurred to bony elements, soft tissues and/or neurological structures. The two things that surgeons are most concerned about, in the case of spinal trauma, are instability of the vertebral column and actual or potential neurological injury.
Stability to the spinal column can be compromised when bony elements are injured or there is disruption to soft tissues such as ligaments. Instability causes the back to become unable to successfully carry normal loads, which can lead to permanent deformity, severe pain and in some cases catastrophic neurological injuries. Most often the instability comes from a fracture in one of the bony parts of the vertebra, specifically the vertebral body, the lamina or the pedicles.
In the case of trauma, dislocations and fractures happen simultaneously and can result in a very unstable spinal column. They can occur in any region of the spine and are associated with a degree of neurological injury. A surgeon needs to restore the mechanical stability of the spine to try and prevent more neurologic injury, progressive deformity or prolonged incapacitation pain.
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Back pain in pregnancy
Introduction to back pain during pregnancy
For pregnant women, back pain during pregnancy is not a trivial matter. If not addressed, it can have a negative impact on your daily lifestyle, cause missed time from work, and make your delivery more difficult. Back pain in the course of your pregnancy can also create problems that will continue for an extended period after delivery.
Addressing back pain during pregnancy
While it is fairly common, back pain during pregnancy should definitely not be accepted as just part of the process. To help make your pregnancy as pleasant as possible and facilitate an easier delivery, back pain should be always be addressed as quickly as possible and managed throughout your pregnancy.
Low back pain of long duration (several weeks or months) during pregnancy is a predictor for post partum back pain (pain after birth). For this reason, pregnant women are encouraged to seek appropriate treatment for back pain during pregnancy.
lumbar radiculopathy, which refers to pain in the lower extremities in a dermatomal pattern. A dermatome is a specific area in the lower extremity innervated by a specific lumbar nerve. This pain is caused by compression of the roots of the spinal nerves in the lumbar region of the spine. Diagnosing leg and back pain begins with a detailed patient history and examination.
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Scoliosis is defined as a side-to-side deviation from the normal frontal axis of the body. Although traditional, this definition is limited since the deformity occurs in varying degrees in all three planes: back-front; side-to-side; top-to-bottom. Scoliosis is a descriptive term and not a diagnosis. As such, a search is made for the cause. In more than 80% of the cases, a specific cause is not found and such cases are termed idiopathic, i.e., of undetermined cause. This is particularly so among the type of scoliosis seen in adolescent girls. Conditions known to cause spinal deformity are congenital spinal column abnormalities, neurological disorders, genetic conditions and a multitude of other causes. Scoliosis does not come from carrying heavy things, athletic involvement, sleeping/standing postures, or minor lower limb length inequality.
In managing AIS, the judgment of the surgeon and the participation of informed patients and families are as important in determining treatment outcome as surgical techniques. Decision-making in the management of AIS remains complex despite the availability of data on natural history, prognosis of different curve patterns, brace treatment factors, and surgical innovations.
The management of AIS includes several steps and treatment options:
· screening and early detection of deformity,
· observation of changes in deformity over time with informed judgment regarding prognosis, orthotic and non-operative interventions,
· surgical planning and operating.
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This is a condition which causes pain down the back of one or both thighs. Inflammation of the sciatic nerve (which is the largest nerve in the body-about the diameter of your little finger) can be either constant or intermittent. Success in solving this problem is directly correlated to the diagnosis. Sciatica can be caused by a pinched nerve as it exits the low back spine or it can be caused by prostatic cancer. Odds are usually that the cause is some structural imbalance, but there are so many potential causes, some serious and some benign, it is better to at least know that there may be a grave cause to the symptoms.
This doesn't mean that you shouldn't immediately incorporate a strategy to eliminate any structural imbalances. In most cases, this will resolve the problem. If the problem doesn't respond to these basic efforts, then professional assistance may be needed. The first effort in relieving sciatic symptoms should be to review Hip Pain.
Trigger points can accumulate in the piriformis muscle forcing a contraction and strangulation of the sciatic nerve. The tennis ball exercise should be incorporated to help to relax the piriformis muscle. Stretching may be beneficial, but that is more of a "try an see" exercise.
If there are no improvements with this approach, refer to Low Back Pain to better understand the relationship between the sciatic nerve and the low back spine. Seeking help from a chiropractor or orthopedist may be indicated if the solution can't be found at home.
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