Back & Neck Pain
What are the common causes of back and neck pain?
Chronic back and neck pain is most often due to changes in the spine, usually involving one or more of the spinal discs. Chronic back or neck pain is different from acute pain, say from lifting an item awkwardly and straining a back muscle or from sleeping wrong on your neck. This type of pain will usually resolve in a few days up to a few weeks. Chronic pain won’t go away without treatment. At Dr. Elborno of Elbrono Center in Willowbrook, IL specializes in treating back and neck pain.
Chronic pain most often occurs in the cervical spine, the seven vertebrae that make up the neck; or the lumbar spine, the five vertebrae that make up the lower back. Here are the main causes of chronic neck or lower back pain:
- Disc herniation — When a disc herniates, the soft, inner gel that gives the discs their cushioning properties pushes outward, through a crack or tear in the outer membrane. This herniation presses on a nerve root or the spinal cord, causing pain in the area and often radiating down into the area the nerve services.
- Degenerative disc disease — Over the decades, our spinal discs take a beating. This wear and tear is known as degenerative disc disease and it causes the discs to thin and provide less protection to the vertebrae and surrounding nerve roots. This leads to periods of low-level, chronic back pain.
- Osteoarthritis — This is known as “wear and tear” arthritis. It affects the facet joints of the spin, and allows excess friction when twisting or bending. This leads to the development of bone spurs, which then compress a nearby nerve root, leading to pain.
- Spondylolisthesis — This occurs when one vertebra slips forward over the vertebra below it. This strains the disc and joints at that spinal segment, leading to low back pain and weakness.
- Spinal stenosis — The spinal canal, which holds the spinal cord, can narrow due to a disc herniation or bone spurs. As it narrows, this leads to compression of the spinal cord or the nerve roots. This is stenosis, and it can often only be corrected with surgery to either remove part of the lamina or otherwise create more space in the spinal canal.
What are the common causes of a herniated disc?
Our spinal discs can be thought of as akin to a jelly donut — a soft gel-like center is enclosed by an outer membrane. When a disc herniates, the inner soft material, clinically known as the nucleus, pushes through a crack or tear in the outer membrane, the annulus.
Most people can’t pinpoint when a disc herniates. The discs gradually degenerate over time due to wear and tear. As we age, the discs also lose much of their water. This makes them less flexible and more prone to tearing or rupturing with even minor strains or twists.
If you’re overweight, this places more load on your discs in the lower back, making them more likely to herniate. Also, physically demanding jobs that require repetitive lifting, pulling, pushing, bending sideways, and twisting increase your risk.
How is the pain from a herniated disc treated?
Dr. Elborno has myriad options for treating the pain caused by a herniated disc. Conservative treatments, even things such as posture changes, often will relieve the pain in many patients. Exercise and physical therapy can strengthen corresponding muscles, helping to lessen the pressure on the nerve roots. Here are a few other possible treatments:
- Medications — Pain medications can be effective, but some have the risk of addiction.
- Corticosteriod injections — Inflammation-suppressing corticosteroids can be injected directly into the area around the spinal nerves. Dr. Elborno uses imaging to guide the needle to the appropriate location.
- Nerve root blocks — This is a steroid injection specifically into the area where the nerve root exits the spinal column.
- Kyphoplasty — In this procedure, an injured or collapsed vertebra is injected with special cement to restore height to the vertebra and to relieve nerve compression.
- Surgery — In a small number of people, conservative treatments don’t relieve the pain and surgery is required. This is usually only the treatment route if the patient is experiencing numbness of weakness in the area serviced by the compressed nerve, difficulty walking or standing, or loss of bladder or bowel control. In these procedures it is often possible to remove just the protruding portion of the disc, relieving pressure on the nerve. In other cases, the entire disc needs to be removed and the two vertebrae will usually be fused together.