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3 Conditions Affecting Neck Pain, Back Pain and Sciatica and Their Treatment
There are many causes of neck, back, and sciatica or sciatic pain in adults and children. We discussed back strains and back sprains in a previous article and now we will discuss more serious conditions and their symptoms. The conditions are herniated intervertebral discs (IVD), cervical radiculopathy and spondylolithesis, sometimes accompanied by spondylolysis. The spine itself is made up of 33 bones called vertebrae and stretches from the skull to the pelvis. The cervical or cervical vertebrae are made up of seven bones, the atlas articulating (in contact) with the skull, the thoracic vertebrae cover the region from the seventh cervical vertebra to the first lumbar vertebra, the lumbar vertebrae are made up of five large, in rare cases six, stout vertebrae at the base of the spine. The sacrum, often referred to as the coccyx, sits at the base of the spine, along with the coccyx (the true coccyx); and, is also part of the pelvis, joining the two halves at the sacroiliac joints. We will discuss sacroiliac degradation and associated symptoms in a future article. Between each pair of vertebrae there is a disc and an intervertebral disc or IVD, made up of cartilage and a jelly-like center, much like a jelly doughnut. The IVD acts as a shock absorber not only for the spine but for the whole body. When something happens to that support system, that shock absorber, neck pain, back pain, and even sciatic nerve pain, sciatica, usually ensues.
As stated above, and in a previous article, there are many causes of neck pain, back pain, and sciatica. We have already covered back pain and sciatica as a result of back strains and sprains, now we will discuss the symptoms of herniated discs (DIV), cervical radiculopathy and spondylolisthesis. The region of the spine affected by trauma and/or herniated disc will usually dictate the type of symptoms the person with neck and back pain will experience. If the cause of the pain is centered in the cervical region, we often experience what is commonly referred to as “pain in the neck”. Neck pain can also affect the shoulder and arm, even in the hand with pain, tingling and numbness. Symptoms in the chest area are usually more difficult to identify. Symptoms in this area can manifest as stiffness, chest pain, back pain radiating laterally, and/or even the feeling that your back must be “cracked”. In the lumbar region, usually the area most affected by herniated discs and spondylolisthesis (the most common L5 of all), back pain can either be localized in the lower back, often radiating through the iliac crest or hip , or manifest as pain. on the buttocks, radiating to one or both legs. This is usually due to pressure on the nerve roots, for a variety of reasons, including ruptured discs, bulging discs, stenosis (narrowing of nerve channels), and is called sciatic nerve pain or sciatica.
In the cervical region, cervical radiculopathy is one of the main causes of neck pain. The condition can be caused by anything from a ruptured disc to normal degenerative changes in discs as we age. Progressive age deterioration is a consequence of aging, especially with respect to the secondary curvatures of the spine, cervical and lumbar regions (discussed in a previous article). Again, the main symptom is pain that radiates from the neck to the shoulders and arms, even affecting the chest in some people. It’s not uncommon to experience numbness and even a tingling sensation in your hands and fingers, something like your hand falling asleep. Treatments for cervical radiculopathy may include anti-inflammatories (such as ibuprofen), corticosteroid injections, ice, and physical therapy. Because the cervical region is so vital, not only in terms of movement but also for regulating basic bodily functions, it is important to be seen by a doctor if pain persists for more than 24 to 48 hours. The only way to diagnose this condition is through X-rays, MRIs, and/or CT scans. Delaying medical treatment can lead to significant and permanent damage.
Spondylolisthesis can be caused by many factors and usually affects the lumbar region. The most affected vertebrae are L4 and L5, at the base of the spine, but other regions of the spine can also be affected. Some of the clauses of spondylolisthesis are trauma, usually either a stress fracture or an impact due to a sports injury in adolescents and sometimes adults. Also, the vertebral body can break down as a result of infection or disease. Spondylolisthesis can coexist or be expressed with a condition known as spondylolysis, a spinal defect predisposing to spondylolisthesis. Spondylolysis is a malformation or birth defect causing separation of the facet joints, the true facet joints (surfaces) between the vertebrae causing the vertebral body itself to slide forward. This condition can lead to incredible back pain, sciatica, tingling, numbness and even loss of function. Treatments for spondylolisthesis may include reduction in activity, especially contact sports and physical labor, artificial supports such as braces, usually discouraged if possible due to atrophy and further weakening of muscles muscles, exercising the core muscle group and even the back. surgery, known as surgical fusion, when all other measures fail. As previously stated in a previous article, a spinal fusion is like opening Pandora’s box and should be avoided if possible!
While surgery was the first response to severe neck pain, back pain and sciatica for many patients with cervical radiculopathy and spondylolisthesis, especially when expressed with spondylolysis, more conservative treatment is now generally exhausted before surgery is indicated. A treatment program consisting of anti-inflammatory medications, ice compression braces and exercises to strengthen the core muscles, primarily the abdominal muscles, obliques, spinal erectors and even some of the larger muscles that originate or insert into the lower back. It is extremely important to listen to your body, read the symptoms and act in a timely manner when the pain lasts for more than 48-72 hours with no sign of relief. There are, as noted above, many causes of neck pain, back pain, and sciatica. In children and adolescents, back pain is usually an indication of a more serious problem, medical supervision should be instituted immediately. In adults, there are a myriad of conditions that can express themselves as pain in this area. A program, as defined above, is the best first step in treating the symptoms of neck pain, back pain and sciatica; anti-inflammatories, ice, exercise, proper shoes, cushions and support for the feet (orthotics) and even alternative medicine (like acupuncture), which we will discuss in a later article.
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