Signs & Symptoms

Low Back Pain
Neck Pain

Low Back Pain: Low back pain is one of the most common causes of disability in the United States and can, again, result from a very large variety of causes. Most cases of low back pain are degenerative in nature and related to either disc degeneration or arthritic change. As disc material between vertebrae ages, it becomes dried out or dessicated. This lack of effective cushioning leaves vertebrae vulnerable to injury. Bone may grow along the edges of the vertebrae to stabilize the vertebrae. This bony overgrowth may cause stiffness and loss of flexibility, but more importantly, may cause narrowing of the spinal canal (spinal stenosis) or its openings that allow nerves to pass out of the canal (foraminal stenosis). The dessicated disc material may also bulge through its outermost fibrous covering and extend into the spinal canal. This disc material can be extremely irritating to spinal nerves as they pass through and leave the spinal canal. These changes may all result in pain that is localized to the low back and/or may extend into and shoot through the buttocks, thighs and calves.

Low back pain may also result from arthritic change involving the bony facet joints. These facet joints can be affected by rheumatoid arthritis or osteoarthritis, just like any larger joint in the body. This degenerative change may, again, greatly impact mobility while the resultant inflammation greatly irritates the nerves that supply these joint spaces, as in any similar arthritic joint.

Neck Pain: Almost all individuals will experience some neck pain at some point in their lives. Most episodes of neck pain will be mild and not particularly limiting and are likely to resolve with rest. However, if pain persists for more than a week or two, or is severely limiting to everyday activities, further evaluation may be needed. Neck pain may vary and may involve sharp or dull pain, may be associated with stiffness or inability to rotate the neck, and may present as pain shooting to the shoulders, arms or hands, perhaps even without perceived pain in the neck region itself.

Neck pain may occur secondary to many factors. Muscle strain from poor positioning or posture or, perhaps, athletic injury may give a sensation of pain. The joints between vertebrae in the neck may experience arthritic change just as any other joint in the body, limiting range of motion and causing stiffness. Disc disease occurs commonly with aging as the gelatinous disc material between vertebrae becomes dry and brittle, possibly limiting flexibility. This weakened disc material may push or protrude into the spinal canal in the neck and push on or irritate nerves or the spinal cord itself, resulting in sharp pain or altered sensations in the arms or legs (radiculopathy). More acute trauma, as in a car accident, may severely damage vertebrae, discs, or the surrounding muscles and ligaments and result in rapid onset of these same symptoms.

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