The spine is a complex structure composed of bones, muscles, ligaments, tendons, joints, discs and nerves, all working together to provide both structural support and mobility. Some of the spine conditions we treat include:
- Facet Syndrome is back or neck pain that comes from the facet joints of the spine. The facets are small joints found on both sides in the back part of the spine. A small capsule surrounds each facet joint, holding the bones together and providing lubrication for the joint. The facets help control movement in the spine.
- Osteoporosis develops when there is a decrease in bone mineral density. It results in decreased mechanical strength and increased likelihood of structural failure. Osteoporosis is the most common skeletal disease associated with aging.
- Radiculopathy refers to any disease of the nerve root. Radiculitis is when the nerve root becomes inflamed. The resulting pain is sometimes called radicular pain. An inflamed nerve root can result from a herniated disc.
- Sacroiliac Joint Dysfunction (SI) is when there is a dysfunction of the joint where the ilium and sacrum join. These joints are on the lower back where you can see two small dimples at the belt line. The SI joint is one of the largest and most stable joints in the body. Very little motion occurs in the SI joint, and the motion that does occur is a combination of sliding, tilting and rotation. SI joint dysfunction can cause pain when walking, standing or running.
Wellness & Prevention
Because spine conditions can develop from such a wide range of causes and factors, there is no known way to fully prevent them from occurring. The best way to take care of your spine health is by practicing good posture, strengthening your back muscles to increase spinal support and lifting with the legs rather than the back. Exercises such as tai chi, yoga, walking and water aerobics can help strengthen your muscles and develop flexibility. This can minimize your risk of falling and experiencing a bone fracture.
It’s also important to get avoid tobacco, excess alcohol consumption and overexerting your body, especially for women. Extreme female athletes sometimes stop menstruating and develop thin bones. To maintain optimum bone density, you can take calcium supplements and get plenty of vitamin D, either from brief daily sun exposure or from certain foods.
There is no single test to diagnose all spine conditions. The diagnostic approach your doctor uses depends on your symptoms and medical background.
Facet syndrome is usually diagnosed through an examination. You may experience pain over a fairly small area on one or both sides of the spine. Sometimes, people experience an ache in the leg or arm, but the pain usually doesn’t follow a specific nerve path. Those with lumbar facet syndrome typically have pain that worsens with standing, bending backward and twisting. Cervical facet pain usually increases when a person looks up while turning his or her head and neck. A facet joint can hurt without evidence of structural damage on imaging studies such as X-rays, MRI scans or CT scans. Doctors may inject a local anesthetic into the facet joints or nerves to see if there is any pain relief. This can help determine whether the facets are the cause of pain.
Osteoporosis is often diagnosed after weak bones have caused a fracture. X-rays may be used to view a bone fracture, but they cannot determine bone density. A DEXA scan measures your bone mineral density to see if you may have osteoporosis. Osteoporosis is defined as bone density below a score of -2.5.
Radiculopathy can be diagnosed with a combination of a physical exam and imaging tests. During a physical exam, the doctor will attempt to locate the source of pain. He or she will also check for any abnormalities in muscle strength, sensation and reflexes. Depending on the results of the physical exam, the doctor may use X-rays, CT scans, MRI scans or EMG studies to determine any damage or inflammation to the nerve root.
SI is difficult to diagnose because structural tests, such as X-rays or MRI scans, cannot determine whether the sacroiliac joint is functioning properly. SI pain can be caused by infection or inflammation. Additionally, the nerves that go into the SI joints come from many areas of the lumbar spine and sacrum. This means there are many possible conditions that can contribute to SI pain. A physical exam or injections of local anesthetic can be used to determine the source of pain.
Treatment for spine conditions depends on the exact condition and any other treatment plans currently in place.
Facet joint syndrome is normally treated without surgery. Treatment may involve joint mobilization and/or manipulation, stretching and strengthening exercises and education on proper spine posture. Anti-inflammatory medications and facet joint injections with cortisone can also help.
Osteoporosis can be managed with medications that slow the breakdown of bones. Women with a deficiency of estrogen may undergo hormone replacement therapy. Doctors may also suggest diet and nutrition programs to increase calcium intake. However, there is no treatment to reverse osteoporosis.
Radiculopathy is normally treated with nonsurgical approaches. Physical therapy, medications and select spinal injections may be used to alleviate symptoms. Most people respond well to radiculopathy treatment and symptoms are typically improved after six weeks to three months.
SI joint pain is treated with a variety of physical rehabilitation procedures. This may include individualized stretching and strengthening exercises, mobilization and manipulation. Special belts may be used for those with laxity of the ligaments, such as in pregnancy. Injections can be used for difficult cases.
Some spine conditions may go away after treatment, while others, like osteoporosis, must be continually managed. Take care of your spine by maintaining proper posture, eating a calcium-rich diet and practicing safe lifting.
Based on the treatment your doctor uses to manage your spine condition, you will be provided with detailed aftercare instructions.