As we age, we sometimes begin to think of back pain as inevitable. It’s at the very least quite common; pain in the lower back, or lumbar region, and pain in the neck, or the cervical region, is highly prevalent.
These areas are prone to strain and sprain due to their weight-bearing function and involvement in moving, twisting, and bending. The area of the spine between the lumbar and the cervical, thoracic region, is much more rigid and less prone to injury.
Typically, spinal pain is caused by sprains and strains of the soft tissues supporting the spine. Strains occur when muscle fibers are abnormally stretched or torn, and sprains occur when the bands of tissue that hold bones together, or ligaments, are unusually stretched. These types of injuries can result in pain and muscle spasms.
However, there are more serious injuries that can result in spinal pain that may require surgical consideration. These types of injuries will usually involve spinal pain that radiates into the arms, legs, or in the rib cage and chest.
Spinal Pain Anatomy
There are three types of muscles that support the spine:
- Extensors (back muscles and gluteal muscles)
- Flexors (Abdominal muscles and iliopsoas muscles)
- Oblique or rotators (side muscles)
There are also a significant number of tendons and ligaments that help bind these muscles to the spine and to the surrounding bone. The spinal cord itself is also home to a plethora of nerves that could be injured or disturbed, potentially causing severe spinal pain.
SPINAL PAIN AND SYMPTOMS
Non-surgical lumbar, cervical, or thoracic pain will usually only affect the spinal area and not radiate into the arms, legs, or chest. Pain that radiates is often a symptom of an underlying nerve issue or some other injury that may require further consideration if non-surgical treatments do not alleviate the symptoms.
General symptoms of back sprains or strains include:
Stiffness in the low back area, restricting range of motion
Inability to maintain normal posture due to stiffness and/or pain
Muscle spasms either with activity or at rest
Pain that persists for a maximum of 10-14 days
Notable loss of motor function such as the ability to tiptoe or heel walk
How is Spinal Pain Diagnosed?
Usually, diagnostic testing will only be necessary if the pain is persistent or has been present for more than two weeks. If the pain radiates into other regions of the body, nerve issues or disc issues also can’t be ruled out. For pain that is persistent or pain that may have a more serious underlying cause, a doctor may order any of the following tests:
This can show details of the bony structures of the body more accurately than any other imaging test. It can also still show soft tissue and nerve tissue.
A Magnetic Resonance Imaging test produces 3D images of the body structures. This can be used to examine the nerves. With the addition of contrast in the test, it can even detect inflammation.
X-rays of the spine can show the structure of the vertebrae and joints. This imaging test can be used to detect underlying causes of spinal pain such as spinal malalignment, tumors, or bone fractures.
Or Nerve Conduction Velocity Testing. This can help localize nerve compression or any other issues related to the nerves.
How is Spinal Pain Treated?
Depending on the underlying cause of your spinal pain, there are nonsurgical and surgical methods of treatment.
Nonsurgical Treatment for Spinal Pain
Sprains, strains, and even some neural compression due to disc herniations can be treated with diminished activity or even a few days bed rest for more serious cases. However, prolonged bed rest can lead to a loss of muscle strength or mobility.
Initial nonsurgical medical treatment will usually be some anti-inflammatory medications for mild to moderate spinal pain, or potentially muscle relaxants or narcotics for more severe spinal pain.
Depending on the severity of the injury, a doctor may also recommend physical therapy. Your doctor and a physical therapist will work together and create a regimen specifically designed to exercise the muscles around the spine and give them their best chance to heal.
Surgical Treatment for Spinal Pain
Surgically significant spinal pain may be caused by:
- A herniated disc caused by a single excessive strain or injury.
- Compression fractures
- Neural pathology
There are multiple surgical procedures that can be used to treat spinal pain resulting from these types of injuries, including:
- Disc arthroplasty. This is the surgical replacement of a diseased or herniated disc with an artificial disc made of plastic and titanium. This procedure can be used to alleviate the pain of a herniated disc.
- Discectomy. This is the removal, either partial or complete, of a diseased or herniated disc.
- Laminectomy. This is the surgical removal of a bony arch, or lamina, that may allow for decompression of a nerve. This can occur with or without the removal of a disc.
- Laminotomy. This is an opening made in a bony arch that will allow the surgeon access to neural elements such as the nerve roots so that pressure can be relieved.
- Platelet Rich Plasma Therapy
- Spinal Cord Stimulator
- Endoscopic Facet Fusion
Spinal Pain Recovery
For simple strains and sprains, 90% of people return to everyday normal activity with some over the counter medications and bed rest. However, frequent back sprains or strains may require lifestyle changes to avoid escalating into a chronic condition.
Post-surgery, the surgeon will be able to give specific instructions as to care and activity level for each individual patient. Sometimes a spinal brace might be necessary for weeks or months, depending on the surgical procedure. Your doctor will be able to tell you when you can return to normal activities such as driving and exercising.
Discomfort when returning to normal activities post-surgery is relatively common, but pain can be a warning sign that you are doing too much too soon. Rushing your recovery can be very dangerous; it may be three months or more before you can fully resume regular activity. However, your recovery may be longer, or shorter; when dealing with the spine, each individual patient is different.
The most critical step on the path to recovery is finding a pain management doctor who can address your pain management needs successfully. The Pain Relief Center and its five specialized institutes are dedicated to meeting any and all of a patient’s needs. Located in the Dallas-Fort Worth area, Dr. Rodriguez and his friendly staff will help you along the path to recovery.
Our new center in Dallas is part of a nationwide development by Pain Relief Centers, geared to providing individualized and comprehensive healing and pain management services with unprecedented levels of compassion, care, and comfort for each patient.