The Spine
The spine is one of the most supportive but complex structures in the human body. It is composed of many bones, discs, and ligaments that support the weight of the body and allow for movement and posture. Due to the fundamental nature of the spine, it is one of the most frequently injured joints and can easily impact activities of daily living.
If you’re experiencing spinal pain, call the office in San Francisco or book an appointment online to get started.
Spine Anatomy
The spine consists of 24 bones, also known as vertebrae, that are separated into the cervical, thoracic, and lumbar spine. Each of these vertebrae are separated by an intervertebral disc that protects the bones from rubbing against each other and aids in shock absorption. Around each of these structures there’s a complex set of ligaments and joints that provide structure.
The cervical spine, also known as the neck, has 7 vertebrae (C1-C7). After the cervical spine are the 12 thoracic vertebrae (T1-T12) that comprise the mid-back. Finally, the low back, or lumbar spine has 5 vertebrae (L1-L5) followed by the sacrum and coccyx, also known as the tailbone. A healthy functioning spine typically has a S-shaped curve to allow for proper range of motion of the back.
What causes spinal pain?
Neck and back pain are some of the most commonly treated conditions in orthopedics. They vary from simple muscular pain that can come from a muscle spasm, exercise, poor posture, or stress to more complex issues such as fractures of the vertebra or a herniated disc. These can present as localized neck and back pain or radiating pain down the arm or leg.
Common Conditions
+ Muscle Strain or Spasm
Neck and back pain are quite commonly due to a muscular cause, especially in a younger population. Muscular pain can be caused by a muscle spasm or strain that results in acute stiffness or pain in the neck or back. Additionally, poor posture (especially in a work setting), repetitive use, and stress can be causes of chronic neck or back pain. These are diagnosed with a physical examination by a provider. There are various treatments including physical therapy (to work on posture and muscular strengthening), ergonomic work setups, and stress reduction techniques. Medications such as anti-inflammatories and muscle relaxants are also commonly used.
+ Degenerative Disc Disease (Cervical and Lumbar Disc Herniations)
The intervertebral discs (cartilaginous discs between the vertebrae) can bulge out or herniate, causing a significant amount of back pain. This is typically due to a combination of osteoarthritis in the spine (degenerative disc disease) and repetitive torsional stress put on the spine. This can cause local pain in the neck or back, but also frequently causes pain that radiates down the arm or legs (sciatica). Most patients will improve with non-surgical treatment including rest, anti-inflammatories, and physical therapy exercises such as those that work on strengthening the back, neck, and core. X-rays and MRIs can be done to confirm the diagnosis but in many cases are not necessary. For more severe cases that are not improving with conservative treatment a steroid injection can be done in the area or a referral can be sent to spine surgery for surgical management.
Disc herniations can vary between mild herniations that can be treated conservatively to cases that need immediate surgical management. We recommend seeking advice from a professional immediately after experiencing radiating pain.
+ Spinal Stenosis and Spondylothesis
The spine has many intricate structures including vertebrae, intervertebral discs, ligaments, and nerves. With age these can wear or change positions causing neck or low back pain. Spinal stenosis is a condition that is caused by a ligament that hypertrophies, causing a narrowing of the spinal canal. Spondylosis is a condition that is caused by age related changes to the vertebrae that cause them to move slightly forwards or backwards. Each of these are quite complex disorders. They are typically diagnosed with a physical examination and, when needed, imaging including X-ray and MRI.
Spinal Stenosis and Spondylosis are both conditions which vary in severity and therefore the treatment varies as well. Typically, they can be treated with conservative measures including rest, anti-inflammatories, oral steroids, and physical therapy. For more complex cases that are refractory to conservative measures, surgery can be done to decompress these areas and aid in pain relief.
Treatment
At Urgently Ortho we customize a treatment plan to meet your individual needs. Most conditions in the spine can be treated with conservative measures including physical therapy, medication management, and activity modification. We also work with you to discuss whether imaging, including X-rays and MRIs, are right for your condition, and order them when needed. For more complex cases where surgery or local corticosteroid injections are indicated as the best option, we work with some great spinal surgeons in the Bay Area to get you in for an appointment as quickly as possible.
Ephraim Dickinson, MD and Breiana Brady, PA-C at Urgently Ortho have extensive experience treating your neck and back pain and providing therapies to prevent future problems and to keep you active and healthy. Don’t continue to suffer from spine related pain. If you have questions about your back or neck pain, call Urgently Ortho in San Francisco or use the online booking tool to schedule an appointment today.