Anatomy
CERVICAL SPINE ANATOMY
The spine, also called the back bone, plays a vital role in stability, smooth movement and protection of the delicate spinal cord. It is made up of bony segments called vertebrae with fibrous tissue called intervertebral discs between them.
THORACIC SPINE ANATOMY
Thoracic spine is the central part of the spine, also called as dorsal spine, which runs from the base of the neck to the bottom of your rib cage. The thoracic spine provides flexibility that holds the body upright and protects the organs of the chest.
LUMBAR SPINE ANATOMY
The spine, also called the back bone, plays a vital role in stability, smooth movement and protection of the delicate spinal cord. It is made up of bony segments called vertebra with fibrous tissue called intervertebral discs between them.
LUMBAR SPRAIN AND STRAINS
Lumbar sprains and strains are the most common causes of acute low back pain. Lumbar sprains result from torn ligaments and lumbar strains result from over stretched muscles. Sprains and strains can happen from overloading the spine gradually or all of the sudden such as during a fall, lifting a heavy object, or during sports.
LUMBAR DEGENERATIVE DISC DISEASE (DDD)
The disc provides cushioning between the vertebral bodies and bears much of the load with the facet joints. The disc is made up of a jelly material in the middle called the nucleus pulposus and tough annular fibers surrounding the nucleus.
LUMBAR DISC HERNIATION
A lumbar disc herniation is found with disruption of the annulus or tears that allow the inner nucleus to extend beyond the margins of the disc space. Lumbar disc herniation may present as a protrusion or extrusion depending on the shapes. A disc herniation may also be intra-vertebral or within the disc.
SCIATICA
Sciatica is inflammation of the sciatic nerve which is a large nerve connecting the L4-S3 levels and exiting the spinal canal through the piriformis muscle travelling down the hamstrings to the calf and foot.
SACROILIAC JOINT DISORDERS
Sacroiliac joint disorders are inflammation of the joint where the pelvis meets the sacrum in the back and can present with similar symptoms. There are paired joints that work to help load and transfer weight.
TROCHANTERIC BURSITIS
Trochanteric bursitis can be found in up to 70% of people with sciatica-like symptoms and mainly affects middle-aged women. The trochanteric bursa is a fluid-filled sac that sits on top of a bony prominence on the femur and can become inflamed causing pain in the outside of the thigh or buttock.
NEUROPATHY
Neuropathy means damage to a nerve or a disease affecting nerves which may present as altered sensation, numbness, weakness, or pain. Neuropathy can affect a single nerve (mono-neuropathy), multiple nerves or have a more widespread effect on nerves (peripheral neuropathy.) Diseases causing peripheral neuropathy include most commonly diabetes, alcoholism, auto-immune disorders, medications, inherited diseases and hypothyroidism.
OSTEOARTHRITIS OF THE HIP
Osteoarthritis or wear and tear of the joints mostly affects large load-bearing joints such as hips and knees. Joint pain is worse with standing or walking and improves with sitting or rest.
PIRIFORMIS SYNDROME
The piriformis muscle is a deep pyramidal shaped flat muscle in the buttock region which originates over the sacrum and inserts over the greater trochanter of the femur. This muscle lies deep to the gluteus maximus and helps to externally rotate (or rotate away from the center of the body) the hip.
SPONDYLOLISTHESIS
A spondylolisthesis is a slippage of one vertebral body over another. This can slip forward (anterolisthesis) or backwards (retrolisthesis.) The lower lumbar vertebrae L4 and L5 are most commonly affected. Classification is based on the cause of the slippage.
SPONDYLOLYSIS
Spondylolysis can be one sided (unilateral) or both sides are affected (bilateral.) This is the most common cause of back pain in adolescents and usually presents around 11-15 years of age. This is usually due to a weak or defective pars interarticularis which gets injured with repetitive motion.
LUMBAR SPINAL STENOSIS
Lumbar stenosis refers to narrowing within the spinal canal which can be mild, moderate or severe. The classification is based on advanced imaging studies which measure the diameter of the spinal canal.
OSTEOPOROSIS AND COMPRESSION FRACTURES
Osteoporosis is a classification of bone density loss. There is normal, osteopenia (in the middle) and osteoporosis which is based on Bone Mineral Density from a DEXA scan (dual energy x-ray absorptiometry). Osteoporosis increases the risk of fractures affecting the spine and hips.
CERVICAL DEGENERATIVE DISC DISEASE
The disc provides cushioning between the vertebral bodies and bears much of the load with the facet joints. The disc is made up of a jelly-type material in the middle called the nucleus pulposus and tough annular fibers surrounding the nucleus.
CERVICAL DISC HERNIATION
The cervical disc provides cushioning between the vertebral bodies. When the disc which abnormally protrudes past its margins this is called a herniation. If there is a tear in the outer annulus of the disc, the inner nucleus can herniate from the middle of the disc.
CERVICAL COMPRESSION FRACTURE
This occurs more commonly in the thoracic (mid-back) or lumbar (low back) compression fractures. Cervical compression fractures are much rarer and occur due to a hyper-flexed (bent forward) position or injury.
SPINOUS PROCESS FRACTURE (CLAY-SHOVELER’S FRACTURE)
The spinous process is the bony prominence which can especially be felt at the lowest cervical level at C7. A fracture can occur in the lower cervical spine from a significant tearing away of the muscles or ligaments due to an overly extended or flexed type injury.
CERVICAL WHIPLASH INJURY
Whiplash injury occurs when there is a hyperflexion and then hyperextension event affecting the cervical spine mainly by rear-ended motor vehicle accidents, but can happen by head-on or side collisions.
CERVICAL STENOSIS
Cervical stenosis is narrowing of the spinal canal where the spinal cord and the nerves travel. Spinal stenosis can be caused by overgrowth of bone spurs, degenerative disc disease and a significant disc herniation.
PHYSICAL THERAPY
Physical therapy can be a key component to treatment of your pain. Physical therapists work closely with the referring physician to help tailor your treatment program to the presenting diagnosis.
CORE STRENGTHENING
Many research studies have recommended the use of core strengthening as an adjunct in the treatment of LBP. The term “lumbar core” pertains to those muscle that lay closest to the spine and are responsible more for stabilization rather than initiating movement.
ACUPUNCTURE
Acupuncture is the placement of thin needles into the skin to stimulate very specific points. Acupuncture is practiced in multiple ways by traditional Chinese medicine providers and Western practitioners.
MASSAGE
Massage therapy has numerous psychological and physical benefits. This is a non-invasive way to improve blood flow, reduce inflammation and swelling, reduce muscle tension and provide relaxation. This type of therapy is used as an adjunct to other treatments and can improve the overall results of a treatment plan.
RADIOFREQUENCY ABLATION
Radiofrequency ablation (RFA), also called rhizotomy or neurotomy, is a novel non-surgical technique of treating pain. This technique employs radiofrequency waves to produce heat and the heat produced damages the nerves transmitting pain signals to the brain.
PLATELET RICH PLASMA
Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process.
STEM CELL THERAPY
Stem cells are being used in regenerative medicine to renew and repair diseased or damaged tissues, and have shown promising results in treatments of various orthopedic, cardiovascular, neuromuscular and autoimmune conditions.
