There are many types of back and neck disorders that affect the majority of the population in the United States. Injury, aging, general health, and lifestyle may influence the development of some conditions. Most spinal disorders are known to result from soft tissue injury, structural injury, and degenerative, or congenital conditions.
Compressive Neuropathy (nu-rop-ah-thee) occurs when nerves in the spine are compressed. This disorder often affects older people. The nerves that exit the spinal canal become trapped, compressed, and swollen. Foraminal stenosis can be extremely painful and debilitating. The effects may temporarily damage or permanently destroy nerves. Foraminal stenosis (foe-ray-min-al sten-oh-sis, e.g. spinal stenosis) is an example of a compressive neuropathy.
A slipped, herniated (her-knee-ate-ed), ruptured or bulging disc may cause nerve compression. Nerves may also be compressed or even displaced by the growth of bone spurs. A compressive neuropathy may cause pain to radiate into one or both buttocks, down the legs below the knees and may be felt in the ankles and feet. Pain may be accompanied by sensations of tingling, numbness, and weakness. These types of symptoms are generally referred to as "sciatica."
Sciatica (sy-attic-ka) is a symptom of a compressive neuropathy involving one or several of the lower spinal nerves that make up the sciatic nerve. It is a common ailment named for the sciatic nerve, which is a collection of smaller nerves descending from the spine and joining together to resemble a cable. The spinal nerves come together in the pelvis to form the sciatic nerve. The sciatic nerve then travels down through each buttock into the legs. At certain points, such as in the posterior thighs, nerves branch off from the main sciatic cable. This is why sciatic pain may be felt in various muscles of the leg.
A direct blow to the sciatic nerve in the leg may occur when falling down. This may injure the sciatic nerve. The force from falling down could initiate bleeding around the nerve and cause nerve compression and pain. If a disc or bone spur protrudes into the spinal nerves that become the sciatic nerve, the problem may become severe. A bone spur could displace a spinal nerve creating intense pain. Fortunately there are non-surgical treatments available to help reduce inflammation and associated pain. These treatments include medication and steroid injections.
When nonsurgical treatment fails and, depending on the patient's symptomatology, surgery may be considered. In some cases a surgical procedure called a laminotomy (lamb-in-ah-toe-me) may be performed to give the surgeon greater access to the offending intervertebral disc. Removal of the disc is called a discectomy or microdiscectomy (under magnification).
Peripheral Neuropathy is a degenerative, toxic, or nutritional condition affecting the nerves that branch into the body's extremities such as the arms, hands, legs, and feet. Diabetes or even certain drugs can cause peripheral neuropathy. The disease causes the peripheral or distant parts of nerves to shrink. Eventually the affected nerves may deteriorate to the point that the nerves can no longer carry impulses. Sensory (feeling) and motor (movement) function may be lost. Symptoms may include burning or a feeling of pins and needles, numbness in the toes or fingers, and weakness when gripping an object or while walking. Medication may help to slow the effects of peripheral neuropathy but may not cure or stops its progression.
Spinal Infections are rare and painful. Immediate medical attention is always necessary. If an infection is not detected and treated, the effected area swells and causes pain to radiate into adjoining tissue. A spinal infection may cause permanent injury or take root in the epidural cavity (ep-e-do-ral). This cavity is a fatty area near nerve roots and provides space for an infection or abscess. Epidural cavities are found in the cervical (sir-ve-kal), thoracic (thor-as-ick), and lumbar (lum-bar) spine. An MRI may be performed to confirm a spinal infection. Nonsurgical treatment may include intravenous or oral antibiotics combined with bed rest. In some cases surgical intervention may be necessary to eradicate the infection.
Spinal Meningitis (men-in-ji-tis) is an infection that causes inflammation of the membranes in the brain and spinal cord. This is a serious disease and may require hospitalization. Treatment includes intravenous or oral antibiotics combined with bed rest. Symptoms may include fever, weakness, pain that radiates from the spine, muscle spasm, sensitivity to touch, decreased spinal flexibility, fatigue, sweating, and weight loss. When a child is affected, symptoms may include his refusal to stand or sit because it is painful. Increased backache may be an indication in older children and adults. Neck pain and sensitivity to light are common symptoms.
This article is an excerpt from the book Save Your Aching Back and Neck: A Patient’s Guide, edited by Dr. Stewart Eidelson.
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