FAILED BACK SYNDROME | CHARLESTON, SC

Neck pain is extremely common and a frequent reason for visits to a doctor.  It can occasionally occur secondary to an injury or trauma although most commonly presents without a specific cause.  The pain could be secondary to a muscle strain, joint inflammation, or pinched nerve due to a bad disc.  Pain can be isolated to the neck region itself.  It can also radiate into the scalp and may be associated with headaches.  Some patients will describe pain radiating into the shoulder blades and mid back area.  If the nerve inflammation is significant, patients may experience pain, numbness, and even weakness in the arms and/or hands.  Non-surgical treatment options include, but are not limited to, trigger point injections, epidurals, facet injections, nerve blocks and physical therapy.  An MRI, CT, or EMG may be necessary to better determine the source of pain and optimal treatment.

Low back or lumbar pain is the second most common reason that patients visit the doctor, only behind the common cold.  The pain may be secondary to a trauma or injury, but frequently is not related to any specific event.  As with many conditions of the spine, the pain can be significant.  Common causes are a bad disc irritating a nerve, joint inflammation, arthritis, or muscle strain.  Non-surgical treatment options include, but are not limited to, trigger point injections, epidurals, selective nerve blocks, facet injections, sacroiliac joint injections, intradiscal steroid injections, spinal cord stimulators, and physical therapy.  An MRI, CT, or EMG may be necessary to better determine the source of pain.  The pain may be in the middle of the back, on both sides, or isolated to one side of the back.  It can also radiate into the buttocks, hip, and groin regions.  In some patients, the pain will radiate into the legs and individuals may also experience numbness and/or weakness.  The reason for this is that all of the nerves in the legs come from the back.  As a result, any issue with the low back can potentially affect the legs.

Pain in the hip region may not be related to the hip joint itself. In many patients, the pain is referred from the lower back due to a pinched or inflamed nerve, bad disc, or joint inflammation. Symptoms are frequently worse with prolonged walking and going from a sitting to standing position. An x-ray, MRI, or CT may be necessary to further evaluate the true source of pain. If the pain is referred from the back, non-surgical treatment options include trigger point injections, epidurals, selective nerve blocks, joint injections, and physical therapy. If the discomfort is secondary to a problem with the hip joint itself, nonsurgical treatment options include intra-articular hip injections and physical therapy.

Many patients will present to our spine center with complaints of joint pain that may not be related to the neck or back itself.  Common causes are arthritis, inflammation of the tendons (tendinitis), inflammation of the bursa (bursitis), or even a tear of a supporting structure such as the rotator cuff or a ligament.  An x-ray or MRI may be necessary to further evaluate the source of pain.  Non-surgical treatment options include a peripheral joint injection that places a strong anti-inflammatory into the joint itself to decrease pain and irritation.  Physical therapy may also be necessary in combination with the nonsurgical treatment.

Many patients will present with pain and/or numbness in the arm or leg.  In many cases, the discomfort will be associated with neck or back pain.  However, individuals may have pain isolated to the leg or arm only.  In the majority of cases, the symptoms are secondary to an irritated or pinched nerve traveling from the spine into the arm or leg.  It should be noted that all the nerves in the arms come from the neck.  The nerves in the legs come from the low back or lumbar region.  If the individual has a bad disc or stenosis, the nerves that travel into the arm or leg may become inflamed resulting in severe pain, numbness, or even weakness.  An MRI, CT, or EMG may be necessary to determine the exact source of pain.  Non-surgical treatment options include, but are not limited to, trigger point injections, epidurals, selective nerve blocks, intadiscal steroid injections, spinal cord stimulators, and physical therapy.

Please read about degenerative disc disease for a brief overview.  In some patients, the outer part of the disc called the annulus may become weakened either due to an injury or wear and tear.  If it becomes weak enough, the inner part of the disc (called the nucleus) may herniate or rupture through the outer fibers.  This will often cause direct pressure on a spinal nerve resulting in neck, back, arm, or leg pain/numbness.  An MRI or CT may be necessary to visualize the disc herniation.  Non-surgical treatment options include, but are not limited to, epidurals, selective nerve root blocks, intradiscal steroid injections, and physical therapy.

The spine is made up of bones called vertebral bodies with the discs in between.  In most patients, the bones line up although individuals do have a normal curvature in the neck, mid back, and lower back regions.  In some cases, the bones or vertebral bodies may not line up properly.  This is often called a slipped disc or spondylolisthesis and can put tremendous pressure on the disc in between the bones.  Over time, the disc can degenerate at a much faster rate than normal.  The combination of the bone slippage and the bad disc can result in narrowing of the opening where the nerves come out.  This can often result in nerve irritation or even a pinched nerve resulting in neck, back, arm, or leg pain.  An MRI, CT, or x-ray may be necessary for accurate diagnosis.  Nonsurgical treatment options include, but are not limited to, epidurals, selective nerve blocks, facet injections, intradiscal steroid injections, and physical therapy.

Many doctors will describe degenerative changes of the spine as arthritis.  Over time, the joints in the spine may become worn out, which can result in painful joints and even irritation of the surrounding spinal nerves.  An x-ray, MRI, or CT may be necessary for accurate diagnosis.  Nonsurgical treatment options include, but are not limited to, epidurals, selective nerve blocks, facet injections, sacroiliac joint injections, and physical therapy.

Individuals with neck or back pain are often experiencing discomfort due to nerve inflammation.  Some spinal nerves control the muscles in the neck, back, arms, and legs.  If these nerves become inflamed, patients may have discomfort radiating into the arm or leg.  Other patients may have pain isolated to a joint. In either case, the irritated nerve sends pain signals to the brain.  An MRI, CT, or EMG may be necessary to determine which nerves are causing the pain.  Nonsurgical treatment options include, but are not limited to, epidurals, selective nerve blocks, facet injections, intradiscal steroid injections, and physical therapy.

Many patients will present to our spine center with continued pain despite having already undergone surgery.  In these cases, the pain may be related to chronic nerve inflammation, joint inflammation, scar tissue, degenerative disc disease, or stenosis.  An MRI, CT, or EMG may be necessary to better determine the source of pain.  Nonsurgical treatment options include, but are not limited to, selective nerve blocks, facet injections, intradiscal steroid injections, and spinal cord stimulators. Many of our patients experience significant improvement despite minimal relief with previous treatments.

A large joint is found in the gluteal/buttocks region that connects the pelvis to the sacrum. It is called the sacroiliac joint or SI joint.  Either due to trauma, altered gait, or wear and tear, the joint may become inflamed or degenerated over time.  In patients with discomfort isolated to the buttocks region, nonsurgical treatment options may include sacroiliac joint injections performed under x-ray.  Manipulation of the joint itself with a physical therapist may occasionally be recommended.

Some individuals will present with pain isolated to the tailbone region only.  It is often aggravated with prolonged sitting and moving from a sitting to a standing position.  The pain may be secondary to trauma or can simply occur over time.  An x-ray may be necessary to further visualize the tailbone region.  Treatment options include, but are not limited to, coccyx injections in which a strong anti-inflammatory is placed around the tailbone.  Individuals may also have to utilize a doughnut cushion or other soft seating surface to decrease pressure on the area when in a seated position for a period of time.

Pain in the middle of the back is often due to muscle strain. However, in some patients the symptoms may be related to a disc or joint. If a nerve in the mid back region becomes irritated, it can cause significant pain. Some individuals will describe radiation of the pain into the side of the chest and occasionally into the front chest wall. Some patients will have pain in the mid back referred from the neck or lower back regions. Non-surgical treatment options include trigger point injections, epidurals, facet injections, selective nerve blocks, and physical therapy. An MRI or CT may be necessary to better determine the source of pain.

Pain in the gluteal region is frequently due to a pinched or irritated nerve, muscle strain, or joint inflammation.  Non-surgical treatment options include, but are not limited to, epidurals, selective nerve blocks, sacroiliac joint injections, and physical therapy.  An x-ray, MRI, or CT may be necessary to best determine the source of pain.

Some patients will describe pain in the groin region right where the front of the leg starts. Pain in this area is frequently associated with hip joint problems. An x-ray or MRI may be necessary to further evaluate the hip for arthritis or other causes of pain. Non-surgical treatment options include, but are not limited to, intra-articular hip injections and physical therapy. In some cases, pain in the groin region may actually be referred from a nerve that comes from the low back. In these cases, an MRI or CT of the low back may be necessary often followed by a selective nerve block.

Many patients will present with complaints of pain, numbness, and even weakness in the hands and fingers.  If the symptoms do not travel all the way up the arm, the patient may have a pinched nerve somewhere near the wrist or elbow.  One of the common causes is carpal tunnel syndrome which is a pinched nerve in the wrist. An EMG/nerve conduction study may be necessary to determine the exact cause of pain and numbness.  The test is performed to determine if the patient has a pinched nerve or potential nerve damage.  Once the source of the pain and numbness is identified, it can frequently be treated.

A disc is part of the spine that is found in between the bones.  They allow your neck and back to rotate as well as bend forward and backward.  The inner part of a disc is called a nucleus.  The outer part is made of cartilage that is tightly wrapped in circles sort of like a coil.  This is called the annulus.  Over a period of years, the disc may begin to degenerate and the outer part loses its strength. The nucleus may begin to bulge outward.  The further out the disc bulges, the higher the likelihood it can press on a nerve causing pain and inflammation.  In some cases, the outer part of the disc may become so weak that it ruptures (or herniates) and sits directly on a nerve. This can result in pain radiating into the arm or leg.  Degenerative disc disease can cause neck, mid back, lower back, gluteal, hip, and arm/leg pain.  Non-surgical treatment options include, but are not limited to, trigger point injections, epidurals, selective nerve blocks, intradiscal steroid injections, and physical therapy.  An MRI or CT may be necessary to identify the degenerative disc.

All the nerves in the arms come from the neck. All the nerves in the legs come from the back.  A pinched nerve in the spine can result in severe arm or leg pain, numbness, and even weakness.  Patients will also often describe pain in the neck, mid back, low back, and/or gluteal region. An MRI, CT, or EMG may be necessary to determine which nerves are pinched or irritated.  The nerve can be tested for potential damage.  Non-surgical treatment options may include, but are not limited to, selective nerve blocks and epidurals.

The spine has many openings where the nerves travel.  In some patients, these openings may be extremely narrow, which is called stenosis.  In these individuals, the nerves do not have enough room and they become easily irritated due to compression.  Over time, the nerves may become inflamed or pinched resulting in neck, back, arm, or leg pain.  An MRI, CT, or EMG may be necessary for accurate diagnosis.  Nonsurgical treatment options include, but are not limited to, epidurals, selective nerve root blocks, spinal cord stimulators, and physical therapy.

Some individuals may severely strain their neck or back with certain activities causing pain. In some cases, the pain is severe enough to warrant physician evaluation.  Nonsurgical treatment options include trigger point injections and physical therapy.  If the symptoms continue, the pain may not be from the muscle itself. An MRI, CT, or x-ray may be necessary to evaluate for other causes of pain, including a bad disc, pinched nerve, or joint inflammation.

On top of many large joints in the body, patients have a fluid-filled protective sac called a bursa that protects the bone.  If this sac becomes inflamed, it can cause significant pain or tenderness and is called bursitis.  The most common areas of bursitis pain involve the hip and shoulder regions.  An x-ray may be necessary to further evaluate.  Nonsurgical treatment options include, but are not limited to, hip bursa and shoulder injections.  In some cases, physical therapy may also be necessary.

The spine has many joints somewhat similar to the joints throughout the rest of the body.  A facet joint is in the spine where the bones above and below each other meet.  Over time or due to injury, the joint itself may become damaged or degenerated.  Often, inflammation will occur resulting in significant neck or back pain.  An x-ray, MRI, or CT may be necessary to accurately diagnose.  Nonsurgical treatment options include trigger point injections, facet injections, and physical therapy.

For additional details, please also click on degenerative disc disease.  The disc itself is made up of an inner part called the nucleus and an outer part called the annulus.  The annulus is made up of a type of cartilage that is wrapped in a coil around the nucleus.  Over time or due to injury, the outer part of the disc may become weakened and a tear develops in the fibers.  An MRI may be necessary to visualize the tear in the disc.  Nonsurgical treatment options include, but are not limited to, epidurals, selective nerve blocks, intradiscal steroid injections, discography, spinal cord stimulators, and physical therapy.

Pain Radiating Into The Arms or Legs

Many patients will present with pain and/or numbness in the arm or leg.  In many cases, the discomfort will be associated with neck or back pain.  However, individuals may have pain isolated to the leg or arm only.  In the majority of cases, the symptoms are secondary to an irritated or pinched nerve traveling from the spine into the arm or leg.  It should be noted that all the nerves in the arms come from the neck.  The nerves in the legs come from the low back or lumbar region.  If the individual has a bad disc or stenosis, the nerves that travel into the arm or leg may become inflamed resulting in severe pain, numbness, or even weakness.  An MRI, CT, or EMG may be necessary to determine the exact source of pain.  Non-surgical treatment options include, but are not limited to, trigger point injections, epidurals, selective nerve blocks, intadiscal steroid injections, spinal cord stimulators, and physical therapy.