Back and Neck Pain Doctor in Plano and Allen TX
Are you looking for an experienced neck and back pain specialist who can help you relieve your pain symptoms like sharp aching pain in your spine, leg numbness, and dull or burning pain in your back? Look no further than American Pain and Wellness! We have convenient locations to serve you in Allen, TX, and Plano, TX, and provide a variety of treatment options for pain. For more information, please contact us or book your appointment online.
Introduction
Back Pain
One of the most common medical problems in the United States. Eight out of ten people will develop a back problem at some time during their lives. It is the second most common cause of missed work days and is the leading cause of disability between the ages of 16–45. Approximately 50 billion dollars is spent because of back pain each year, and the cost keeps growing.
No matter what the treatment form, most episodes of back pain resolve within 6–12 weeks. In some individuals, back pain will become chronic. It becomes especially important for these people to become proactive about their back pain. A person with back pain becomes proactive by sitting properly, sleeping correctly, balancing on 2 legs (or boots), and prioritizing their activities in order to prevent the worsening of their underlying spinal problem. Although there may be no “quick” fix to a back problem, many individuals can be treated effectively and lead productive lifestyles.
Back conditions usually do not develop suddenly. Your back is subject to many repeated stresses or injuries over your lifetime. Everything from falling off your bike as a child, to lifting a mattress, to carrying around extra weight for several years may contribute to a spinal condition. These repeated stresses or injuries will add up over your lifetime, resulting in degeneration of the spine.
The goal of a spine treatment program is to improve symptoms and slow the progression of the degenerative process in the spine. Usually this involves a joint effort between the individual with back pain, the treating physician, and other allied healthcare professionals such as physical therapists.
Anatomy of the Spine
The spine has three main parts:
• Vertebral column — bones and discs
• Neural elements — the spinal cord and nerve roots
• Supporting structures — muscles and ligaments
The spinal column consists of individual bones called vertebrae. The vertebrae provide support and protection to the spinal cord. The spine contains seven cervical vertebrae (C1–7) in the neck, twelve thoracic vertebrae (T1–12) in the mid back, five lumbar vertebrae (L1–5) in the lower back, a fused sacrum in the sacrum, and three to five fused vertebrae forming the coccyx or tailbone.
On the front side of the spine, the vertebrae are connected by intervertebral discs. The discs contain a harder outer ring called the annulus fibrosus and an inner jelly-filled center called the nucleus pulposus. The annulus surrounds the vertebrae while the nucleus provides shock absorption properties of the spine and allows the spine to flex and bend. On the back side of the spine, a pair of joints called the facet joints allows the spine to twist and bend forward.
Nerves connecting the brain to the body make up the spinal cord. The spinal cord runs through the center of each protective vertebra. Nerves branch off from the spinal cord to organs and muscles including the arms and legs. The nerves carry messages from the brain to the organs, muscles, and bones.
The soft tissue supporting structures of the spine — the muscles and the ligaments — enable the spine to function in an upright position and allow the trunk to move in a variety of positions. They are vital in maintaining stability to the spine.
Risk Factors for Back Pain
A risk factor is something that increases your odds of developing a disease or condition. The following are risk factors for developing back pain:
• Smoking
• Lack of regular exercise
• Injury
• Obesity
• Handy-mans with back conditions
• Pregnancy
• Previous back injuries due to lifting a heavy object, improper lifting, sudden twisting or bending, bad posture, prolonged sitting or standing, vibration from vehicles or heavy equipment
• Prior back surgery
• Low job satisfaction
• Interpersonal relationship problems
• Depression
• Fatigue or lack of sleep
• Alcohol or drug abuse
• Excessive stress
Treatment
Medication
• Pain relievers such as acetaminophen, naproxen, or ibuprofen
• Muscle relaxants
• Corticosteroids or injections
• Antidepressants for chronic pain
Physical Therapy
• Hot or cold packs
• Stretching and strengthening exercises
• Education
• Massage
• Ultrasound
• Electrical stimulation
Complementary Medicine
• Relaxation training
• Hypnosis
• Chiropractic manipulation
• Acupuncture
• Biofeedback
Prevention
• Exercise regularly
• Stop smoking
• Lose weight
• Use good posture to reduce stress on your spine
• Avoid sitting or standing in one position for prolonged periods of time
• When lifting, hold the object close to your chest, maintain a straight back, and use your legs to slowly rise
• Consider job retraining if your profession requires too much heavy lifting or sitting
Causes of Back Pain
Muscles / Ligaments
There are many causes of back pain, the most common of which is a sprain or strain of muscles or ligaments. Muscle spasms can occur after lifting, or bending awkwardly, or from a simple sneeze or cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, or injections.
Disc Problems
Disc Degeneration
Disc problems are common causes of back pain. Discs are usually moist, like a sponge with water in it. After a disc injury, or with age, discs lose water and deteriorate in a process called disc degeneration.
The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosus (outer portion) of the disc. The annulus fibrosus is like a large round ligament that protects the nucleus pulposus (inner portion) of the disc from pushing outward. Tears in the annulus heal by scar tissue — a weak filling of tissue that is not as strong as normal tissue. The repeated cycle of injury and scar tissue healing leads to a disc that begins to degenerate.
As a disc degenerates, it becomes stiff, narrows, and loses its ability to act as a shock absorber. Bone from the vertebrae above and below the disc may grow to form bone spurs. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal, causing pain, numbness, and weakness in the arms or legs.
The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause, is called spinal stenosis. Spondylosis or spinal stenosis can occur at any level in the spinal vertebrae — cervical, thoracic, or lumbar.
Bulging Disc, Protruding Disc, Herniated Disc, Extruded Disc
Over time, because of injury or degeneration, discs start to change shape. Many terms describe this change in shape including bulging, protruding, herniated, prolapsed, and slipped. This generally describes a disc that is displaced beyond the limits of the intervertebral disc space.
The earliest change in shape is often in the form of a disc bulge — a wide-based extension of the disc. Often, disc bulges do not cause pain. As the degenerated annulus progresses, the nucleus pulposus can extend through a tear in the annulus wall of the disc. If this material comes in contact with nerve tissues, inflammation will result.
Some patients will have only mild symptoms. However, sometimes symptoms can become severe. Disc delamination is a severe instance of disc protrusion in which a large portion of the nucleus pulposus is displaced through the end of the disc. Disc extrusion almost always causes symptoms.
Facet Joints
Lumbar facet joints are small pairs of joints on the back side of the spine where the vertebrae meet. These joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist.
Inflammation of facet joints can occur from injuries or from arthritic history. Many times, particularly in the case of injuries, one may not see abnormalities on an X-ray or MRI.
Spinal Stenosis
The term lumbar stenosis refers to any narrowing of the spinal canal. There are four causes of spinal stenosis; the most common is degeneration of the spine, which occurs almost inevitably as part of the aging process.
Several factors contribute to narrowing of the spinal canal with degenerative changes:
Wear and tear causes the facet joints to enlarge into the spinal canal
The ligamentum flavum undergoes hypertrophy (enlargement) and buckling
Intervertebral discs may bulge or herniate into the canal
The vertebrae may slip forward — a condition called spondylolisthesis
These changes may also occur in a congenitally narrow canal.
The hallmark of lumbar stenosis is pain in the back and legs which is aggravated by standing and walking and relieved by sitting or forward bending.
Symptoms include:
• Pain worsened with walking
• Pain relieved by sitting or bending forward
• Sensory loss in a nerve root distribution
• Diminished pulses or vascular changes (if vascular insufficiency is present)
Spondylolysis and Spondylolisthesis
The most common cause of low back pain in adolescent athletes is a stress fracture in one of the vertebrae that make up the spinal column. This condition is called spondylolysis. It usually affects either the fourth or fifth lumbar vertebra in the lower back. The fracture site is called the pars defect.
If the fracture weakens the bone so much that it cannot maintain its proper position, the vertebra can shift forward. This condition is called spondylolisthesis.
In adults, spondylolisthesis is usually caused by degenerative changes in the spine. If too much slippage occurs, the bones may press on nerves and surgery may become necessary.
Causes include:
• Genetics
• Athletics such as gymnastics, weight lifting, football
• Degenerative changes
• Medical conditions such as cerebral palsy
Sacroiliac Joints
The sacroiliac joints connect the sacrum with the pelvic crest. The joint:
• Transmits all the forces of the upper body to the pelvis and legs
• Acts as a shock absorber
• Has limited motion
The sacroiliac joint can become inflamed from acute injury or from chronic postural abnormalities such as unequal shear on the joint after laminectomy fusion surgery. Pain can occur in the back, buttock/hip, abdomen, groin, or legs.
Ankylosing Spondylitis
Ankylosing spondylitis primarily affects the spine. In this condition, the joints and ligaments that normally permit the spine to move become inflamed and stiff. Vertebrae may grow together, causing the spine to become rigid and inflexible. Other joints such as the hips, shoulders, knees, or ankles may also be involved.
Other Rare Causes
• Benign or malignant tumors
• Infections
• Problems of the digestive or genitourinary tract
• Vascular problems such as an aneurysm or hardening of the arteries
The nerve patients from Allen TX, Frisco TX, McKinney TX, Parker TX, Plano TX, Murphy TX, Lucas TX, Richardson TX, and Collin County Texas.
