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in reply to: going nuts-sound in spine #4715
Most likely, the sound you hear in your neck is some mild irregular facet surface wear. This is very common, even in patients that have not had prior surgery. The facets are covered with cartilage, a smooth glistening gliding surface. Over time, the cartilage develops small irregularities like pits and small ridges. If you are very quiet when you move your neck, you can hear the irregular surfaces rub together. It is normal and generally, nothing to worry about.
The reason you can hear this noise is that your hearing is amplified with bone conduction. The bones of your neck directly conduct the noise to the bones of your ear. We are all lucky that our ears are not near our lower backs. If that was so, any small movements of our lumbar spines would sound like a trash compactor!
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: Pain in back #4713A nerve block normally consists of two medications, a numbing agent like novocaine and a corticosteroid like celestone. It can be placed through the lamina of the vertebra above the dural membrane (an epidural steriod injection or ESI) or through the foramen (a selective nerve root block or SNRB). The injection normally serves two purposes, diagnosis and treatment.
The diagnostic portion of the block is the numbing portion. When you go to the dentist and have an injection in your jaw, he or she is blocking the sensory nerve to the jaw. The numbness lasts approximately three hours. The same principle occurs in your back or neck. If one particular nerve or area is suspected of causing pain, this block will temporarily numb the painful nerve or area. If there is relief noted in the first three hours, this block has successfully diagnosed the problem.
The steroid is the second medication in the injection. This medication can take up to three days to work. It does so by reducing inflammation to the nerve. Relief can last up to six months but in some individuals, relief may not occur. It is unfortunately unpredictable.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: Severe Headaches #4710You note recurring neck pain with headaches at least 3 years after a fusion at C6-7. You don’t note any accidents or traumas. A CT scan and an MRI from another doctor note a congenital or acquired fusion of C1-2 but this is not noted by your original surgeon.
Headaches can be caused by any number of problems. Headaches originating from the neck are typically generated from the C2 (greater occipital nerve) which radiates pain from the base of the neck over the top of the head ending above the eye or C3 (lesser occipital nerve) which radiates pain from the base of the neck over the ear into the jaw. Degenerative upper cervical facets very commonly can cause headaches by the same mechanism.
Congenital fusion of C1-2 is extremely rare. You might have severe degenerative C1-2 facet disease (unusual but much more common than congenital fusion) which might also explain your headaches. If you cannot rotate your head very well from side to side, this finding would also go along with C1-2 arthrosis (facet disease). If you never could rotate your head well since you were a child, this might go along with congenital fusion. Look for the radiologists report from the MRI and CT to see what that specialist had to say.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: constant low back pain advice appreciated #4707The Med-X machine was popular in the 1980s and there are still some that should be around today. This machine is really an exerciser machine designed to strengthen the multifidi and rotator muscles of the lower back. I can be effective but not all the time.
The surgeon who thinks he can help you- is he suggesting discograms to determine if surgery can help you? Please review discograms in the website for more information. Based upon blinded discograms, you may or may not be a candidate for surgery.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: constant low back pain advice appreciated #4705Bt your report, your pain could be discogenic from degenerative disc disease. Lyrica is a membrane stabilizer and a reasonable medication if it works for you. Make sure you are on the correct dosage by asking your physician.
Have you tried a pilates stabilization program administered by a well trained therapist? To see results, this could take at least three months. You could try using the Med-X machine which stabilizes and strengthens back muscles.
Finally, you could get a consult with a spine surgeon to have an appropriate diagnosis made and look to see if you are a potential surgical candidate.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.in reply to: constant low back pain advice appreciated #4703Lower back pain can be caused by degenerative disc disease (most common cause), degenerative facet disease (about 5-10% of the time) and even a disc herniation or spinal stenosis (narrowing of the spinal canal) but these are not as common causes. The pain from degenerative disc disease can originate from the annulus (see degenerative disc disease on the website) or from the bony endplates of the vertebra (isolated disc resorption). Even though a disc herniation does not commonly cause back pain (it normally causes leg pain by nerve compression), it can stretch the annulus enough to create back pain.
Does the pain occur with standing, bending and lifting or does it occur with sitting? Standing/ lifting pain is generally more associated with degenerative disc disease and sitting is associated more commonly with the herniation. Is the pain in the center of the back or is it more to one side (the sacroiliac joint)? Central pain is generally associated with degenerative disc disease and pain to the side can be associated with either the disc or the herniation.
Your MRI notes multilevel degenerative changes in the lumbar spine. If your pain originates from the disc, any of the levels can generate pain but normally the bottom two levels (L4-5 and L5-S1) are more commonly pain generators.
The “spinal decompression” machine is essentially spinal traction with a fancy name. I have no typical objection to it except for the cost and the number of visits normally “required” to sign up to gain access to the machine. The only two conditions I think are contraindicated are a spondylolysthesis or instability of the lumbar spine (see website for more details). Will it work- not very likely but there is still a chance of it being effective.
I am a big fan of Pilates for spinal rehabilitation. You would need a physical therapist or chiropractor who is well trained in Pilates rehabitiation.
Only if noting else is effective and you cannot tolerate the pain is surgery an option. You would need a surgical workup to determine if you are a candidate for surgery.
Good Luck!
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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