In our orthopedic clinic, we see a great many patients with acute or chronic back or neck pain. The acute group includes people who’ve recently suffered a work-related injury. The chronic group are those people whose pain lingers, sometimes for years.
For those who are injured at work, there is the extra stress of being unemployed, even if only temporarily. We try to teach these patients how to move and protect their spine while applying conservative therapies to control the pain.
A common cause of work related injuries is repetitive motion. If you are making the same movements over and over again, those muscles, tendons, ligaments, nerves and bones are subject to unusual stress. Eventually, the wear and tear takes its toll.
Often the patient will tell me that he had been feeling some muscle strain for a long time, but he chalked it up to age and tried to ignore it. Another will say that she felt a growing discomfort in her neck or wrist but decided it wasn’t worth a visit to the doctor.
Unfortunately, these injuries could have been prevented if our friends had taken steps early on to minimize the strain.
Aching, Tingling, Numb Limbs
Some injuries are progressive, but there are also traumatic injuries— from a fall, for instance— that can result in spinal problems at sites from the neck to the tailbone. A compression fracture can cause a herniated disc, potentially setting up the patient for a long spell of pain and inactivity.
We usually treat the injury conservatively, and try to help the patient understand how lifestyle can affect their prognosis. While it’s true that the spine is more vulnerable as we grow older, we can retain much of our flexibility and strength by exercising and moving wisely.
Treatment of a herniated disc might include anti-inflammatory pain medication (NSAIDs) and physical therapy. The patient is also shown how to bend and lift, walk and pivot, sit and lie down in ways that produce the least pain and damage to the spine.
At one point, surgery was considered a last resort. However, we now have new techniques that make this a good option for some cases.
Diagnosis is Complicated
Low back pain is a difficult condition to pinpoint precisely. It may stem from nerve irritation, muscle strain or a bone lesion.
Some patients can trace their pain to an incident, but even those injuries were probably years in the making.
Degenerative conditions such as arthritis or osteoporosis, viral infections or abnormalities we were born with . . . can lead to susceptibility to any kind of strain.
Some Common Disorders of the Spine Include:
- Bulging discs. When the spinal discs are under pressure, the soft inner tissue can ooze out and press against a spinal nerve. Most herniated discs are in the lower, or lumbar, part of the spine.
- Sciatica is when a herniated disc presses on the large nerve that extends down the leg. This is characterized by pain that radiates down the leg.
- Spinal degeneration, when the discs start to disintegrate, can cause a narrowing of the spinal canal. This condition is signified by stiffness in the back when you first awake, or pain when you stand or walk for a long time.
- Osteoporosis is a bone disease that makes the bones fragile and brittle, and prone to fracture. Women are most likely to have this condition, especially women of northern European descent.
At our clinic, we have various tools for diagnosing back problems. Imaging tests such as x-rays, MRI or CT scans give us a picture of the spinal column. We also use electrodiagnostic techniques such as electromyography (EMG) and evoked potential (EP) to detect nerve damage.
If you have been hurt at work, you can try applying ice (frozen peas wrapped in a towel is the standard home ice pack). After a few days, a heating pad or hot bath might help.
If you still feel incapacitated after a few days, call our clinic and make an appointment.
Let’s talk about getting you back on your feet— and back to work.