Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain. Physical therapy, stretching exercises, pain medication, and joint injections are used first to manage the symptoms. Surgery to fuse the joint and stop painful motion may be recommended.
The SI joints are located between the iliac bones and the sacrum, connecting the spine to the hips. The two joints provide support and stability, and play a major role in absorbing impact when walking and lifting. From the back, the SI joints are located below the waist where two dimples are visible. Strong ligaments and muscles support the SI joints. There is a very small amount of motion in the joint for normal body flexibility. As we age our bones become arthritic and ligaments stiffen. When the cartilage wears down, the bones may rub together causing pain. The SI joint is a synovial joint filled with fluid. This type of joint has free nerve endings that can cause chronic pain if the joint degenerates or does not move properly.
A herniated disc occurs when the soft inner gel that cushions the spine’s vertebrae protrudes into the spinal canal. This places pressure on nearby nerves, causing pain, tingling, numbness or weakness in the arms or legs. Herniated discs are very common and can be caused by injury.
A herniated disc can be managed nonsurgically with medication, physical therapy, and pain management. In some cases, surgical intervention is necessary.
Spinal Stenosis can occur in the neck (cervical spine) or the lower back (lumbar spine) and refers to the condition when the spinal canal becomes narrow causing "pinching" of the spinal cord or nerves. When spinal stenosis occurs in the lumbar spine, the pinching on the nerve roots can cause shooting pain, tingling, numbness, and weakness. Pain is usually worse with walking and is often improved with rest. When Spinal Stenosis occurs in the cervical spine, patients often experience tingling, numbness, or pain in the shoulders and arms.
Stenosis is most common in men and women over 50 years of age and can be caused by arthritis or aging. There are many nonoperative treatments that can help manage theses symptoms, but when those are no longer working, decompression surgery (creating space for the nerves) can often cure the disease.
Degenerative Disc Disease
Degenerative disc disease happens to all people as we age, and it is due to "wear and tear" of the disc. It often occurs in either the lower back (lumbar spine) or neck (cervical spine).
Discs are the cushions that sit between the vertebrae (bones) of your spine. They act as shock absorbers for the spine and allow for bending. As a person ages, the disc can wear down and become injured. As the disc degenerates, a patient can experience back or neck pain.
Treatment for degenerative disc disease often involves many modalities including physical therapy, pain management, medications, and possibly surgery.
Spondylolisthesis is a condition in which a bone in the spine (vertebra) "slips" out of position. This can be something people are born with or it can occur due to degeneration or trauma. Often times the "slipped" vertebrae may be minor and not cause many symptoms. However, if the condition is more severe, patients can have back or neck pain and nerves can also be compressed.
Treatment for spondylolisthesis depends on a number of factors. Often patients are successful with non-surgical treatment, but if the slip is severe, surgical intervention may be necessary.
Trauma to the spine can cause acute or chronic pain. Whether caused by a fracture, torn ligaments, or the less severe sprain "whiplash" injury, the pain that accompanies trauma can be severe. Treatment strategies are tailored on a case by case basis to help you overcome the injury as soon as possible.
Spinal Compression Fractures
Spinal compression fractures are more and more common in our aging population. They can be caused by osteoporosis, aging, cancer, infection, or trauma. Compression fractures can occur anywhere in the spine but most commonly they occur in the upper back (thoracic spine) or the upper lumbar vertebrae. Patients experiencing these fractures often have acute back pain, which can lead to chronic pain, deformity, and height loss.
Most commonly the fractures can be treated with conservative means using medications, braces, and therapy. However, certain circumstances and more severe cases may require surgical intervention.
Spinal Infections can occur in the vertebral column, intervertebral discs, the spinal canal, the dural sac, or the adjacent soft tissues. Infections can be caused by bacterial or fungal organisms and often occur in patients who recently underwent surgery or who have particular set of risk factors, such as diabetes. Symptoms of a spinal infection can include fever, chills, pain, headache, neck stiffness, wound tenderness, and wound drainage. In some cases, patients may notice new weakness, numbness, or tingling sensations in the arms or legs.
Spine tumors can cause pain and progressive paralysis. The most common type of spinal tumor is due to metastatic cancer, when cancer is spread from other sites and causes tumors in the spine. Primary spinal tumors are rare tumors which originate from the spine itself. These tumors can vary in complexity depending on their location and extent of growth.
Proper diagnosis is paramount in selecting the appropriate surgery. Surgery can be a highly effective method of preserving the ability to walk, reducing pain, and decreasing the tumor burden in order for other treatments to take effect.
Spinal Deformity and Scoliosis
The adult spine is structured with a series of natural curves and angles which allow the head to rest comfortably in balance with the pelvis, hips, and legs. When these curves and angles bend to abnormal degrees, the spine becomes imbalanced, which can lead to pain and limitation of function.
One type of spinal deformity often first seen in children during a growth spurt is scoliosis. Scoliosis is typically a sideways curvature of the spine. Adults can also develop scoliosis which is often related to degeneration of the spine. This "imbalance" can be the traditional sideways (coronal scoliosis) curve or commonly in adults, more of a "humpback" (kyphosis) deformity. Whatever the deformity, pain can be quite disabling and quality of life can be severely diminished. Nonoperative treatments are always an option that should be attempted, but often times correcting scoliosis and other spinal deformities requires complex surgery.
Austin's Spine Specialist