Your Aching Back

Armen Hareyan's picture
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Nearly everyone will experience back and neck pain at some point. In fact, more people seek medical advice for musculosketal pain than any other health concern. Your aching neck and back could be the result of a number of conditions ranging from simple muscle strain to the presence of a tumor or infection.

Two of the most common causes of back and neck pain are injury and situations in which the person is engaged in strenuous, out-of-the-ordinary physical activity. Muscles are attached to the entire length of the spine by tendons. Muscles can become strained from lifting (especially while in an off balanced position), overexertion, and the performance of an unfamiliar activity. Minor, episodic back and neck pain usually last for several days and are alleviated with bed rest and over-the-counter pain relievers such as aspirin, ibuprofen, or acetaminophen.

More severe back and neck pain is often accompanied by numbness and tingling sensations in the hands and arms, and legs and feet. These symptoms are typically associated with a problem related to the spine rather than muscles. Nerves and nerve roots, connective tissue, vertebrae and discs or other structures of the back may be affected. This pain is more serious, lasts longer, and requires professional intervention and treatment.

Many people who suffer with severe and chronic musculosketal pain may be experiencing a degenerative process that can be related to aging, previous trauma, arthritis, or degenerative joint disease. Persistent back pain can also be the result of tumor growth as well as infection.

Herniations of intervertebral discs are a common result of overuse. These most often occur in the lumbar (low back) and cervical (neck) areas of the spine. These are the most mobile parts of the spine and most likely to be affected by overuse.

In simple terms, a disc is herniated when the cushiony inner material of the disc pushes through to the outer portion of the disc. The hernia applies pressure to spinal nerve roots and can cause neurological symptoms as well as pain. Symptoms include numbness, tingling, burning, or a feeling like an electric shock running down the arms and/or legs and sometimes into the hands and feet. Motor weakness, and bowel and bladder complications may also result.

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In the case of infection, a persistent fever will generally accompany the musculosketal pain. Examination by a specialist is necessary to rule out the possibility of a tumor and/or infection.

Musculoskeletal pain and the aging process

Arthritic spurs, inflamed and swollen joints, thickened ligaments and the wearing away of intervertebral discs are common age-related phenomena. These conditions are most often accompanied by stiffness, diminished mobility, and intermittent pain.

Spinal stenosis is most common over the age of 50. (It can, however, develop in younger adults as the result of injury and/or excessive exercise.) This condition is characterized by the deterioration of intervertebral discs, which are intended to act as both cushions and separators between vertebrae. When discs wear away, vertebrae can rub together. In addition, bone spurs can also develop, further narrowing the spaces between vertebrae. When vertebral space is narrowed, nerves that run through the spinal column and between vertebrae can become pinched. Severe pain can result from each of these conditions.

The Spine Center, a collaboration of Newton-Wellesley Hospital and Massachusetts General Hospital

Susan, an active mother of three in her 40s, was referred by her primary care physician to an orthopaedic surgeon. Pain in her lower back became so intense that she was unable to bear normal activities, let alone her daily jogging routine. Radiologic testing revealed a herniated disc and surgery was recommended. Susan hoped there might be an alternative to surgery. "I have a busy life with three children," she comments, "and the prospect of being limited for months felt almost as bad as living with the pain."

Susan's back problem and her response to the prospect of surgery is not unusual. In fact, she is a prime example of one of the types of patients for whom The Spine Center, a collaboration of Newton-Wellesley Hospital and Massachusetts General Hospital, was developed.

Opened at Newton-Wellesley Hospital in July 2002, The Spine Center offers the expertise of the leading back and neck experts in the Boston area, in a convenient suburban setting. It is a unique health care service that brings together a multidisciplinary team of professionals

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