The spine consists of bones (vertebrae) separated by soft cushions (discs). Nerves that travel from the brain to the rest of the body all pass through the spine. When pressure from spinal vertebrae is applied to nerves, pain, numbness, tingling, or weakness can occur. These sensations are not always relegated to the back or spine; rather, they can occur in many areas of the body, depending on what nerves are pressed, where they originate in the spine, and where they travel to. Pain is identified two different ways: acute and chronic. Most people with back or neck injuries suffer from acute pain, which lasts four to six weeks and can stop without medical treatment. Chronic pain lasts for more than three months and requires medical treatment. Common causes of associated back and spine pain include

  • Degenerative disc disease (flattening of the disc)
  • Facet syndrome (inflammation of facet joints)
  • Hematoma (pocket of blood)
  • Herniated Disks (Disks slip out of place or rupture and leak, pressure is applied to nearby nerves)
  • Infection
  • Muscle strain (pulled muscle) or spasm (overworked muscle)
  • Osteoarthritis (Cartilage surrounding the spinal vertebrae gradually erodes, causing bone to contact with nerve)
  • Osteoporosis(Bone density is lost, causing vertebrae to weaken, fracture, or collapse, putting pressure on spinal nerves)
  • Scoliosis (abnormal spine curvature)
  • Spinal stenosis (narrowing of spinal canal, compressing nerves)
  • Spondylolisthesis (slippage of one vertebra over another)
  • Spondylolysis (instability of vertebral column)
  • Tumor

Associated Pain Care at MedStar Georgetown

Our team of accomplished, experienced orthopedic surgeons specializes in both traditional and contemporary management of neck, back and spine problems.  Our approach to your care includes:

  • Multidisciplinary partnerships – Our multidisciplinary approach to your care means our team will collaborate with other relevant specialists to diagnose and treat your condition.
  • Conservative management – Our experience shows that surgery is not the solution to every problem. When appropriate, we focus on managing your condition with non-surgical options like physical therapy and medication before moving toward surgery. 
  • Patient education – You will benefit from the time we devote to making sure you and your family understands your condition and your options. We explain the risks and benefits of all possible options, and give you the final say to choose the best treatment option for you.

 

Arm and Leg Pain

Experiencing serious pain in our arms and legs can make even the simplest tasks feel very difficult.  Arm and leg pain can arise from the common causes listed earlier, but also from the following spinal issues or injuries:

  • Brachial Plexus Injury: The brachial plexus is a group of nerves that transmit messages from the spine to the hand, shoulder, and arm. Inflammation, a tumor, or a serious shoulder injury can damage the brachial plexus and cause arm and shoulder pain, as well as numbness, weakness, or paralysis in the arm.
  • Sciatica: Sciatica occurs when a herniated disk puts pressure on or damages the sciatic nerve, which supports the muscles and controls sensation in the leg and foot. Those with sciatica often feel leg cramping, burning, weakness, numbness, and tingling as well as experience bladder control problems
  • Herniated disc: The spine, which runs from your neck to your lower back, is made of a long column of bones called vertebrae. Flexible disks filled with thick fluid cushion the space between the vertebrae. These disks can “herniate,” or slip out of place, or “rupture,” meaning leak. A herniated or ruptured disk puts pressure on nearby nerves, causing pain in either the arms or the legs.
  • Spinal stenosis: The spine, which runs from your neck to your lower back, is made of a long column of bones called vertebrae. The spine forms a protective covering around the very delicate spinal cord. Spinal stenosis results when the space between the vertebrae and the spinal cord narrows and puts pressure on the spinal cord.

Back Pain

No matter how sharp, or how long it lasts, back pain often limits our ability to feel active and productive. The top priority for anyone suffering from back pain is simply to eliminate the pain.

Back Pain Causes

The spine is a long column of bones, called vertebrae, that runs from your neck to your lower back. It forms a protective cushion around your spinal cord, which is a delicate bundle of nerves connected to your brain. The brain and spinal cord communicate through electrical signals to control our movement, our sensations, and our reflexes.  Injuries, inflammation, or swelling in any part of the spine or spinal cord can cause back pain.

Common causes of back pain include

  • Aging 
  • Weakened bones due to osteoporosis
  • Too much activity that strains the back muscles
  • Being out of shape or overweight, allowing extra weight to strain the back

More serious injuries and conditions can also affect the spine and cause back pain.  These conditions include:

Arthritis

Arthritis is an inflammation of the tissues that line your joints.  This inflammation can cause pain, swelling, and joint damage. Types of arthritis include:

  • Osteoarthritis – The natural aging process can wear down the cushioning between the vertebrae, causing inflammation and pain.
  • Rheumatoid arthritis – This immune system dysfunction attacks and wears away at the cushioning between the vertebrae, causing stiffness and pain.

Herniated Disc

Flexible disks filled with thick fluid cushions the space between the vertebrae. These disks can “herniate,” or slip out of place. They can also “rupture,” or leak. A herniated or ruptured disk puts pressure on nearby nerves, causing back pain. Other symptoms can include:

  • Burning sensation
  • Arm and/or leg weakness
  • Numbness
  • Tingling, like your arm or leg “fell asleep”
  • Bladder control problems

Scoliosis

A healthy spine curves slightly, but scoliosis is a condition that causes the spine to curve dramatically, in the shape of a C or an S. Scoliosis generally affects children, especially girls, but it can also develop in adults.  Scoliosis causes parts of the body to be lopsided, including the hips, shoulders and waist. This lack of balance results in back pain.

Pressure on the Spinal Cord

Pressure on the spinal cord can cause pain, weakness, and numbness in the neck and back, and can result from two different conditions:

  • Spinal stenosis – In this condition, the vertebrae, or bones that make up the spine, tighten around the spinal cord, reducing the cushioning space between them. Without this cushioning space, the vertebrae can put too much pressure on the spinal cord.
  • Spondylosis – Flexible disks filled with thick fluid cushion the space between the vertebrae. In this condition, the fluid dries up, reducing the space between the vertebrae.  When the vertebrae are too close together, they can put too much pressure on the joints between the spine, and on the spinal cord itself.

Infection or Cancer

In some cases, an infection in the spine, or a tumor pressing on the spine, can result in back pain.

Back Pain Diagnosis

The orthopedic surgeons at Georgetown are experts at diagnosing the full range of back pain causes.  Our initial exam generally includes:

  • Taking your medical history – This includes asking questions about when your pain began, and when the pain feels most severe. Other questions may be about whether you have other medical problems, and if you take any medications.
  • Physical exam – The orthopedist will determine where your back is most sensitive by examining it and by asking you to move and bend in different directions.
  • Imaging tests – Your orthopedist may want to examine the bones and joints themselves using a variety of imaging techniques, including:
    • X-ray, which can help determine if you have any broken bones, or if your bones are aging or curving
    • CT scan, which combines X-ray technology with computers to provide a very detailed picture of the spine
    • MRI, which uses powerful magnets and computer technology to create a picture of your muscles, tissues, nerves, and disks
    • Bone scan, which can show whether you have a bone infection or cancer
    • Bone density test, which shows how strong your bones are, and whether you may be suffering from osteoporosis
    • Nerve test, which can show how well your nerves are functioning, and indicate whether you are suffering from a herniated disk or spinal stenosis
  • Laboratory tests – Your orthopedist may order blood or urine samples to determine whether an infection is the source of your pain.

Back Pain Treatment at MedStar Georgetown

Back pain treatment generally depends on how severe your pain is, and what the underlying cause of it is.  The experienced team of spinal surgeons at Georgetown will carefully review your diagnosis to determine the cause of your pain. Then, we will work with you and your family to develop the most effective treatment plan.  Our team will recommend any combination of non-surgical and surgical treatment options designed to ease your pain and improve your quality of life. 

Treatment options aside from surgery may include:

  • Prescription and over-the-counter anti-inflammatory or pain medications
  • Injections of steroids or anti-inflammatory medications
  • Physical therapy, including applying heat or ice, massage, and exercises to strengthen the back
  • Braces that you wear around your back and stomach to keep your back from moving

Back Pain Surgery Options

If non-surgical treatment does not relieve your pain, you may need surgery. The orthopedic surgeons at Georgetown have extensive training in the most advanced and innovative surgical procedures to treat back pain, including:

Learn about treatment options for back pain at MedStar Georgetown. 


Neck Pain

It’s no accident that we use the expression “pain in the neck” to describe something that bothers us. Actual neck pain is very bothersome, and can make going about our daily routine very difficult.

Our first step in diagnosing and treating neck pain is determining its underlying cause. Common causes of neck pain include:

  • Poor posture, especially while using a computer or watching television
  • Quickly moving or twisting your head
  • Sleeping in a bad position

More serious injuries and conditions can also affect the neck muscles, nerves, and spine and cause neck pain.  These conditions include:

Arthritis

Arthritis is an inflammation of the tissues that line your joints.  This inflammation can cause pain, swelling, and joint damage. Types of arthritis include:

  • Osteoarthritis – The natural aging process can wear away at the cushioning between the bones in your neck, causing inflammation and pain.
  • Rheumatoid arthritis – This immune system dysfunction attacks and wears away at the cushioning between your bones.  It is common for rheumatoid arthritis to affect the neck, causing stiffness and pain.

Herniated disk

The spine, which runs from your neck to your lower back, is made of a long column of bones called vertebrae. Flexible disks filled with thick fluid cushion the space between the vertebrae. These disks can “herniate,” or slip out of place. They can also “rupture,” or leak. A herniated or ruptured disk puts pressure on nearby nerves, causing pain in the neck, as well as the spine itself and the arms or the legs. Other symptoms can include:

  • Burning sensation
  • Arm and/or leg weakness
  • Numbness
  • Tingling, like your arm or leg “fell asleep”
  • Bladder control problems

Pressure on the spinal cord

Pressure on the spinal cord can result from two different conditions:

  • Spinal stenosis – In this condition, the vertebrae, or bones that make up the spine, tighten around the spinal cord, reducing the cushioning space between them. Without this cushioning space, the vertebrae can put too much pressure on the spinal cord.
  • Spondylosis – Flexible disks filled with thick fluid cushion the space between the vertebrae. In this condition, the fluid dries up, reducing the space between the vertebrae.  When the vertebrae are too close together, they can put too much pressure on the joints between the spine, and on the spinal cord itself.

Both conditions cause pain, weakness, and numbness in the neck.

Neck Pain Treatment

Associated pain treatment generally depends on how severe it is and the underlying cause. Common non-surgical treatment options may include:

  • Prescription and over-the-counter anti-inflammatory or pain medications
  • Injections of steroids or anti-inflammatory medications
  • Physical therapy, including applying heat or ice, massage, and strengthening exercises
  • Braces

If non-surgical treatment does not relieve your pain, you may need surgery. The orthopaedic surgeons at MedStar Georgetown have extensive training in the most advanced and innovative surgical procedures to treat back pain, including minimally invasive back surgery and motion sparing surgery.

 

 

Make an Appointment

For more information or to schedule an appointment with a spine specialist, call our scheduling line. 

Phone: 202-295-0549