How to Properly Care for your Pain
Section 1 "The Playing Field"
Spine: Forms the axis of the torso from the base of the skull to the pelvis. The front of the spine is made up of alternating bones and discs. The back of the spine is made up of bones and joints. The structure allows a normal spine to move freely without pain or stiffness.
Spinal canal: A tunnel in the back of the spine that is formed by the bones, discs, and joints. The spinal canal contains the spinal cord, spinal nerves, spinal fluid, blood vessels, ligaments, and fat. With injury or degeneration, the canal can sometimes become narrow enough to place pressure on the spinal cord or spinal nerves causing pain, tingling, numbness, weakness, or other neurological problems.
Discs: These function like cushions between the bones in the front of the spine. If injured, a disc can cause pain either by pressing on the spinal cord or spinal nerves or by leaking its contents through a tear. Degenerating (aging) discs can also be painful.
Facets: These are small paired joints in the back of the spine. Together with the discs, these allow for flexibility of the spine. Facets can cause pain if injured or degenerated.
Sacroiliac joints: These two large joints at the base of the spine connect the sacrum with the pelvis. Sacroiliac joints can cause pain if injured or degenerated or occasionally after childbirth.
Hip joints: These two, large, simple ball-and-socket joints carry the weight of the upper body when upright. Strictly speaking, the hip joints are not part of the spine but can cause pain in the groin, pelvis, sacrum, and legs that resembles pain originating in the spine.
Shoulder joints: These two smaller, complex ball-and-socket joints attach the arms to the upper torso and are structured to allow mobility in multiple directions. Strictly speaking, the shoulder joints are not part of the spine but can cause pain in the neck, upper back, shoulders, and arms that resembles pain originating in the spine.
Section 2: Care of the spine, hips, shoulders
Eat well. The spine and joints are living structures, not simply firm scaffolding. They need proper nutrition and weight control, especially if injured or healing.
Smoking. It is well known that smoking impairs circulation and healing. Discs, joints, ligaments, and tendons are especially vulnerable because circulation to these structures is limited to begin with. DO NOT SMOKE!!
Activity. The human body was designed for movement, especially the spine and joints. One need not be a “gym rat” but even modest amounts of exercise can keep circulation moving and weight from accumulating.
Targeted exercises. The structural integrity of the spine and joints depends critically upon the strength of certain muscle groups. A regular program of specific exercises targeting specific muscles is crucial for maintaining a healthy spine and joints.
Section 3: If pain becomes consistent and persistent
The first step is to see your primary physician or physical therapist or chiropractor. He or she will ask you questions and examine you. If appropriate, imaging (x-ray, CT, MRI) may be done in order to help with the diagnosis.
The next step is usually conservative care. Conservative care might consist of developing an exercise program, weight control, smoking cessation, prescribing anti-inflammatory or muscle relaxant medications.
If conservative care is not successful, then sometimes an interventional pain physician is consulted in order to see if a targeted procedure is appropriate to diagnose or treat the pain.
If there is a sudden neurological compromise, or loss of function, or if targeted procedures fail to resolve the problem, then a surgeon may need to be consulted.
Section 4: What we do
We accept referrals from primary physicians, neurosurgeons, orthopedic surgeons, chiropractors, and physical therapists for persistent focal pain originating from or near the spine.
Our evaluation includes a detailed history, thorough physical examination, and review of relevant imaging.
If appropriate, a targeted interventional procedure is performed in order to diagnose or treat a pain, or both.
Depending on results, an interventional procedure might be repeated, or a different procedure might be performed.
When intervention is completed, the patient is referred back to the referring physician or to an exercise specialist or to a neurosurgeon or orthopedic surgeon.
Section 5: Our Goal
By focusing our evaluation on your specific pain, we customize and target our treatment in order to maximize the chance of improving your condition.