Back Pain and Injury

Back arthritis is a common condition where the joints in the spine wear down and become inflamed, leading to pain and stiffness over time. It typically develops with age as cartilage breaks down, causing bones to rub together and create discomfort.

Common symptoms include persistent back pain, reduced flexibility, and a grinding or locking sensation during movement.

Risk factors include aging, prior injuries, repetitive strain, and conditions like obesity or other joint diseases.

While it can’t be cured, treatment focuses on managing symptoms through things like physical therapy, medications, injections, and in some cases, surgery.

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Back Sprains and strains are often caused during sports activities or daily tasks. Sprains are ligament injuries and strains are muscle or tendon injuries.

Most acute (sudden) injuries of this type can be treated using the RICE method:

• Rest
• Ice the injury site for 20 minutes at a time, several times a day
• Compression bandage
• Elevate the injury site above your heart

However, moderate or severe strains may benefit from evaluation and a treatment plan from medications like muscle relaxants, home exercises, or heat or ice therapies. At OrthoNebraska, we believe in working together to arrive at a treatment plan that balances the risks and benefits as you recover.

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Often also referred to as degenerative joint disease, arthritis forms over time and results in pain and inflammation when joints move. In this case, when the back or spine moves.

Back and neck arthritis are more specific forms of this condition, which is typically characterized by pain and discomfort.

Most people are scared to seek treatment early for fear of needing surgery, but a large percentage of patients never have surgery. At OrthoNebraska, your treatment plan is developed collaboratively between you and your care team, and includes a discussion of the risks and benefits as they pertain to you individually.

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Diabetic neuropathy is a type of nerve damage caused by prolonged exposure to high levels of blood sugar. It affects the nerves in the body and can lead to a range of symptoms, including numbness, pain, weakness, and loss of sensation in the feet or hands. Over time, it may also cause organ damage.

The most common causes of diabetic neuropathy include diabetes that is poorly managed, as well as other medical conditions, such as kidney disease or an underactive thyroid.

Common symptoms of diabetic nerve damage include numbness and tingling in the hands and feet, muscle weakness or pain, sensitivity to touch, burning or stabbing pain in the legs or feet, loss of coordination, and digestive issues. If left untreated, it can lead to organ damage and further complications.

Treatment for diabetic neuropathy typically focuses on reducing the nerve-related symptoms while also managing diabetes more effectively. This may involve taking medications to manage nerve pain or controlling blood sugar levels through diet and exercise. In some cases, physical therapy and lifestyle changes can help to reduce the symptoms of diabetic neuropathy.

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Herniated discs can occur anywhere in the spine, but are most often found in the low back, or lumbar region of the spine. They result when the jelly-like discs that sit between each spine bone (vertebra) and allow it to move and act as shock absorbers suffer a loss of integrity in the outer ring. This can be due to wear and tear or an injury.

If you are experiencing sharp, shooting back from the buttocks down the back of one leg, it is likely being caused by a herniated disc. Other symptoms can include:

• Numbness or tingling in a leg or foot
• Weakness in a leg or foot
• Loss of bladder or bowel control (this is a medical emergency – call 911)

Treatment of herniated discs will be based on an individual patient’s specific symptoms, needs and desires, following a natural progression from conservative to invasive treatment. This can include:

• Rest and activity modifications
• NSAIDs like ibuprofen
• Physical therapy
• Steroid injections
• Surgery, such as a microdiscectomy

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Kyphosis is a condition where the upper spine curves forward excessively, creating a rounded or hunched posture. While mild curvature is normal, more severe cases can cause pain, stiffness, fatigue, and difficulty standing upright, and in advanced cases may affect breathing or mobility.

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Low back pain can be caused by a number of different conditions. It can be really difficult for anyone who is not a back or spine specialist to properly identify the root cause and work through different treatment options.

At OrthoNebaska, we are well equipped to help patients along this journey, because we have three spine specialists with different types of training and backgrounds. If you are wondering which one is most appropriate for you, see our guide to spine specialists. If you are wondering about the need to see someone for spine back in general, you can take our back and neck assessment.

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Pressure or stretching injuries can cause fibers within the nerves to break. When a nerve is broken, it can interfere with the nerve’s ability to send or receive signals from the brain.

A nerve injury can occur almost anywhere in the body, so many factors will be considered when developing your treatment plan.

While it depends on the location and severity of the nerve injury, surgery is often recommended to repair the nerves. More than likely physical therapy will be needed after surgery, which includes retraining your brain to send signals to those nerves and preventing any joints from becoming stuff.

The OrthoNebraska team will work collaboratively with you to determine your needs, risks and the appropriate treatment plan.

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A pinched nerve (lumbar radiculopathy) occurs when a nerve in the lower spine is compressed or irritated, often causing pain that radiates from the back down the leg—commonly referred to as sciatica.

This condition is typically caused by factors like herniated or bulging discs, arthritis, spinal stenosis, or injury, and may be influenced by lifestyle or physical strain.

Common symptoms include burning, shooting, or aching leg pain, along with tingling, numbness, or weakness; leg pain is often more prominent than back pain.

Diagnosis involves a physical exam and sometimes imaging to confirm nerve involvement and rule out other conditions.

Most cases improve within 4–6 weeks using conservative treatments such as activity modification, medications, and physical therapy, while only a small percentage of patients require surgery.

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Sometimes due to the natural aging process, the spinal cord can become compressed or squeezed, resulting in spinal cord compression or, clinically speaking, spondylotic myelopathy. More rarely, a traumatic injury or disease like rheumatoid arthritis may contribute.

Symptoms for this condition vary widely, but patients may experience:

• Tingling or numbness in the arms, hands or fingers
• Weakness or lack of grip strength in the arms, hands or fingers
• Lack of balance or coordination
• Pain or neck stiffness
• Difficulty with fine motor skills such as handwriting or plugging something into an electrical outlet

Initial treatment for this condition is often non-surgical. This may involve:

• Physical therapy
• Bracing or collaring
• Medications such as NSAIDs (ibuprofen) or corticosteroids
• Spine injections

Over time, most patients with the condition are known to benefit from surgery. However, this depends on your age, pain tolerance, the therapeutic value of conservative treatment and other factors. We always discuss the risks and benefits of any treatment plan, whether surgery is recommended or not.

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A spinal cord injury results when a fall or traumatic injury such as a car accident fractures or dislocates the vertebrae bones in your spine.

Symptoms resulting from damage to the spinal cord might include pain when moving your back or spine, partial or complete loss of feeling and muscle control (paralysis) and problems with bowel or bladder control.

A detailed diagnosis is really important, even if your symptoms are minor, because damaged nerves tend to recover quickly or not at all. Seeing a specialist in treating spinal cord injuries who will put together a detailed treatment plan for your situation can make a big difference when it comes to the final outcome and recovery from a spinal cord injury.

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Spinal stenosis happens due to pressure placed on the spinal cord or nerves that provide sensation and strength to the legs.

Typically, the pain associated with spinal stenosis occurs in the low back, buttocks, thigh, calf or groin. Tingling, weakness, cramping or fatigue in the legs are also common. People with this condition typically feel worse when walking or standing and better when sitting or leaning forward.

Treatment options include:

• Physical therapy
• Nerve pain medications
• Muscle relaxants
• NSAIDS
• Steroid or spine injections
• Surgery

At OrthoNebraska, your treatment plan is developed collaboratively between you and your care team, and includes a discussion of the risks and benefits as they pertain to you individually.

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Spine fractures can occur from low-impact injuries like falls or sports collisions, or high-impact events such as car accidents. Severity generally depends on the force involved.

Fractures are classified into three types based on the movement that caused them: extension, flexion and rotation. While symptoms vary, back pain that worsens with movement is most common.

Nonsurgical treatment may include bracing for at least six weeks and can be effective when damage is limited. However, surgery is often recommended if there are:

• Multiple bone fragments
• Abnormal bone alignment
• Significant loss of vertebral height
• Damage to the spinal cord, nerves or ligaments

At OrthoNebraska, your care team will work with you to create a personalized treatment plan, including a discussion of risks and benefits.

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Infections can happen anywhere after surgery, including in the spine. Any time a foreign body, such as an implant to replace bone or screw to hold in in place, are introduced, there is a slight risk of infection.

The symptoms associated with infection are:

• Redness
• Warmth
• Inflammation
• Stiffness
• Pus or drainage
• Loss of range of motion
• Fever
• Chills

Infections are considered a medical emergency, so you should see a provider immediately if you suspect it. Left unchecked, infections can completely destroy bone and surrounding tissue. If resulting from a surgery, a second procedure will be required to clean out the infection and antibiotics will be described.

OrthoNebraska, as a specialty hospital, has really low infection rates due to our focus on orthopedic-specific infection control.

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Spondylolisthesis is a big word for the misalignment of the vertebra (bones) in your spine.

It usually produces symptoms related to the resulting compression of the spinal cord, including:

• Dull back or leg pain
• Numbness
• Weakness

Treatment of this condition is based on the symptoms and will typically follow a progression.

• NSAIDs such as ibuprofen
• Activity modifications
• Physical therapy or back exercises
• Spine injections

Surgery may be recommended if symptoms persist despite the above treatments, or based on a discussion between the surgeon and patients weighing the risks and benefits of treatment options.

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