Back Pain and Injury

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 arthritis may be the problem if you have any or some of the following symptoms

• Pain
• Loss of range of motion
• A “grating” or “locking” sensation
• Joint swelling (often occurs over time)

For patients experiencing early stages of back arthritis, weight loss or activity modifications, acetaminophen, NSAIDs, physical therapy and steroid or viscosupplementation injections are all good options. Eventually, some people do opt for 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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Where Lower Back Pain Begins

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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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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Where Lower Back Pain Begins

Guide to Back and Neck Pain Relief

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Where Neck Pain Begins

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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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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Where Lower Back Pain Begins

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 there are many factors that 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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Lumbar radiculopathy is the clinical term for any disorder that is impacting the nerve roots in the lower back. The pain that results is called sciatic pain or sciatica, which are more commonly used.

A clear cause such as a herniated disc may be impacting the nerve roots, or it could be:

• Wear and tear
• A cyst (benign or cancerous)
• A traumatic injury
• Narrowing of the spinal canal

Leg pain is the primary symptom of this condition, which is treated with a typical progression from conservative to more invasive treatment plan:

• Activity modifications
• Heat and ice
• Medications (NSAIDs such as ibuprofen)
• Home exercises
• Physical therapy
• Spine injections
• Surgery such as a decompression or microdiscectomy

At OrthoNebraska, your treatment plan will be influenced by your specific symptoms, pain levels and the success or lack thereof of past treatments. We believe in coordinated decision-making, including a discussion of the risks and benefits as they pertain to you individually.

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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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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 sprains usually result in a pretty loose joint. While rarely requiring significant treatment, bracing or other equipment may be helpful. Severe sprains are torn ligaments, which typically require medical attention. They may be treated by home exercises or physical therapy or in the case of tears, surgery would sometimes be recommended. At OrthoNebraska, we believe in working together to arrive at a treatment plan that balances the risks and benefits.

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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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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 result from minor injuries such as a fall or sports collision or from higher energy events like car accidents. The severity of the fracture often follows the force of impact.

There are three types of fractures which will be diagnosed based on the fracture pattern:

• Extension
• Flexion
• Rotation

While symptoms will vary based on the fracture pattern, the general theme is back pain that is made worse by movement.

Nonsurgical treatment typically consists of long-term bracing (at least six weeks), and can be successful when there is not much collateral damage. Sadly, that is not often the case, and surgery is typically recommended if any of the following are present:

• Multiple bone fragments
• Bones are bent or angled due to the injury
• Severe loss of vertebral body height
• Spinal cord, nerve or posterior ligament damage

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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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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There are two types of spine tumors.

• Osteoblastoma (non-cancerous)
• Chordoma (cancerous)

Both are relatively rare, so general spine pain is more likely to be caused by something else. However, headaches and muscle spasms may be more of an indicator of tumors than other causes of back pain. For a definitive diagnoses, medical imaging such as an MRI is typically necessary, unless the tumor is easily visible. Spine tumors are slow to grow, so symptoms usually gradually worsen over time.

Treatment for these conditions is nearly always surgery and in the case of chordoma, sometimes accompanies by chemotherapy or targeted radiation therapy. The OrthoNebraska team will work collaboratively with you to determine your needs, risks and the appropriate treatment plan.

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