Acute and Chronic Symptoms

For a neck problem:

  • Pain in the neck and arms
  • Tingling in the arms or hands
  • Numbness in arms or hands
  • Weakness or clumsiness in the arms or hands

For a low back problem:

  • Pain in the low back and legs
  • Tingling in the legs or feet
  • Numbness in the legs or feet
  • Weakness or clumsiness in the legs or feet

Low Back Pain

Most Americans will experience back pain at some point during their life. Since the low back is subject to a great deal of mechanical stress and strain, a number of problems may arise. Most back pain resolves in a short time but back pain, which does not go away in a few days or weeks, should be evaluated. Some common causes of back pain include:

  • Muscle, ligament and joint overuse
  • Disc herniation
  • Arthritis of various types including osteoarthritis
  • Spondylolisthesis (slippage of one spinal bone on another)
  • Spinal stenosis (compression of nerves in the spinal canal)
  • Fracture (due to repeated stress or injury)
  • Compression fracture
  • Spinal deformities

Disc problems

The discs are soft tissue structures, which are located between the bones (vertebra) in the spinal column of the neck and the back. They are stabilized and held closely to the bones by tough ligaments. The discs act as "shock absorbers" and help the spine to move in many directions. As aging occurs, the disc become more degenerative and can become painful. Discs can also be a source of pain when the inner "jelly" breaks through the outer wrapper and presses against a nerve (disc herniation). While herniated disc can occur in children, it is most common in young to middle-aged adults. Disc problems can cause a number of symptoms including:

  • Neck or back pain
  • Pain in the arms or legs
  • Numbness or tingling in the arms or legs
  • Weakness or clumsiness in the arms or legs

Cervical Spine Instability

Cervical spine (neck) instability is characterized by excessive motion within the spinal segments of the neck and which can cause neck pain. If the instability is more severe, there is risk of injury to the spinal cord and nerves. Spinal instability can limit the ability to perform various activities of daily living and hamper lifestyle. Instability can result from various problems such as:

  • Degenerative changes in the neck that arise from naturally occurring "wear and tear"
  • Other types of arthritis such as rheumatoid arthritis
  • Congenital conditions
  • Injury to the bones or ligaments in the neck

Joint problems in the spine

The spine is not only made up of discs and bone but also has a pair of small joints at each level. These spinal joints are called "facet joints". They are much like other joints in the body such as those of the hip, knee or elbow. The spinal joints allow motion to occur in the spine and are also subject to many of the problems that occur in other joints in the body. They can be fractured due to injury, are prone to degenerative arthritis and become painful due to excessive motion and overuse. The inflammation that occurs in these joints due to any of these causes is responsible for back pain in many patients. A diagnostic injection called a "facet injection" can be used to help determine whether facet pain is a large part of a back pain problem. A small amount of anesthetic and steroid (an anti-inflammatory drug) is injected into each of the suspected painful joints and temporary relief can be diagnostic of a facet joint problem. If that is the case, carefully taking away the nerve supply to each joint can be associated with some pain relief. This procedure is called a "rhizotomy" and can be performed using various local burning techniques. A newer technique uses a small arthroscopic instrument called an endoscope to actually visualize and burn the nerves to the joint. This technique can decrease pain for months and sometimes for more extended periods of time.

Numbness and weakness in Extremities

The central nervous system is made up of the brain and the spinal cord and the spinal cord is located within the protection of the boney spinal canal. The peripheral nervous system is located mostly outside the spinal canal such as in the nerves of the arms and legs. Both of these groups of nerves give the body the ability to have feeling and to move the muscles. Spine problems such as herniated discs can cause pressure on the nerves and result in numbness or weakness in arms or legs.