Cervical Radiculopathy

Cervical radiculopathy results from compression, irritation, or inflammation of the nerve(s) traveling from the cervical spinal cord through the openings in the bony spine called foramina.

Symptoms of such a condition can result in numbness, tingling, and/or weakness in the upper extremities (shoulders, arm, forearm, and hand).

Causes of this condition can be, a tear in the disc in proximity to the nerve, bony spur(s), or a fracture of the bone in proximity to the nerve. One can also experience such symptoms from or thickening of the bones or the ligaments leading to. Of note, not all degenerative conditions are symptomatic, and in fact, most degenerative conditions are asymptomatic.

 
 

Compression fractures of the Spine

Compression fractures develop when the front of the spine starts collapsing developing wedging due to stress from the weakening of the bone due to osteoporosis where the bone is soft and spongy rather than being dense like a brick. Some of the conditions that cause the weakening of the bone could be due to vitamin D deficiency, diabetes, aging, and bony replacement by soft cancerous cells. Trauma from falls or accidents may also result in fractures despite having normal bone density.

 

Degenerative Disc Disease

Degenerative Disc Disease is a normal aging process that may commence in the mid to late 20’s and continue into old age without ever causing symptoms. As one goes through life, normal wear and tears of the discs, our shock absorbers, occurs without any major symptoms. It is through an external event such as an accident, fall, improper bending, lifting, and/or twisting that can make an asymptomatic disc, symptomatic.

 

Facet Joint Syndrome

Facet Joints are in the posterior aspect of the spine and provide for approximately 20% of the spinal stability. These joints are lined by a membrane that produces fluid (synovial fluid) that lubricates the bones, and under normal conditions allows for restricted, but the pain-free motion of the spine. These joints can become thickened from excessive stress due to obesity or strenuous activities but remain asymptomatic, however can become symptomatic due to trauma.

 

Herniated Disc

Discs are the shock absorbers and are present throughout the spine, separating the bones and allowing for pain-free bending and twisting of the spine. A normal disc consists of a gel-like center called nucleus pulposus and an outer shell that contains the jell in a place called the annulus fibrosis. Think of the Jelly filled doughnut; the center soft jelly would represent the nucleus pulposus and the outside the annulus fibrosis. When the shell (annulus fibrosis) gets injured, the center portion of the jell (nucleus pulposus) leaks out – this is what is referred to as a disc herniation. If this herniation is in proximity to the nerve(s), it may cause symptoms of numbness, tingling, sharp shooting pain, neck or back pain, weakness in a limb or two, and in certain cases of spinal cord compression, bowel, bladder disturbances, paralysis, or stroke-like symptoms. There is also a strong possibility that even with a large disc herniation(s) one may not have any symptoms whatsoever.

 

Discogenic Pain

Discs are our shock absorbers and are present throughout the spine, separating the bones and allowing for pain-free bending and twisting of the spine. A normal disc consists of a gel-like center called nucleus pulposus and an outer shell that contains it in a place called the annulus fibrosis. Think of the Jelly filled doughnut; the center soft jelly would represent the nucleus pulposus and the outside the annulus fibrosis. Injury to the shell or the jelly-like substance may result in back pain. That is what is referred to as discogenic pain.

 

Pinched Nerve

A nerve is a cable that allows information to transmitted to and from the brain from any part of the body via the spinal cord. Compression of a nerve, or pinching, leads to interruption of the smooth flow of communication which can result in pins and needles, numbness, tingling, sharp shooting pain, weakness in a limb or two, and in certain cases of spinal cord compression paralysis or stroke-like symptoms, bowel, or bladder disturbances. The pinched nerves could be due to ligamentous thickening, trauma with a blood clot, bony fractures, spurs, or disc herniation.

 

Lumbar Radiculopathy (Sciatica)

Lumbar radiculopathy results from compression, irritation, or inflammation of the nerve(s) traveling from the lumbar region (lower back) through the openings in the bony spine called foramina.

Symptoms of such a condition can result in numbness, tingling, sharp shooting pain, and/or weakness in the lower extremities (buttocks, thighs, calves, sheen, feet).

Causes of this condition can be from lumbar disc displacement, a tear in the disc in proximity to the nerve, bony spur(s), or a fracture of the bone in proximity to the nerve. One can also experience such symptoms from degenerative disc disease or thickening of the bones or the ligaments leading to spinal stenosis. Of note, not all degenerative conditions are symptomatic, and in fact, most degenerative conditions are asymptomatic.

 

Myelopathy

Myelopathy is a condition where there is compression of the spinal cord. Interruption of communication to and from the brain to the limbs and internal organs can occur. Myelopathy may develop slowly over time or acutely from an injury such as a fracture of the spine or a disc herniation. When it develops slowly over time, a person may not become symptomatic until much later in life when the presentation could be difficulty walking or stroke-like symptoms. Infiltration of the bone by cancer can also lead to compression of the spinal cord. Dysfunction of the bowel and/or bladder may also occur along with imbalance. This condition may also result in weakness in one's limbs with difficulty carrying out day-to-day activities.

 
 

Osteoporosis

Osteoporosis is a condition where there is a weakening of the bone which can lead to pain with or without compression fractures of the spine. With compression fractures of the spine, one can develop deformity such as a hunchback which in turn can lead to difficulty ambulating and breathing. Risk factors for osteoporosis are post-menopausal, female, vitamin D deficiency, and smoking to name a few.

Post-laminectomy Syndrome (Failed Back Surgery)

Post-laminectomy Syndrome (Failed Back Surgery) is a generalized term for patients who have undergone previous spinal surgery with continuing pain. This can also occur in patients who may have had temporary relief of their pain after decompressive surgery, however over a period develop instability with pain. Patients may experience symptoms of difficulty ambulating, shooting pain down the legs, weakness in the limbs, burning sensation in the limbs, and possibly bowel and/or bladder disturbances.

 

Cervical Spinal Stenosis

Cervical Spinal Stenosis is a condition whereby the bony channel in the cervical spine, through which the spinal cord runs is narrowed. This could be due to a congenital anomaly (something you were born with), bony overgrowth, ligamentous thickening, disc herniation, slip in the vertebral bodies, or all of the aforementioned. There is also the possibility of compression by a tumor.

Symptoms of spinal stenosis could be weakness and/or numbness in arms and/or legs, difficulties with bowel and/or bladder, and/or difficulty with balance.

Thoracic Spinal Stenosis

Thoracic Spinal Stenosis is a condition whereby the bony channel, the thoracic spine, through which the spinal cord runs is narrowed. This could be due to a congenital anomaly (something you were born with), bony overgrowth, ligamentous thickening, disc herniation, or all the aforementioned.

Symptoms of spinal stenosis could be weakness and/or numbness in the legs, difficulties with bowel and/or bladder, and/or imbalance. There is also the possibility of compression by a tumor.

 
 

Spondylolisthesis

Spondylolisthesis is a condition whereby one vertebral body slips forward relative to the rest of the normally aligned ones in the spine. This condition may arise from a congenital anomaly whereby the facet joints are disconnected from the rest of the vertebral body allowing for the slip. Spondylolisthesis may also result from trauma or prior surgery where a laminectomy was performed.

Symptoms of this condition include low back pain, leg pain, weakness, difficulty walking long distances, difficulty standing in one position.

 
 

Whiplash

Whiplash is common because of a sudden flexion and extension of the cervical spine as occurs after a rear-end collision. It usually an injury to the muscles and ligaments stabilizing the cervical spine.

Symptoms of whiplash-type injury include stiffness, difficulty turning the head side to side, difficulty looking upwards, headaches as well as shoulder pain and discomfort.

 

Post-Whiplash Headache

It is not uncommon for patients to develop headaches after whiplash-type injury; however, they tend to be short-lived. In a small subset of patients, however, the headaches may continue for months and at times years after the injury.

 

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a condition where there is compression of the median nerve in the wrist. Some of the causes of these include trauma from motor vehicle crashes, falls, fractures of the wrist, diabetes, hypothyroidism, and pregnancy.

Some of the symptoms are nocturnal numbness in the hands, weakness, tingling, and pain in the hand. Patients also may have trouble holding onto simple objects such as toothbrushes, shaver, steering wheel whilst driving due to the numbness and a weak grip.

 

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is also known as ulnar neuropathy at the elbow is a condition that can develop gradually over time from remote trauma to the elbow, sometimes over a decade ago. This condition can also develop without any clear-cut reason.

The symptoms include numbness and tingling in the ring and little finger with clumsiness and grip weakness.

 
 

Sacroiliac Joint Pain

Sacroiliac (SI) joint dysfunction can result in buttock pain that can radiate to the groin and thigh, resulting in weakness with difficulty walking, sitting, and standing. Some of the causes are trauma to the joint in motor vehicle crashes and postpartum. Certain types of arthritis can also result in SI joint pain.

Spinal Infection

A spinal infection could be secondary to trauma or prior spinal surgery resulting in back pain, fever, chills, and malaise. The infection could spread into the vertebral bodies as well as intervertebral discs causing deterioration with neurologic compromise. Pain, numbness, and weakness are not uncommon depending on the location.

 

Spondylosis

Normal wear and tear aging process that involves all elements of the spine. As the degeneration occurs slowly over time, a person may not necessarily be symptomatic from all the abnormalities that may be noted n the imaging studies such as MRI scans.