Low Back, Leg, Neck, and Arm Pain

Condition – Lower Back Pain

Definition: Back pain is one of the most common reasons people go to the doctor or miss work and a leading cause of disability worldwide. Most people have back pain at least once. Fortunately, you can take measures to prevent or relieve most back pain episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.

Symptoms:

  • Muscle ache
  • Shooting or stabbing pain
  • Pain that radiates down your leg
  • Limited flexibility or range of motion of the back

Causes: Back pain can come on suddenly and last less than six weeks (acute), which may be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain. Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:

  • Muscle or ligament strain: Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back may cause painful muscle spasms.
  • Bulging or ruptured disks: Disks act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you undergo spine X-rays for some other reason.
  • Arthritis: Osteoarthritis can affect the lower back. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
  • Skeletal irregularities: Back pain can occur if your spine curves abnormally. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain, but generally only if the scoliosis is severe.
  • Osteoporosis: Your spine’s vertebrae can develop compression fractures if your bones become porous and brittle.

From: Mayo Clinic

Condition – Neck Pain

Definition: Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it’s leaning over your computer or hunching over your workbench. Osteoarthritis also is a common cause of neck pain. Rarely, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm.

Symptoms:

  • Pain that’s often worsened by holding your head in one place for long periods, such as when driving or working at a computer
  • Muscle tightness and spasms
  • Decreased ability to move your head
  • Headache

Causes: Your neck is flexible and supports the weight of your head, so it can be vulnerable to injuries and conditions that cause pain and restrict motion. Neck pain causes include:

  • Muscle strains. Overuse, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting your teeth, can strain neck muscles.
  • Worn joints. Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain.
  • Nerve compression. Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord.
  • Injuries. Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
  • Diseases. Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain.

From: Mayo Clinic Staff

Condition – Leg Pain

Definition: Leg pain can be constant or intermittent, develop suddenly or gradually, and affect your entire leg or a localized area, such as your shin or your knee. It can also take a number of forms — stabbing, sharp, dull, aching or tingling. Some leg pain is simply annoying, but more-severe leg pain can affect your ability to walk or to put weight on your leg.

Symptoms: Most leg pain results from wear and tear, overuse, or injuries in joints or bones or in muscles, ligaments, tendons or other soft tissues. Some types of leg pain can be traced to problems in your lower spine. Leg pain can also be caused by blood clots, varicose veins or poor circulation. Some common causes of leg pain include:

  • Achilles tendinitis
  • Achilles tendon rupture
  • ACL injury
  • Baker’s cyst
  • Bone cancer
  • Broken leg
  • Bursitis
  • Chondromalacia patella
  • Chronic exertional compartment syndrome
  • Claudication
  • Deep vein thrombosis
  • Fibromyalgia
  • Gout
  • Growing pains
  • Growth plate fractures
  • Hamstring injury
  • Herniated disk
  • Infection
  • Juvenile rheumatoid arthritis
  • Knee bursitis
  • Legg-Calve-Perthes disease
  • Torn meniscus
  • Muscle cramp
  • Night leg cramps
  • Osgood-Schlatter disease
  • Osteoarthritis
  • Osteochondritis dissecans
  • Osteomyelitis
  • Paget’s disease of bone
  • Patellar tendinitis
  • Peripheral neuropathy
  • Posterior cruciate ligament injury
  • Posterior tibial tendon rupture
  • Pseudogout
  • Rheumatoid arthritis
  • Sciatica
  • Shin splints
  • Spinal stenosis
  • Sprains and strains
  • Stress fractures
  • Tendinitis
  • Thrombophlebitis
  • Varicose veins

From: Mayo Clinic Staff

Condition – Arm Pain

Definition: Arm pain can be caused by a wide variety of problems, ranging from joint injuries to compressed nerves. Depending on the cause, arm pain can start suddenly or develop over time. In many cases, arm pain actually originates from a problem in your neck or upper spine. Arm pain, particularly pain that radiates into your left arm, can even be a sign of a heart attack.

Causes:

  • Angina
  • Brachial plexus injury
  • Broken arm
  • Broken wrist/broken hand
  • Bursitis
  • Cancer (malignancy), primary or metastatic
  • Carpal tunnel syndrome
  • Cervical dystonia (spasmodic torticollis)
  • De Quervain’s tenosynovitis
  • Dislocated elbow
  • Fibromyalgia
  • Heart attack
  • Herniated disk
  • Rheumatoid arthritis
  • Rotator cuff injury
  • Sprains and strains
  • Tendinitis
  • Tennis elbow
  • Thoracic outlet syndrome
  • Ulnar nerve entrapment

From: Mayo Clinic Staff

Treatments We Offer

Pharmacotherapy – The treatment of sciatica may include medications like NSAIDs (Ibuprofen-like drugs), acetaminophen, membrane stabilizing drugs, muscle relaxants, and other analgesics.

Epidural Steroid Injections (ESI) – These injections deliver a long-lasting steroid and a local anesthetic into the epidural space, targeting the irritated nerve root. The steroid reduces inflammation and irritation and the anesthetic works to interrupt the pain-spasm cycle and transmission of pain signals (Boswell et al, 2007). The combined medicines then spread to other levels and portions of the spine, reducing inflammation and irritation. The entire procedure usually lasts under fifteen minutes. ESIs have been shown to provide rapid relief of symptoms that allows patients to regain normal daily activity (Vad V et al, 2002). A large study in 2005 including two hundred and twenty-eight patients with a clinical diagnosis of unilateral sciatica were randomized to either three lumbar ESIs of or a placebo injection at intervals of three weeks. The ESI group demonstrated a 75% pain improvement over the placebo group (Arden et al, 2005).

Physical Therapy – Physical Therapy helps improve symptoms of sciatica by increasing flexibility, range of motion, posture, and improving muscle strength. In fact, current evidence shows that an active exercise program promotes early recovery in sciatica patients (Goh L et al, 2003).

Nutrition and Exercise – Exercise improves the pain of sciatica by increasing flexibility and range of motion. Another benefit is the releases hormones called “endorphins,“ which are your body’s natural pain relievers. Nutrition and healthy eating may be powerful treatments to combat nutritional deficits.

Staff

Jonathann Kuo, MD
Pain Medicine / Executive Director
Alexander Rances, DO
Pain Medicine / Medical Director
Robert Zhang, MD
Pain Medicine / Anesthesiology

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