Archive for category spine
Facet Joint Health, Low Back Pain and Upper Back Pain review by KBNI Houston, Kingwood, Spring, Sugarland, Katy, Pearland, Baytown, Beaumont, Clear Lake, Memorial City, the Woodlands
Posted by admin in arthritis, back pain, baytown, beaumont, chiropractic, chiropractor, Clear Lake, conroe, facet joint, Galleria, houston, Humble, imaging, katy, Kingwood, low back pain, lumbar spine, Memorial City, Missouri City, nerves, pain, Pearland, physical exam, physical therapy, Port Arthur, spinal, spinal column, spinal discs, spine, spondylolisthesis, spondylolysis, Spring, Texas City, Tomball, upper back pain, woodlands on January 21, 2016
Facet Joint Health, Low Back Pain and Upper Back Pain
Simply put, the facet joint links the vertebrae of the human spinal column and allow for the articulation of the spine. When they facet joints are not functioning properly, or when they become degenerated, develop arthritis, or slip, they may be the cause of low back pain and upper back pain. In addition to providing mobility, the facet joints also help stabilize the spinal column by being oriented in such a way that they decrease the chances of preventing forward vertebral slippage (spondylolisthesis). The ends of the facet joints are covered in cartilage, which allows for pain-free operation over a normal range of motion (bending, twisting, lifting, sitting, standing, etc.). While the cartilage does break down naturally over time (in this manner resembling cartilage in other parts of the body), the facet joints are still quite durable if direct physical trauma (such as from an accident) is not an issue. The condition known as spondylolisthesis exists when one vertebral body is slipped forward upon the vertebral body below. This is also known as anterolisthesis. When the vertebral body is slipped backward upon the vertebral body below, the condition is known as retrolisthesis. Spondylolisthesis may occur as a result of degenerative changes of the facet joint. When a patient has a condition known as spondylolysis, the patient is prone to develop spondylolisthesis. Spondylolysis is a condition where there is a gap in what may be considered the roof over the spinal canal. It may occur from an injury, or a person may be born with it. When this condition occurs, the facet joint is no longer able to help support the vertebral bodies from slipping forward upon each other, and instead, all of this burden is placed upon the intervertebral disc, which separates two adjacent vertebral bodies. Spondylolisthesis, whether anterolisthesis or retrolisthesis, may be related to low back pain or upper back pain, as it relates to possible instability of the spinal column.
With all of these essential functions, the facet joints are a little-known but important means to preventing low back pain and upper back pain. These joints, along with spinal discs (the shock-absorbing pads between our vertebrae) help relieve pressure on the spinal nerves during routine motion, lowering the incidence of nerve compression (and accompanying sharp low back pain). Over time, however, the facet joints begin to break down just like any other mechanical component in the human body. Repetitive bending, lifting, and twisting can all accelerate the natural degenerative processes in the human spinal column, and the facet joints are no exception. The cartilage on the ends of the joints breaks down as spinal discs become thinner, harder, and less capable of bearing shock as we grow older. All of this leads to higher incidence of compressed (pinched) spinal nerves, which in turn can cause muscle weakness, numbness, low back pain, upper back pain, and decreases in overall mobility.
As such, maintaining the health of our facet joints as we age should be a priority for everyone. Patients with chronic low back pain and upper back pain are advised to explore the option of physical therapy or chiropractic designed specifically for the spine. Typically, spine-specific physical therapy programs use a regimen of core-strengthening exercises to build muscles along the spinal column and throughout the torso. Stronger core muscles are more capable of relieving load-bearing stress on other degenerated portions of the spine, such as the discs and facet joints. Continuing physical therapy at home will also help back pain patients maintain optimal muscle mass as they age, which will in turn lower the incidence of injury, low back pain and increase overall mobility. Patients are advised to consult their physicians prior to beginning any physical therapy regimen to ensure they do not have any structural deformities that would be exacerbated by an exercise program. Imaging tests (x-rays, magnetic resonance imaging (MRI) ) may be necessary to confirm this, depending on the physician’s findings during your physical exam. Standing low back x rays in flexion and extension will show whether spondylolisthesis is stable, or whether it moves.
Low back pain is one of the most common reasons for individuals to visit their doctor, and for loss of work. Finding the source of the low back pain is important, before the low back pain can be addressed, and treatment begun. Causes of low back pain include the facet joint, the spinal disc itself, the ligaments attached to the low back spinal column, the nerves leaving the spine in the low back, and the muscles which attach to, and create movement in the low back.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Pearland, Galleria, Beaumont, Baytown, Clear Lake, Port Arthur, Katy, the Woodlands, Spring, Memorial City, Humble, Kingwood, Conroe, Tomball, Missouri City, Texas City, and Texas Medical Center (TMC)
Patients suffering from a low back pain or neck pain, or who have been told they may require a low back surgery or neck sugery, can
contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
Keywords: facet joint, low back pain, back pain, physical therapy, spinal column, spondylolisthesis, spinal, Houston, Pearland, Galleria, Beaumont, Baytown, Clear Lake, Port Arthur, Katy, the Woodlands, Spring, Memorial City, Humble, Kingwood, Conroe, Tomball, Missouri City, Texas City, TMC, Texas Medical Center
Whiplash review by KBNI Houston, Katy, Sugarland, Spring, Woodlands, Baytown, Beaumont, Port Arthur, Tomball
Whiplash / Houston
Each year more than two million Americans experience a whiplash injury (a.k.a. whiplash-associated disorder) to their neck. Numerous studies have shown that the most common cause of whiplash is a 6 to 12 mph rear-end automobile collision where the individual has a sudden, hyper-extension (backward movement) and flexion (forward movement) of the neck. The violent, unexpected motion forces the neuromuscular structure of the cervical region to exceed its normal movement parameters. Collisions at higher speeds have a commensurately higher incidence of severe damage to the cervical spine region.
Whiplash-associated disorder can also be caused by a front-end or side-impact automobile collision, contact sport-related accident, e.g., being struck from behind, diving/swimming pool accident, amusement park ride, or physical abuse (e.g., shaken baby syndrome). The pain the individual feels can be mild to severe and acute (short term) or chronic (long term). It is generally agreed that as many as 40% of patients with acute, whiplash-associated neck pain will develop chronic neck pain.
Soft Tissue Injury
In the majority of cases, the whiplash injury damages the soft tissue of the neck resulting in a sprain or strain of the neck muscles or ligaments. In the past, damage to the soft tissues was nearly impossible to visualize. Even with the aid of various advanced imaging technologies (MRI, CT-scan, standard x-ray with contrast, etc.) visualization remains difficult. There are times when patients will experience soft tissue injury, with pain, yet the imaging studies are completely normal. This means that the key factor in soft tissue diagnosis is the knowledge and experience of the spine specialist.
The symptoms of a soft tissue neck injury include neck pain, arm and hand pain, stiffness, back pain, shoulder pain, ringing in the ears, dizziness, neck-related (cervicogenic) headache, paresthesia (burning, tingling or prickling sensation), or injury to the discs, facet joints of the low back or sacroiliac joints. Some people may also experience cognitive deficits such as memory loss and impaired concentration as well as sleep disorders or psychological conditions, e.g., nervousness, depression or irritability. It is important to keep in mind that while the symptoms of a whiplash-associated disorder usually appear within 24 hours, in some cases the symptoms may not manifest themselves until days or even weeks after the accident.
If a soft-tissue injury is confirmed, there are a number of passive treatment alternatives that may be recommended including bed rest, hot and cold compresses, pain relieving medications such as non-steroidal anti-inflammatory drugs, and muscle relaxants. The decision as to which medication(s) is prescribed will depend on the type and severity of pain being experienced, the individual’s pain tolerance, and their general medical condition. Spine specialists now prefer that the patient pursue their daily activities in as normal a manner as possible. In the past, whiplash patients were advised to wear a cervical collar to limit neck movement. This type of immobilization is no longer considered an effective therapy as prolonged collar wear can cause weakness in the neck muscles.
Most patients with mild to moderate whiplash will have pain relief within a few days to two weeks, with a prognosis of full recovery in 10 to 12 weeks. For those individual’s whose neck pain becomes chronic (more than 12 weeks) or worsens the spine specialist may recommend, in addition to pain medication, some form active intervention including physical medicine, e.g., physical therapy, traction, range of motion exercises, etc. In the rare case of prolonged, debilitating soft-tissue pain the patient may be prescribed anti-inflammatory cortisone injections, opioid analgesics and/or anti-depressants. Surgery is not considered to be a treatment option for a soft-tissue whiplash-associated disorder.
Cervical Spine Injury
The pain symptoms of a cervical spine injury due to whiplash-associated disorder are similar to that of a soft tissue injury. If the spine specialist’s examination and imaging studies reveals damage to the facet joints, intervertebral discs, nerve roots and/or vertebrae of the cervical spine a more aggressive treatment regimen is usually undertaken. This approach may include physical medicine, anti-inflammatory pain medications, injections of cortisone into facet joints, facet joint radiofrequency neurotomy, facet joint laser ablation, therapeutic nerve blocks (steroid plus analgesic), and/or anterior cervical discectomy or laminectomy with fusion.
End Note: Although whiplash injuries occur with ever-greater frequency, the diagnosis of a whiplash-associated disorder is a challenging undertaking. The success of whiplash treatment will be a function of the thoroughness and accuracy of the spine specialist’s diagnosis.
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