Spinal stenosis is back pain caused by wear and tear on the spine; the majority of cases occur in the lower or lumbar spine, and to a lesser extent, in the cervical spine (neck).

Spinal stenosis typically develops very slowly as we age, usually occurring after the age of 50. It can be caused by a curvature of the spine (scoliosis) or congenital factors may lead to spinal stenosis in younger individuals, or slippage and misalignment of the vertebrae, known as spondylolisthesis.

Symptoms: 

• Cramping or aching in the calves that impairs walking, often confused with a circulation problem
• Tingling, numbness, or pain that radiates from the low back into the buttocks and legs
• Neck or low back pain
• Pain, numbness, tingling or cramping in the arms
• Weakness in the arms or legs

Diagnosis:

• X-rays
• MRI
• CT scan
• Electrodiagnosis (EMG)

Herniated discs are common back conditions. They are sometimes referred to as also a ruptured or slipped disc. This occurs when one of the rubbery pieces of cartilage between the vertebrae ruptures or slips out of place. 

Symptoms: 

• Pain in both legs
• Weakness in one or both legs
• Burning feeling in the buttock or leg
• Increased pain when sitting, bending or sneezing

Diagnosis:

• X-rays
• MRI 
• CT scan

Degenerative Disc Disease (DDD) is the local wear and tear of the spine; weakening and breakdown of one or more vertebral discs, a structure that sits between the bones in the spine to provide cushioning and allow movement between the spine levels; most often occurs in the low back or lumbar spine, but can affect the neck and mid-back.

Causes: 

• Drying out of the disc
• Daily activities and sports
• Injuries, which can cause swelling, soreness and instability

Symptoms: 

• Pain in your lower back, buttocks or upper thighs that comes and goes
• Pain feels worse when you sit, and better when you move and walk
• Pain feels worse when you bend, lift or twist
• Pain gets better when you change positions or lie down

Diagnosis: 

• X-rays
• CT scan
• MRI
• Discography

 Causes:

• Osteoporosis
• Primary or metastatic spine tumor
• Traumatic injury to spine, such as a fall or car accident
• Metastatic spread of cancer to the bones – destroys part of the vertebra and weakens spine

Symptoms:

• Back pain
• Pain that gets worse when you stand or walk but is relieved when lying down
• Trouble bending or twisting body
• Loss of height
• Curved, stooped shape of spine (kyphosis)
• Stomach or breathing problems
• Hip pain

Diagnosis:

• X-rays
• MRI
• CT scan
• DEXA (bone density scan)
• Vertebral fracture assessment

Bone biopsy if needed

Adult Degenerative Scoliosis is the abnormal curve of the spine giving the spine an “S” or “C” shape in a skeletally mature person. This condition is caused by a combination of aging and wear and tear on the structures of the spine.

Symptoms: 

• Backache or low back pain
• Numbness, weakness and/or pain in the legs.
• Spine curves to one side
• A hump may appear to be present on the back
• Uneven hips and/or shoulders (one is higher than the other)

Diagnosis:

• X-rays

A nonunion occurs when a broken bone fails to heal.

Causes:

• Infection
• Not enough blood flow to the bone
• Separation of the fractured ends of the bone
• Insufficient stabilization of the fracture

Symptoms:

• Pain
• Swelling
• Tenderness
• Deformity
• Inability to bear weight despite enough time since the break

Diagnosis:

•  X-rays
• MRI
• CT scan

Car accidents, falls and sports injuries can cause fractures, wounds, extensive bruising and damage to the back’s bones, joints, connective tissue, muscles or nerves. 

Symptoms: 

• Extreme back pain or pressure in your neck, head or back
• Weakness, incoordination or paralysis in any part of the body
• Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
• Loss of bladder or bowel control

Diagnosis:

• X-rays
• MRI
• CT scan
• Bone scan
• Nerve studies
• Electromyography (EMG)

Chronic neck and upper back pain—also called thoracic spine pain—can limit movement and cause recurring headaches. There are many causes for both, including poor posture, muscle overuse, osteoarthritis, a pinched nerve, or infection. Whether you’re experiencing whiplash or cervical myelopathy, we can help eliminate pain and discomfort through both surgical and nonsurgical procedures.

A cervical strain or sprain, commonly called whiplash, is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip.

Causes: 

• Rear-end car accidents
• Sports accidents
• Physical abuse 
• Trauma such as a fall

Symptoms: 

• Neck pain and stiffness
• Worsening of pain with neck movement
• Loss of range of motion in the neck
• Headaches, most often starting at the base of the skull
• Tenderness or pain in the shoulder, upper back or arms

Diagnosis:

•  X-ray
• MRI
• CT scan

Causes: 

• Degenerative conditions such as osteoarthritis (wearing down of joint cartilage) and spinal stenosis
• Herniated disc
• Pinched nerve
• Whiplash
• Mental stress
• Physical strain–overusing your neck muscles during repetitive actions or strenuous activities
• Poor posture
• Excess body weight
• Weak abdominal muscles
• Masses including tumors, cysts and bone spurs
• Other health conditions, including meningitis, rheumatoid arthritis and cancer

Symptoms:

• Persistent ache
• Stabbing or burning pain
• Increased sensitivity to mild pressure applied to neck
• Neck pain plus headache and numbness or tingling in one or both arms
• Increased tension/tightening in the muscles in the neck

Diagnosis:

• X-rays

Cervical Radiculopathy is a pinched nerve in the neck or upper back. A pinched nerve can damage or change the way the nerve communicates with the spine. The longer that the nerve remains pinched, the more likely that resulting deficits will become permanent or lead to paralysis.

Causes: 

• Pressure from material from a ruptured disc
• Degenerative changes in bones
• Arthritis 
• Injuries that put pressure on the nerve roots
• Tumors in the spine caused by cancer
• Benign, or noncancerous, growths in the spine
• Sarcoidosis, the growth of inflammatory cells

Symptoms: 

• Numbness or tingling in fingers or hands
• Muscle weakness
• Lack of coordination
• Loss of reflexes in your arms or legs

Diagnosis:

•  X-ray
• MRI
• CT scan
• Electromyography

Myelopathy describes any neurologic symptoms related to the spinal cord not functioning properly. Cervical Myelopathy is the spinal cord compression in the cervical spine (neck). If left untreated, cervical myelopathy can lead to significant and permanent nerve damage.

Causes: 

• Wear and tear of the spine
• Rheumatoid arthritis of the neck
• Whiplash or other cervical spine trauma
• Spinal infections
• Spinal tumors and cancers

Symptoms:

• Neck pain
• Stiffness
• Reduced range of motion
• Weakness in the arms and hands
• Numbness or tingling in the arms and hands
• Clumsiness and poor coordination of the hands
• Difficulty handling small objects, like pens or coins

Diagnosis:

• X-rays
• MRI
• CT scan
• Myelogram

Cervical Deformity results in an abnormal position of the head. It often refers to a misalignment of the bones in the neck and upper back. If left untreated, this deformity can cause difficulties in daily activities, including posture and swallowing.

Causes: 

• Progressive collapse of the intervertebral discs and/or vertebrae
• Injury
• Inflammatory conditions such as ankylosing spondylitis

Symptoms:

• Neck pain
• Weakness in the arm, hand, foot or leg
• Numbness or tingling in the arm, hand, foot or leg
• Difficulty with balance and walking
• Bladder or bowel dysfunction (in severe cases)
• Dysphagia (difficulty swallowing)
• Dyspnoea (shortness of breath)

Diagnosis:

• MRI
• CT scan
• Radiograph

Pain between the upper and lower back (thoracic spine) can be mild or severe, temporary or chronic. While middle back pain isn’t as common as lower back pain, it can still cause considerable discomfort, such as a sharp stabbing sensation, cramping, or stiff muscles. Using a range of state-of-the-art procedures, we can correct or treat conditions resulting from accident, injury or deformity—including vertebral compression fractures, kyphosis, or scoliosis.

Causes:

• Osteoporotic compression fractures – caused by osteoporosis, making bones weak and unable to sustain normal pressure
• Pathologic compression fractures – result from primary or metastatic spine tumor
• Traumatic injury to spine, such as a fall or car accident
• Metastatic spread of cancer to the bones – destroys part of the vertebra and weakens spine

Symptoms: 

• Back pain
• Pain that gets worse when you stand or walk but is relieved when lying down
• Trouble bending or twisting body
• Loss of height
• Curved, stooped shape of spine (kyphosis)
• Stomach or breathing problems
• Hip pain

Diagnosis:

• X-rays
• CT scan
• MRI
• DEXA (bone density scan)
• Vertebral fracture assessment
• Bone biopsy if needed

• Progressive collapse of the intervertebral discs and/or vertebrae
• Injury
• Inflammatory conditions such as ankylosing spondylitis

Symptoms:

• Neck pain
• Weakness in the arm, hand, foot or leg
• Numbness or tingling in the arm, hand, foot or leg
• Difficulty with balance and walking
• Bladder or bowel dysfunction (in severe cases)
• Dysphagia (difficulty swallowing)
• Dyspnoea (shortness of breath)

Diagnosis:

• MRI
• CT scan
• Radiograph

Mid-back Pain (Thoracic) occurs when the thoracic spine connects the neck to the low back; thoracic pain is in the chest or upper back; pain starts in the upper part of the body, also known as the thorax.

Causes: 

• Trauma
• Overuse injury in people who perform hard labor
• Severe lung infection
• “Slipped” disc in upper back
• Rib fracture

Symptoms:

• Tense muscles – general ache over a wider area

• Irritated or pinched nerve, electric shocks in the arm(s)
• Shingles
• Backbone fracture, sharp pain in the upper back

Diagnosis (after ruling out a thoracic emergency such as a lung infection or heart attack):

• X-rays
• CT scan
• MRI
• Nerve blocks (injections that help find the source of pain)

Kyphosis is a spinal deformity causing an exaggerated, forward rounding of the upper back. While most spines exhibit a curve, any curvature of more than 45 degrees is considered a deformity.

Causes:

• Metabolic problems
• Neuromuscular conditions
• Osteogenesis imperfecta – brittle bone disease
• Spina bifida

Symptoms: 

• Difference in shoulder height
• The head bends forward compared to the rest of the body
• Difference in shoulder blade height or position
• Height of the upper back appears higher than normal when bending forward
• Tight hamstrings (back thigh) muscles
• Back pain 

Diagnosis:

• X-rays

Thoracic Deformity/Scoliosis is a deformity of the rib cage and spine; sideways curve in the middle (or thoracic) portion of the spine. The deformity becomes apparent when the asymmetry in the trunk is visibly apparent.

Causes:

• Certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy
• Birth defects affecting the development of the bones of the spine
• Previous surgery on the chest wall as a baby
• Injuries to or infections of the spine
• Spinal cord abnormalities
• Age-related wear and tear on the back 
• Complications from past surgeries

Symptoms: 

• Uneven shoulders
• One shoulder blade that appears more prominent than the other
• Uneven waist
• One hip higher than the other
• One side of the rib cage jutting forward
• A prominence on one side of the back when bending forward

Diagnosis:

• X-rays
• MRI
• CT scan
• Spinal radiograph

Lower back pain may result from a strain to muscles or tendons in the back. Although very common, it can be uncomfortable and significantly affect your ability to sit or exercise. Causes may include arthritis, structural problems or disk injuries. Our board certified physicians can create a custom plan for conditions such as lumbar strain, lumbar spondylosis, vertebral compression fractures, and vertebral compression fractures, among others.

Low Back Pain commonly presents as low back aches and leg pain, numbness or weakness

Causes:

• Damage in lumbar spine may create pressure on a spinal nerve, “pinching” it or creating inflammation that causes the nerve to swell
• Spinal nerve in the lower back is irritated
• Herniated disc presses into nearby spinal nerve

Symptoms:

• Low back pain
• Shooting leg pains
• Tingling, numbness or weakness in shoulder, arm, hand or fingers
• Leg weakness
• Leg paralysis (severe cases)
• Hip pain and sciatic
• Incontinence/sexual dysfunction (severe cases)

Diagnosis:

• X-rays
• CT scan
• MRI
• Electromyography (EMG)
• Nerve conduction studies
• Selective Nerve Root Injection (SNRI) (helps find the pinched nerve and reduces pain)

Lumbar Strain/Sprain is an injury to the lower back when the muscle fibers or ligaments are abnormally stretched or torn.

Causes:

• Muscle fibers are abnormally stretched or torn
• Curving the lower back excessively
• Being overweight
• Having weak back or abdominal muscles, and/or tight hamstrings  

Symptoms:

• Pain that gets worse when you move
• Muscle cramping or spasms 
• Decreased function and/or range of motion of the joint – difficulty walking, bending forward or sideways or standing straight
• May feel pop or tear at time of injury

Diagnosis:

• X-rays

Lumbar Spondylosis, also known as Facet Joint Pain, is the degeneration and arthritis of the facet joints (connections between the bones of the spine). An age-related degeneration of the lower back, the changes are marked by the breakdown of the disks that separate the bones of the spine.

Causes:

• Wear and tear
• Arthritis
• Age  

Symptoms:

• Tenderness and sensitivity to touch overlying a spinal joint.
• Muscle spasms
• Worse pain at night
• Pain after long episodes of poor posture such as hunching or slouching while seated
• Nerve pain if the facet joints are inflamed enough to put pressure on nerves

Diagnosis:

• Anesthetic and anti-inflammatory injection in joint

Spondylosis is the displacement of vertebral disc from the spinal column. Outward (forward) displacement is called anterolisthesis and inward (backward) displacement is retrolisthesis. Condition is often preceded by spondylolysis, a degenerative condition of the vertebra.

Causes: 

• Overuse injuries of the spine
• Congenital abnormalities
• Trauma
• Bone disorders 
• Fractures

Symptoms:

• Lower back pain
• Stiffness in the back and tightening of the hamstring muscles from spasms
• Pain in the thighs and buttocks
• Decreased range of motion of the lower back
• Pain and weakness of the legs or numbness because of nerve compression
• Loss of control on bowel or bladder function by severe nerve compression
• Increase in lordosis curve, also called swayback
• Kyphosis (round back)

Diagnosis:

• X-rays

Causes:

• Osteoporotic compression fractures – caused by osteoporosis, making bones weak and unable to sustain normal pressure
• Pathologic compression fractures – result from primary or metastatic spine tumor
• Traumatic injury to spine, such as a fall or car accident
• Metastatic spread of cancer to the bones – destroys part of the vertebra and weakens spine

Symptoms: 

• Back pain
• Pain that gets worse when you stand or walk but is relieved when lying down
• Trouble bending or twisting body
• Loss of height
• Curved, stooped shape of spine (kyphosis)
• Stomach or breathing problems
• Hip pain

Diagnosis:

• X-rays
• CT scan
• MRI
• DEXA (bone density scan)
• Vertebral fracture assessment

Bone biopsy if needed

Sacroiliac Joint Pain is caused by joint pain in the low back and buttocks. It can be aggravated with prolonged sitting or standing, standing on one leg, going from sit to stand, and stair climbing.

Causes:

• Traumatic injury – sudden impact, such as a motor vehicle accident or a fall
• Arthritis
• Pregnancy
• Infection

Symptoms:

• Lower back pain 
• Pain, numbness, tingling, weakness in the lower back area
• Pelvis/buttock pain
• Hip/groin pain
• Feeling of leg instability (buckling, giving way)
• Disturbed sleep patterns
• Unable to sit for long periods

Diagnosis:

• X-rays
• Ultrasound
• injection of numbing medicine into joint

Failed Back Surgery Syndrome (FBSS) is an unsuccessful result from a previous back surgery or spine surgery, with continued pain. The pain may present after surgery, or the surgery may exacerbate or insufficiently ameliorate existing pain. 

Symptoms:

• Pain following back surgery

Diagnosis:

• X-rays
• EOS Imaging 
• MRI 
• CT Scan
• Bone Scan

Causes: 

• Minor injuries, such as a sprain
• Severe injuries, such as damage to a nerve or broken bone
• Injury to joints or tissue
• Relative long periods of immobility, such as would occur with a broken leg

Symptoms: 

• Severe burning pain
• Extreme sensitivity to even mild stimuli, such as clothing or a light touch
• Warm, red-looking skin at injured area, changing from cool, bluish-looking skin later
• Swelling
• Excessive sweating
• Changes in bone and skin tissue
• Muscle spasms
• Loss of motion
• Tenderness and stiffness in joints

Diagnosis:

• X-rays
• MRI
• CT scans
• Electrodiagnosis (EMG)