Pain and conditions

What is adjacent segment disease?

Adjacent Segment Disease (ASD) is a degenerative disc disease (DDD) that can result from pressure at spinal levels directly above or below the site of a former spinal fusion procedure. Following a fusion, that area of the spine typically becomes immobile which may cause abnormal loads to adjacent spinal segments that are compensating for the loss of movement

ASD can also be attributed to the natural progression of DDD or the wear and tear of intervertebral discs which act as cushions for the spine. This wear and tear may result from normal aging or may be due to longstanding trauma.

ASD can lead to disc bulging or disc herniation, development of bone spurs or osteophytes, and loss of disc space and/or alignment. This can cause nerve impingement which may result in pain at the levels adjacent to the previous fusion.

What are the symptoms?

Symptoms of ASD include:

• pain at or near the previous fusion level,
• pain, numbness, and tingling sensation in your arms or legs,
• strong pain that tends to come and go,
• pain that worsens as you move your extremities, and
• symptoms that improve when you sit, lean forward, lie on your back, or sit with your feet raised.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is cervical disc degeneration?

Degeneration of the cervical disc occurs as we age. Injury, daily wear and tear, and genetics also contribute to this process. Degeneration consists of damage to the cervical disc, which may then become narrowed or may herniate. This causes symptoms of pain, numbness, tingling, and/or weakness in the arms or shoulders, and may also cause neck pain.

 What are the symptoms?

 Symptoms of cervical disc degeneration include:

• neck pain,
• pain, numbness, or tingling in the arms or shoulders, and
• weakness in the arms or shoulders.

 If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is degenerative scoliosis?

Adult degenerative scoliosis is a condition where a a condition where a side to side curve develops in a previously straight spine secondary to advanced degenerative disc disease. This curvature occurs as a result of deterioration or degeneration of the joints and intervertebral discs in the spine. As the joints degenerate, they create a misalignment in the back which results in a bend or curvature

Adult degenerative scoliosis is a result of advanced degenerative disc disease (DDD) which is defined as the wear and tear of intervertebral discs. This wear and tear may result from normal aging or may be due to longstanding trauma. DDD typically begins with a decrease in the water content of the nucleus pulposus which can lead to tears in the annulus fibrosis.

With advanced DDD, the loss of disc height can lead to segmental instability resulting in asymmetric disc height loss, causing degenerative scoliosis.

What are the symptoms?

Symptoms of degenerative scoliosis may include:

• pain in the back and/or legs,
• spinal deformity,
• pain that occurs on one or both sides,
• pain that worsens when standing or walking,
• lying down relieves pressure on the spine and reduces pain,
• uneven shoulders or waist, and
• shoulder blade protrusion.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is degenerative spondylolisthesis?

Degenerative spondylolisthesis is a condition where the intervertebral disc degenerates resulting in a loss of disc height and instability, causing one vertebra to slip forward over another vertebra below it. The word spondylolisthesis is comprised of two parts: spondylo meaning spine, and listhesis meaning slippage. This condition can cause impingement of the spinal nerves and/or fatigue of the back muscles and may result in lower back and/or leg pain.

Degenerative spondylolisthesis may be the result of advanced degenerative disc disease where the spinal bones, discs, joints and ligaments degenerate and become less able to maintain the alignment of the spinal column. It may also be caused by other factors such as stress fractures, birth defects (congenital abnormalities) and in rare cases, a tumor or trauma.

Degenerative spondylolisthesis most commonly occurs in the lower back (lumbar spine) and is graded on a numerical scale from one to four, with one being the least severe. It is also more common in people over age 50, and women are two times as likely as men to be diagnosed.

What are the symptoms?

Symptoms of degenerative spondylolisthesis may include:

• low back pain,
• sciatica, an aching pain in the hips, buttocks and lower back that radiates (spreads) into the back of the thighs and legs,
• a shuffling gait when walking,
• weakness in the lower extremities, and
• abnormal posture.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is a herniated disc?

When the gelatinous center of the intervertebral disc pushes out through a tear in the fibrous wall, the disc herniates. This disc herniation adds pressure to the surrounding spinal nerves causing mild to severe pain. It is one of the most common spinal disorders.

A herniated disc may be caused by simple wear and tear from repeated movement over time or disc degeneration. During the natural aging process, spinal discs lose some of their water content making it difficult to support the load from above vertebrae.

Other causes of a herniated disc may include the following:

• long standing trauma,
• hereditary or congenital abnormalities,
• stress fractures, and
• a sudden heavy strain or increased pressure.

What are the symptoms?

While a herniated disc can happen at any level of the spine, it most commonly occurs in the lumbar region or lower back.

Symptoms of a herniated disc may include:

• pain at the site of injury,
• pain, numbness, weakness or tingling in the arms or legs,
• pain that worsens when bending, twisting and/or sitting, and
• muscle spasms.

In addition to these symptoms, if the herniated disc is located in the cervical spine or neck, symptoms may includ

• loss of bladder control,
• loss of coordination,
• the feeling of heavy limbs, and
• trouble balancing.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is lumbar degenerative disc disease?

Lumbar DDD is defined simply as the wear and tear of intervertebral discs that act as cushions for the spine. This wear and tear may result from normal aging or may be due to longstanding trauma.

DDD typically begins with a decrease in the water content of the nucleus pulposus and can lead to tears in the annulus fibrosis.

Disc degeneration can lead to disc bulging, development of bone spurs or osteophytes, and loss of disc space height and/or alignment. This can cause nerve impingement, which may result in pain.

With advanced DDD, the loss of disc height can lead to segmental instability resulting in disc slippage (degenerative spondylolisthesis) or asymmetric disc height loss, causing a side-to-side curvature of the spine (degenerative scoliosis). These advanced degenerative changes affecting the discs, joints and surrounding soft tissues can further result in the narrowing of the spinal canal (degenerative stenosis). This can put increased pressure on the spinal cord and spinal nerves that pass through the spinal canal.

What are the symptoms?

Symptoms of DDD may include:

• low back pain,
• pain, numbness or tingling in the legs,
• strong pain that tends to come and go,
• pain that worsens when bending, twisting and/or sitting, and
• pain that is relieved when lying down.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is lumbar spinal stenosis?

Lumbar spinal stenosis is a condition defined as the narrowing of the bone canal (vertebral foramen) where the spinal nerves, spinal cord and cauda equina pass through the spine. When this narrowing occurs, the spinal nerves and cord are compressed adding pressure which may cause pain and/or nerve damage.

Lumbar spinal stenosis may be the result of advanced degenerative disc disease. It may also be caused by other factors, such as birth defects (congenital abnormalities).

What are the symptoms?

Symptoms of lumbar spinal stenosis may include:

• decreased endurance during physical exercise and activities
• weakness and/or loss of balance,
• numbness and a “prickly” feeling in your legs, calves or buttocks,
• aching, dull back pain radiating (spreading) to your legs, and
• symptoms improve when you sit, lean forward, lie on your back or sit with your feet raised.

If you feel that you are experiencing any of these symptoms, you should consult a physician for an accurate diagnosis.

What is myelopathy?

Myelopathy is a symptom of an underlying spinal condition that compresses or irritates the spinal cord. When the spinal cord is injured, the body and brain cannot communicate with each other properly and this inefficiency can be displayed as myelopathy.

The symptom can present as:

• The feeling of heavy limbs
• Difficulty balancing
• Muscle weakness
• Loss of coordination
• Loss of bladder/bowel control

What may cause myelopathy?

Myelopathy is most commonly the result of:

• Degenerative disc disease
• Spinal stenosis,
• Tumor,
• Trauma.

If you feel that you are experiencing myelopathy, you should see a physician for an accurate diagnosis.

What is radiculopathy?

Radiculopathy is a symptom of an underlying spinal condition that compresses or irritates spinal nerves. It can present as pain, numbness, tingling, or weakness along the path of a nerve.

For example, if a spinal nerve in the lumbar region is irritated, radiating pain may be experienced along the associated nerve route that begins in the lower back and travels through the leg.

What may cause radiculopathy?

Radiculopathy is most commonly the result of a condition affecting an intervertebral disc, such as a bulging or herniated disc that presses against the spinal nerves. Other causes may include:

• degenerative disc disease,
• spinal stenosis,
• bone spurs,
• tumor,
• trauma, and
• diabetes.

If you feel that you are experiencing pain radiating from your back to your limbs, you should consult a physician for an accurate diagnosis.

What is sciatica?

Sciatica is a symptom of an underlying spinal condition that compresses or irritates the sciatic nerve—the largest and longest nerve in the body. Sciatica can present as an aching pain in the hips, buttocks and lower back that radiates (spreads) into the back of the thighs and legs and more commonly occurs on one side of the body.

What may cause sciatica?

Sciatica is most commonly the result of a condition affecting an intervertebral disc, such as a bulging or herniated disc that presses against the sciatic nerve. Other causes may include:

• degenerative disc disease,
• spondylolisthesis,
• spinal stenosis,
• piriformis syndrome (in which the piriformis muscle irritates or compresses the sciatic nerve root),
• sacroiliac joint dysfunction,
• Trauma,
• Tumor,
• pregnancy, and
• muscle strain.

If you feel that you are experiencing sciatica, you should consult a physician for an accurate diagnosis.