Spine

Whiplash

Nearly 3 million people suffer a whiplash injury every year, and roughly half are left with some chronic pain. Whiplash is a relatively common condition that occurs to a person’s neck following a sudden acceleration-deceleration force, most commonly from motor vehicle collisions, sports activities and accidental falls.

Symptoms of Whiplash

The most common symptoms of whiplash are:

• Neck pain and stiffness
• Headaches
• Shoulder pain and stiffness
• Dizziness
• Fatigue
• Temporomandibular joint symptoms (TMJ, jaw pain)
• Arm pain and weakness
• Visual disturbances
• Ringing in the ear (tinnitus)
• Back pain.

Sometimes whiplash symptoms are latent and do not appear immediately following the incident. However, whenever signs of whiplash are present, you should immediately contact a healthcare provider for effective treatment. If whiplash injuries are left untreated, they could lead to long-term disabling neck injuries such as chronic pain, sleep disturbances, fatigue, and much more.

Diagnosing Whiplash

At FASSST Sports Medicine, a thorough examination by our physicians can diagnose whiplash symptoms. In some severe cases, diagnostic image testing may be needed, such as X-rays or MRIs, to rule out any major injuries in the neck.

Treatments for Whiplash

Conservative treatment utilizing chiropractic care or physical therapy is often effective at relieving symptoms of whiplash. 

Arthritis of the Spine

Many people associate the medical condition known as arthritis with hand, hip, or knee pain. However, there are several kinds of arthritis affecting specific parts of the body. Spinal arthritis affects the joints found in your back and is a common cause of lower back pain in individuals over the age of 40.

Generally speaking, the earlier you treat any form of arthritis, the easier it will be to restore your range of motion and alleviate your symptoms. If you suspect you may have spinal arthritis, be sure to contact Comprehensive Medical Care right away to request a free consultation at one of our three convenient New Jersey locations.

Our skilled medical team offers both surgical and non-surgical solutions, including chiropractic care, acupuncture, physical and occupational therapy, interventional pain management, and orthopedic surgery.

Types of Spinal Arthritis

There are several common types of spinal arthritis, and the treatment we recommend at Comprehensive Medical Care will vary according to the type and severity.

Osteoarthritis

A degenerative arthritis, osteoarthritis is caused by wear-and-tear on your spine’s joints due to the natural aging process. Because osteoarthritis is progressive, it may begin by affecting a single joint before affecting others.

Rheumatoid Arthritis

An inflammatory arthritis, rheumatoid arthritis usually affects the hands, feet, or neck more than the lower back region. However, it can lead to back pain in advanced cases with severe joint deterioration.

Spondyloarthritis

Spondyloarthritis affects both the joints and the areas where your ligaments and tendons attach to bones. A common form of spondyloarthritis is psoriatic arthritis, which is linked to a condition called psoriasis that involves itchy, scaly skin. Severe infections cause many forms of spondyloarthritis, which may affect patients of all ages, including children, teens, and young adults. When spinal arthritis causes the spinal canal to narrow significantly over time, an individual has developed spinal stenosis.

Risk Factors of Spinal Arthritis

Factors that put you more at risk for developing spinal arthritis include:

• Age
• Obesity
• Certain conditions with autoimmune system triggers, such as diabetes, irritable bowel syndrome, and gout
• Spinal misalignments from conditions such as scoliosis, traumatic spinal injuries, and repetitive strain injuries

Recognizing the Symptoms of Spinal Arthritis for Early Detection

Do you experience stiffness or lower back pain in the morning that tends to ease up during the day only to become excruciating again by the time you fall asleep at night? This is typical of spinal arthritis because fluid tends to cause swelling overnight due to inactivity.

While back pain is the most common symptom associated with spinal arthritis, it often spreads to the buttocks, thighs, and lower legs. In addition, you may experience joint pain aggravated by motion or tenderness when applying pressure on the joint.

Other symptoms may include a loss of joint flexibility, a grinding noise when moving your neck, or numbness in your arms, legs, or spinal cord nerves. Many patients with spinal arthritis also experience swelling and tenderness in their joints that seem to worsen with seasonal weather changes. Should you ever experience a loss of bladder or bowel control, you should seek immediate medical attention.

Diagnosing Spinal Arthritis

Many patients will not experience pain or any of the other symptoms mentioned, although they may show signs of degenerative disc disease. Conversely, some patients may experience pain before their arthritis can be seen in an X-ray. Therefore, it’s vital to diagnose spinal arthritis accurately, as it often leads to other conditions, including bone spurs, radiculopathy, and spinal stenosis.

A thorough medical and physical exam will be done, followed by spinal X-rays or an MRI or CT scan to diagnose spinal arthritis. The first step to spinal arthritis diagnosis is to identify the underlying causes of your back or neck pain to devise the best course of treatment.

Treatments for Spinal Arthritis

No matter what type of spinal arthritis you are diagnosed with, the goal for treatment remains the same. First, we want to help you decrease or eliminate the pain you’re experiencing, so you can resume day-to-day functionality.

Secondly, we want to help you slow down the condition’s progression. Treatment for spinal arthritis at FASSST Sports Medicine typically begins with a non-surgical multidisciplinary approach, which may incorporate rest, physical therapy exercises, healthy changes in your diet and lifestyle, the use of non-steroidal anti-inflammatory medications to manage the pain, and several alternative treatment options, such as acupuncture or chiropractic care. Simply learning when to stop or slow down is beneficial for many patients with spinal arthritis. In some advanced cases, spinal surgery may be necessary for maximum results.

Nerve Disorders

Nerve disorders are a common symptom of spine diseases, but they can also be caused by conditions of the brain or other areas of the body (such as the hands and feet).

Spine disorders often cause nerve problems because they can affect nerves that travel to or from your spine. For example, sometimes, a herniated disc compresses a nerve root, which is like a long extension of the nerve inside your spine. The disc itself is not a problem; it’s the bulging area that exerts pressure on surrounding areas and causes problems. Many patients with this condition report having severe pain in their lower back and/or leg (a condition known as sciatica).

Some car accidents cause fractures of certain bones, such as the vertebrae that line your spine. These fractures can cause nerve damage because they interfere with the normal movement or position of the bones and discs, putting pressure on nerves. This is a common cause of pain and numbness in the arms and legs, which can be particularly disabling.

Symptoms of Nerve Disorders

The specific nerve affected will determine the symptoms that one experiences. However, the most common symptoms are pain, numbness, tingling and weakness.

Nerves can be affected in the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord). These nerves may be pinched in the neck or back and cause a shooting pain down the arms or legs with numbness and weakness.

Peripheral neuropathy can cause numbness and tingling in both hands and feet. In severe cases of nerve damage, there can even be paralysis and loss of bowel and bladder function.

Nerve Disorder Treatment

When you come to Comprehensive Medical Care, you will get a thorough evaluation and examination to see if any nerve disorders are present. Depending on the finding, you may be required to obtain additional diagnostic workups, such as an MRI or a nerve conduction study.

Treatment can include conservative care with physical therapy or chiropractic care with possible mechanical traction. Depending on the type of nerve disorder, one may also benefit from injections or other procedures.

If you experience pain or discomfort from a nerve disorder, the multidisciplinary team at FASSST Sports Medicine offers a variety of treatment options to address the root cause.

Herniated Disc

A herniated disc, also known as a ruptured or slipped disc, is a relatively common spinal condition. It may occur as a result of gradual wear and tear on a spinal disc or from an injury to the spine that cracks a disc, causing it to bulge or break open.

Spinal discs are cushiony, sponge-like pads that sit between the vertebrae (the bones of your spine). A spinal disc is like a jelly donut. The outside of the “donut” is called the annulus fibrosus (AF). It is made of many ring-like layers of fibrous tissue, with tough on the inside and softer in the middle. The “jelly” part in the middle is called the nucleus pulposus (NP).

With a herniated disc, the NP can break through the outer AF layer, pressing against an adjacent nerve root. If the inner NP tissue touches or presses directly on your spinal cord or nerve root, you could experience pain if the affected nerves are not functioning properly.

Symptoms of a Herniated Disc

Depending on the location of the disc, patients with a herniated disc may experience:

• Pain
• Numbness
• Weakness
• Radiating pain into the legs or arms

Symptoms from a herniated disc often develop suddenly and might gradually go away as the material is reabsorbed back into the disc. However, if the material remains, it can put more pressure on your nerves, which might lead to more severe or chronic pain.

Causes of a Herniated Disc

A herniated disc is often the result of a traumatic injury, such as a fall, car accident, or some other type of impact on your back. However, some people develop a herniated disc without any history of trauma.

Occupational and lifestyle factors may play a role in herniated discs. For example, if you are active, especially if you lift heavy at the gym, you might be at a higher risk for acute herniation, but this will likely go away with rest and at-home treatments.

Likewise, those who work in manual labor jobs are more likely to develop a herniated disc due to the strain they put on their backs. Smokers are also at higher risk because smoking weakens your body’s ability to heal itself.

Diagnosing a Herniated Disc

Your doctor will ask you about your symptoms and medical history, examine your spine for tenderness, muscle spasms or weakness in your back.

If the location where the herniated disc is causing problems suggests a particular structure or nerve is affected, diagnostic tests can be used to identify which spinal structures are involved. If the condition has been developing over time, imaging tests such as an X-ray or MRI can help identify the exact cause.

Treatment for a Herniated Disc

Most herniated discs are acute and will resolve on their own without treatment. Your doctor will recommend rest, avoiding strenuous activity and possibly taking over-the-counter anti-inflammatory medications.

If pain continues, the multidisciplinary team at FASSST Sports Medicine offers a variety of treatment options to address the root cause of a herniated disc and relieve pressure on affected nerves.

Degenerative Disc Disease

As we age, the water and protein content of our cartilage changes. This change results in weaker, thinner and more fragile cartilage. Because our spinal discs and facet joints are partially composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). This natural, gradual deterioration of the discs between the vertebrae is referred to as degenerative disc disease.

Diagnosing Degenerative Disc Disease

Degeneration of the disc is medically referred to as spondylosis. Spondylosis can be noted on X-ray images or an MRI scan of the spine as a narrowing of the normal “disc space” between the adjacent vertebrae. An MRI scan may show early degeneration changes, such as a loss of water content in the discs.

Degenerative Disc Disease Complications

Degeneration of the spinal discs makes them more susceptible to herniation and can cause pain in the affected area. Any level of the spine can be affected by disc degeneration. When disc degeneration affects the neck, it is referred to as cervical disc disease. When the mid-back is affected, the condition is referred to as thoracic disc disease. However, disc degeneration that affects the lumbar spine is referred to as lumbago, which causes pain localized to the low back and is common in older patients.

Treatments for Degenerative Disc Disease

Degenerative disc disease occurs naturally with age. However, some treatments and lifestyle factors may prevent this condition from worsening or causing symptoms that intervene with daily life. These include:

• Maintaining a healthy weight through diet and exercise
• Not smoking or quitting smoking altogether

If you experience back pain, the multidisciplinary team at FASSST Sports Medicine offers a variety of treatment options to address the root cause of degenerative disc disease.

Facet Disease

The facet joints are the structures that connect the spine’s vertebrae to one another. There are two facet joints between each vertebra, located on either side. Like any other joint in the body, it is lined with cartilage (allowing the bones to glide smoothly over one another) and a capsule surrounding it.

The function of the facet joint is to provide support, stability, and mobility to the spine. Facet disease refers to any degeneration of the facet joint that limits its functionality. Facet disease can occur anywhere in the spine, but it is most common in the lumbar region.

Causes of Facet Disease

Facet disease is caused by the cartilage of the facet joints wearing down due to aging, injury or overuse. This type of injury to the spine can be attributed to arthritis of the spine, work-related injury, or a traumatic accident. Another cause of Facet disease is spondylolisthesis, which is when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine.

Symptoms of Facet Disease

Symptoms related to facet joint problems are usually localized to the area of the facet joint. This can occur in the cervical (neck), thoracic (mid-back) and lumbar (lower back).

When the facets are affected in the lumbar region, a person can experience lower back pain radiating to the buttocks and upper thigh area. If the area affected is cervical, then pain can occur in the back of the neck and radiate to the top of the shoulders and around the neck.

Diagnosing Facet Disease

Diagnosis of facet disease often begins with a physical exam. The doctor will also take a thorough medical history and perform imaging studies such as an X-ray or MRI to confirm the diagnosis. The goal of these tests is to rule out any other causes for the symptoms (such as disc herniation).

Treatment of Facet Disease

It is very common for facet disease to be treated without surgery and usually begins with rest. This means avoiding any activities that make the pain worse until the body has had a chance to heal itself. If this isn’t effective after a few weeks, non-invasive measures such as physical therapy or chiropractic care may be used. Sometimes it is necessary to utilize spinal surgery to repair the facet joints, which can provide excellent relief from pain and discomfort that may become unbearable otherwise.

The multidisciplinary team at FASSST Sports Medicine offers a variety of treatment options to address facet disease and improve optimal function.

Failed Back Surgery Syndrome

Failed back surgery syndrome (FBSS) is not a syndrome but a generalized term used to describe when patients have not had successful results from spine surgery. Specifically, FBSS refers to when surgery does not alleviate the problem or creates even more significant problems, causing patients to experience continuous pain after surgery.

Symptoms of Failed Back Surgery Syndrome

Since FBSS is not one specific spine condition, its symptoms can vary greatly. However, having persistent pain following spine surgery is the primary sign of FBSS. Other symptoms include:

• Numbness in the back, arms or legs
• Pain or discomfort in the back, arms or legs
• Weakness

Diagnosing Failed Back Surgery Syndrome

The symptoms and medical history of each patient are necessary for diagnosing FBSS. Diagnosis may also include neurological tests such as an electromyogram (EMG) and nerve conduction velocity (NCV). Because FBSS is a general term, the patient’s medical history is key in diagnosis.

Some patients may need imaging tests such as X-rays, CT scans, or MRI to help pinpoint the cause of pain and determine if other spine problems are present. A general physical examination may also help diagnose FBSS.

Treatment for Failed Back Surgery Syndrome

Patients who have experienced FBSS are often treated through therapy to strengthen muscles and increase flexibility. Occasionally, a second spinal surgery may be necessary.

The multidisciplinary team at FASSST Sports Medicine will work together to develop a personalized care plan to address FBSS.

Foraminal Stenosis

At every level of the spine (cervical, thoracic and lumbar), nerves exit through a small canal called the foramen or foraminal canal. Nerves usually have plenty of room in the foramen, but if the canal gets too narrow, it can compress or pinch the nerves. This is called foraminal stenosis.

Causes of Foraminal Stenosis

Constriction of the nerve roots in the foraminal canal can be caused by any number of spinal conditions, including:

• Bone spurs
• Herniated disc
• Arthritis

Foraminal stenosis can also be caused by the enlargement of a joint (the uncinate process) in the spinal canal.

Symptoms of Foraminal Stenosis

Foraminal stenosis can produce a type of pain called radicular pain, which is pain that radiates into the extremities directly along the course of a specific spinal nerve root.

It is often a deep and steady pain that can be worsened with certain activities such as sitting or walking. It can be accompanied by numbness and tingling, muscle weakness and loss of specific reflexes.

Diagnosis of Foraminal Stenosis

A variety of diagnostic tests may be performed, including X-rays to visualize bony irregularities and MRI scans to reveal any soft tissue injuries. If the problem is caused by an arthritic condition, medication or physical therapy may be recommended. Most causes of foraminal stenosis can be resolved without surgery, although this will depend on the specific situation.

Preventing Foraminal Stenosis

Patients can reduce their risk of foraminal stenosis by maintaining a healthy weight and avoiding activities that place pressure on the spine. In addition, for at-risk patients, an exercise regimen may help strengthen supporting muscles around the spine and lower the risk of foraminal stenosis.

Treating Foraminal Stenosis

In most cases, the treatment for foraminal stenosis is specific to its cause. For example, a herniated disk can be treated with non-surgical interventions like physical therapy or chiropractic.

Many patients with arthritic conditions will benefit from medication or physical therapy to reduce the symptoms of foraminal stenosis. Surgery may be recommended in some cases, but this will depend on the specific underlying condition causing the stenosis.

The multidisciplinary team at FASSST Sports Medicine offers a variety of treatment options to address foraminal stenosis and reduce pressure on the spinal nerves.