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Spinal Conditions & Treatments – Phoenix, AZ

At Hedley Orthopaedic Institute, health care providers offer comprehensive care for a wide range of neck and back pains. On this page, you can learn more about a wide range of spinal-related conditions, diseases, and symptoms, including lower back pain, sciatica, arm and leg weakness, radiating pain, and much more. To schedule an appointment with an orthopaedic physician, please contact us. You deserve to have relief from your back pain. Call Hedley Orthopaedic Institute today to get started.

Spinal Conditions & Diseases Treated

Click on a condition to learn more about it:

Spine-Related Symptoms: Back Pain, Neck Pain & More

Not all spinal conditions present pain in the neck or back. Some spinal conditions cause loss of dexterity, pain that radiates into the arms or legs, loss of bladder or bowel control, and other symptoms. Treatment options are available for many causes and symptoms of spinal-related pain. Learn more about some of the symptoms treated at Hedley Orthopaedic Institute below. This list is not comprehensive; treatment may be available for additional symptoms by your specialist at Hedley Orthopaedic Institute.

Click on a symptom to learn more about it:

For more information about the treatment of neck, back, and spinal-related pain at Hedley Orthopaedic Institute in Phoenix, AZ, contact us.

Spinal Conditions & Diseases Treated

Cervical Disc Degeneration

Cause: This condition – a common cause of neck pain and stiffness – can be caused by injuring the space between two discs in the cervical (neck) region of the spine. A traumatic fall or twisting injury could cause the degeneration process to begin.

Diagnosis: Trained providers at Hedley Orthopaedic Institute begin the diagnostic process by reviewing your medical history and performing a physical examination. Diagnostic tests for neck pain could include x-ray, MRI, and CT-scan.

Treatment: Treatment for cervical disc degeneration is typically non-surgical. Ice and heat, pain medications, physical therapy, and – in some cases – appliances for the neck may be used to reduce pain and stiffness. If symptoms do not respond to conservative care, then your provider may recommend a fusion procedure to reduce painful motion of the degenerative disc.

Cervical Myelopathy

Cause: Myelopathy is a condition that occurs when the spinal cord is put under abnormal pressure, potentially damaging the spinal cord and causing loss of nerve function. When this occurs in the neck region of the spine, the condition is known as cervical myelopathy. Spinal cord pressure may be caused by disc herniation, spinal stenosis, development of bone spurs, or other causes.

Diagnosis: Your Phoenix-area health care provider at Hedley may begin the diagnostic process by reviewing your medical history and performing a physical examination. The provider may perform an imaging test to look for spinal compression. Certain symptoms, such as weakness, pain, numbness, difficulty walking or finding balance, and loss of bladder control could indicate cervical myelopathy.

Treatment: Some patients may find significant improvement in quality of life through medication. For other patients, a surgical procedure may be used to correct the cause of the myelopathy. You can learn more about treatment for spinal stenosis, disc herniation, and other underlying causes of cervical myelopathy on this page.

Cervical Radiculopathy

Cause: Cervical radiculopathy refers to pain and/or neurological symptoms (such as numbness, tingling, loss of motor control) that are caused by nerve irritation in the neck region of the spine. Many nerves throughout the arms and fingers are rooted to the spinal cord in the cervical region of the spine. If these nerve roots are pinched or irritated, symptoms may develop as far away as the fingertips. Disc herniation, degenerative disc disease, and spinal stenosis are all potential causes of cervical radiculopathy.

Diagnosis: After performing a physical examination and reviewing your medical history, your provider at Hedley Orthopaedic Institute may order imaging studies (MRI, x-ray, etc.) to look for nerve irritation. If an imaging study fails to reveal any pressure or irritation of the nerves, then an EMG (a type of nerve test) may be used to aid in the diagnostic process.

Treatment: Treatment for cervical radiculopathy depends on the cause of the pinched/irritated nerve. In some cases, NSAIDs, pain medications, physical therapy, and other non-invasive treatments may provide sufficient relief. For other patients, surgery may be necessary. You can learn more on this page about surgical procedures used to treat underlying causes of cervical radiculopathy.

Cervical Spinal Stenosis

Cause: In some patients, the spinal cord in the neck (cervical region of the spine) becomes compressed or pinched. This is often due to aging, but may have other causes. Patients with this condition may begin to feel arm pain, heaviness in the legs, and reduced coordination, leading to problems with walking, writing, or other fine motor skills.

Diagnosis: To be properly diagnosed, the practitioner at Hedley Orthopaedic Institute will need to review your symptoms and possibly order an imaging test, such as an MRI or CT scan, to see tightening or pinching in the spinal cord. Nerve tests may also help diagnose.

Treatment: Treatments for spinal stenosis of the cervical vertebrae will depend on the severity. Whether or not the stenosis is accompanied by any complicating conditions such as myelopathy is also important to consider. Exercise and physical therapy, along with NSAIDs, may provide substantial relief for some patients. Activity modification may also be recommended to provide comfort and prevent further damage. Your provider may advise using a walker or sitting in a recliner instead of a straight-back chair. Epidural injections, while they cannot “cure” the condition, may provide pain relief for patients suffering from cervical spinal stenosis. In some cases, your Hedley Orthopaedic provider may recommend surgery.

Failed Spinal Surgery

Cause: Some patients experience ongoing or recurring pain after spinal surgery. Others experience relief, only to have the pain either return suddenly or gradually. This is considered a failed spinal surgery, and is sometimes (inaccurately) referred to as Failed Back Surgery Syndrome, or FBSS. The term is not quite an accurate description, as FBSS isn’t a true syndrome. Rather, FBSS is a general term used to describe the failure of a procedure intended to alleviate pain or symptoms through surgery.

Diagnosis: The providers at Hedley Orthopaedic Institute will meet with you and listen closely to not only your current symptoms and conditions but also your experiences prior to and since your surgery. The staff will also carefully review your previous medical records and the imaging tests performed before and after your previous surgery. Additional imaging tests, such as x-rays or MRIs, may be needed.

Treatment: Treatment of pain or limited mobility after a failed spinal surgery will address the new and persisting issues. Sometimes, the prior surgery results in scar tissue or other trauma to the body that causes a new or different issue. Failed spinal surgery can be treated through manipulation, physical therapy and exercise, pain management (oral or injected), and injections or a pump that provides a steady dose of medication to restore function and alleviate pain.

Flat Back Syndrome

Cause: Flat Back Syndrome is a condition in which the patient’s lower spine loses its natural curve and becomes flat. As a result of this flattening, patients may find themselves leaning forward and unable to stand fully upright. Often, this condition worsens as the day goes on, as the muscles in the neck and upper back fatigue. Back and leg pain are also common complaints amongst patients with flat back syndrome. It is a common condition found in people previously diagnosed with scoliosis and treated decades prior with Harrington rods.

Diagnosis: Providers at Hedley Orthopaedic Institute can diagnose flat back syndrome through a combination of the patient’s medical history, symptom complaints, and an x-ray of the spine. Prior surgeries should be disclosed, including dates as accurately as possible, to help determine the diagnosis.

Treatment: Often, the first line of treatments for flat back syndrome is exercise, including aerobic, weight bearing and core strengthening. Other treatments may include manipulation, physical therapy and medication. As a last resort, surgery may be recommended.

Infections of the Spine (Osteomyelitis)

Cause: Osteomyelitis is an infection of the spine that usually spreads through the vascular system and may sometimes present after a urologic procedure. Osteomyelitis is a rare condition, especially among young healthy adults. Elderly patients, people with compromised immune systems, and intravenous drug users are more susceptible to spinal infections. In addition to back pain, other symptoms may include exacerbated nighttime pain, fever, chills, unexplained weight loss or swelling and redness along the infected part of the spine.

Diagnosis: Diagnosing osteomyelitis is difficult in its early stages. However, the experts at Hedley Orthopaedic Institute may use imaging such as x-rays or MRI with a contrast to aid in providing an accurate diagnosis. Inflammatory markers are also excellent tools in finding spinal infections. Blood and bone cultures and laboratory study can provide more specific information that can aid in treatment.

Treatment: Osteomyelitis is often treated with antibiotics, first intravenously then orally. A back brace may be recommended while the spine heals from the infection; rest may be required as well. Occasionally, surgery may be necessary to remove infected tissue if it does not respond to the antibiotics or if nerves are affected.

Lumbar Disc Degeneration

Cause: Lumbar (or lower back) disc degeneration occurs when the disc between two vertebrae becomes inflamed and unstable, wearing down until it is unable to absorb the stress on the spine. Most patients describe the pain as low-grade and continual as opposed to sharp and burning. The pain may become more severe when sitting, bending or twisting.

Diagnosis: Diagnosing lumbar disc degeneration includes the patient providing their history, including how long the pain has been on-going and any activities being performed around the time the pain presented itself initially. The specialists at Hedley Orthopaedic Institute will then perform a physical exam to test for specific symptoms often associated with disc degeneration, such as range of motion, strength and local tenderness. An MRI or other imaging test may also be ordered to assist in ruling out other diagnoses.

Treatment: Oftentimes, lumbar disc degeneration can be treated using medication (including steroids to help with inflammation), physical therapy and exercise. Your provider may suggest you modifying activities to reduce stress on the injured part. This may include correcting posture, methods of lifting or bending, and sitting at a desk. Changing how you sleep may also help. Heat and ice therapy, pain management, and injections may also provide relief. Surgery is usually used only in cases where substantial improvements are not achieved over a six-month period with non-surgical treatments.

Lumbar Disc Herniation

Cause: When a disc in between vertebrae begins to break down, the inner core may leak through the outer portion of the disc. This creates a hernia in the disc, which is located directly underneath the spinal nerve root, putting direct pressure on the nerve. When this occurs in the lower back, most commonly between the L4 and L5 vertebrae, it is known as a lumbar disc herniation, or herniated disc. With this disc herniation in the lower back, leg pain (along with numbness, tingling or weakness in the legs or buttocks) is more likely to occur than actual back pain.

Diagnosis: The providers at Hedley Orthopaedic Institute will review medical records (sometimes herniated discs are repetitive), perform a physical exam, listen to the patient’s symptoms, and conduct an imaging test.

Treatment: Treating a disc herniation will start with non-surgical options, including pain medication, physical therapy, ice and heat therapy, manipulation, pain management, and injections. If, within approximately six weeks, the symptoms do not begin to improve, surgery may be necessary. Often, minimally invasive surgery can be performed to remove the small portion of the disc that is herniated. This procedure can frequently be done as an outpatient procedure and patients may resume normal activities within one to three weeks.

Lumbar Instability

Cause: Lumbar instability is a condition in which there is too much movement between two vertebrae in the spine. The excessive movement may cause nerve roots to be pinched or for excess pressure to be put on joints in the spine, leading to inflammation. The spinal area includes vertebrae, discs, muscles, ligaments and nerves that must all work in perfect harmony to allow strength and flexibility but still remain stable. When one or more of these components is out of sync, lumbar instability can develop. Pain that is chronic or comes and goes can indicate instability, as can a back that feels weak or “goes out.”

Diagnosis: Diagnosing lumbar instability is difficult, as not all practitioners agree upon a singular standard for diagnosing it. However, the practitioners at Hedley Orthopaedic Institute will listen closely to your medical history, your symptoms, any trauma that may have occurred and past treatments. Imaging tests, such as x-rays with the spine in various degrees of flexion or MRIs, may be done. The practitioner will also perform a physical exam to gauge strength and mobility through certain movements. A back brace may be recommended as a diagnostic tool. If limited use of a back brace provides relief, this could indicate lumbar instability.

Treatment: Oftentimes, treatment includes physical therapy and strengthening exercises for the back, as well as the abdominal muscles, which help stabilize the spine. Education on how to move correctly to protect your spine during everyday activities may also be helpful. In extreme cases, where non-surgical treatments have failed, surgery may be recommended. Surgery is used to fuse vertebrae together, thereby reducing instability.

Lumbar Radiculopathy

Cause: Lumbar radiculopathy is the condition in which pain travels from a damaged nerve in the lumbar, usually between compressed vertebrae, down the leg. The most common kind of lumbar radiculopathy is sciatica, in which pain, numbness or tingling runs down the sciatic nerve. With radiculopathy of the lumbar region, the pain in the lower extremity is usually much more severe than the actual back pain.

Diagnosis: Lumbar radiculopathy is a symptom that results from another condition such as a disc herniation with nerve compression, foraminal stenosis, nerve root injury or scar tissue from a previous surgery affecting a nerve root. The physicians at Hedley Orthopaedic Institute understand that diagnosing the cause of the radiculopathy is important in providing the best treatment possible. A physical exam, review of the patient’s medical history and records, as well as an imaging test such as an MRI may provide accurate information as to what underlying condition is causing the lumbar radiculopathy.

Treatment: Treatment of lumbar radiculopathy often includes physical therapy, pain relieving medication and injections into the spine to relieve inflammation and pain. If, after approximately six to eight weeks of treatment, significant improvement is not experienced, outpatient surgery may be recommended.

Lumbar Spinal Stenosis

Cause: Lumbar spinal stenosis most often occurs as a result of aging, thus is most commonly seen in patients 50 and older. The facet joints that stabilize the vertebrae get larger as they degenerate over time and press against the nerve roots. Symptoms of lumbar spinal stenosis include pain, tingling and numbness in the buttocks and legs. Symptoms often increase while walking and can usually be alleviated by stopping and sitting. Sometimes, symptoms stop almost immediately after the patient stops to rest.

Diagnosis: The providers at Hedley Orthopaedic Institute use the latest tools to diagnose lumbar spinal stenosis, including imaging tests such as MRIs or CT scans with a contrast dye. These imaging studies provide accurate information to help confirm which of the three kinds of lumbar spinal stenosis a patient has, allowing for more accurate treatment. The three types of lumbar spinal stenosis are 1) lateral stenosis, 2) central stenosis, and 3) foraminal stenosis.

Treatment: Treating lumbar spinal stenosis often requires a combination of modified activities, new exercises and physical therapies, oral pain medication and epidural injections for inflammation relief. If this combination of therapies does not provide adequate relief in a reasonable amount of time, surgery may be an option to consider. However, spinal stenosis surgery should only be considered if a patient’s daily lifestyle has been dramatically changed or reduced. If a patient is still functioning reasonably well, surgery may not be the right option.

Neck/Back Surgery

Neck or back surgery may be performed to relieve pain, tingling, numbness and other symptoms that occur because of damage to discs, nerves or vertebrae in the spine. These surgeries are usually only performed when non-surgical remedies have failed to provide the desired relief. Neck and back surgery are not done on an exploratory basis (to try to find a source of pain). Rather, neck and back surgery are performed only once an anatomical lesion, such as a herniated disc, compressed nerve root or spinal deformity is diagnosed through non-surgical methods, such as imaging tests. The accurate identification of the problem before the surgery is important to the outcome, allowing the surgeon to reach the most successful outcome possible.

Neoplastic (Spine Tumors)

Cause: A neoplasm is a tumor that may develop on the spine (either spinal cord or spinal column). There are two categories of spinal tumors: primary and secondary. Primary tumors originate in spinal tissue, whereas secondary tumors are extensions of cancer that has already developed elsewhere in the body. Secondary tumors are much more common than primary spinal tumors.

Diagnosis: Your provider at Hedley Orthopaedic Institute may begin the diagnostic process with a physical exam, blood tests, and diagnostic imaging. However, biopsy may be required in order to fully diagnose a spinal tumor.

Treatment: Treatment goals may vary widely from patient to patient. If a spinal tumor is discovered independent of any known cancer in the body, then a full examination of the patient may be advised. If cancer is known to be present, then the secondary spinal tumor may be monitored or removed. If it is possible to safely remove the tumor, your orthopaedic surgeon may do so with the goals of providing relief from discomfort and preserving neurological function.

Neurologic Disorders (Spinal)

Cause: The spinal cord is a bundle of nerves carrying messages to and from the brain and the rest of the body. Spinal neurological disorders may originate from an injury or a compression of discs. External causes that originate independent of the spinal cord may include infection, syphilis, HIV, multiple sclerosis or a copper deficiency. Depending on the source of the disorder and the part of the spine affected, symptoms may include weakness, loss of touch sensation, loss of reflexes, loss of control over bladder or bowel, back pain or paralysis.

Diagnosis: Diagnosing a neurological disorder in the spine is something taken very seriously by the providers at Hedley Orthopaedic Institute. Tools to diagnose a neurological disorder may include a physical exam, a review of symptoms and medical history, as well as using imaging studies such as x-rays, MRIs, or CT scans.

Treatment: In circumstances where paralysis or loss of continence is sudden and unexplained, it is imperative that you seek immediate medical care at the nearest emergency room. Treating neurological spinal disorders may include physical therapy and occupational therapy. In circumstances where restoring full function and curing the disorder is not possible, the goal is to rehabilitate and restore as much function to the patient as possible, helping them adapt to the circumstances of their new life. This may include providing a social worker, therapist, and providing support to the patient and their supportive family and friends.

Osteoarthritis of the Spine

Cause: When the cartilage between two bones in the spine becomes inflamed and degenerates, the bones begin to rub together, creating bone spurs and pain. Range of motion and flexibility decrease progressively. Osteoarthritis can be caused by repetitive and/or heavy motions, advanced age, genetic predisposition, excessive weight and associated diseases such as diabetes, rheumatoid arthritis or gout.

Diagnosis: Patients with ongoing pain or stiffness in the back that persists for two weeks or more may be advised to seek an orthopaedic consultation. A consultation with the practitioners at Hedley Orthopaedic Institute will include a review of medical history, a physical exam, and running medical tests. With osteoarthritis, a bone scan may also be necessary. An accurate diagnosis is critical to properly treat osteoarthritis of the spine. Though no cure exists, early intervention can still lead to the best outcome.

Treatment: There is currently no definitive cure to stop or slow the progression of osteoarthritis, though treatments may help to relieve pain and improve symptoms. Proactive treatments include exercises such as stretching, yoga or Pilates. Gentle exercise will help the vertebrae stay healthy and reduce stiffness. When arthritis is severe enough to cause nerve impingement, surgery may be necessary.

Post-Traumatic Conditions (Syringomyelia, Spinal)

Cause: A trauma to the spine such as a bad fall, car accident, or a traumatic illness like meningitis can cause a syringomyelia. A syringomyelia is a cyst that develops in the traumatized portion of the spinal cord. The cyst expands and elongates progressively, destroying the affected portion of the spinal cord. The damage caused by the cyst can cause pain, weakness, stiffness, headaches or the loss of sensation in the extremities. Because the syringomyelia is caused by a traumatic event and is progressive, it may not appear immediately after the occurring trauma. It may actually wait years before presenting symptoms.

Diagnosis: The physicians at Hedley Orthopaedic Institute will use diagnostic imaging, primarily MRIs, to view the spine, accurately diagnose a syringomyelia, and rule out other issues. An early diagnosis can aid in proactive treatment.

Treatment: Treating syringomyelia caused by a traumatic event usually involves surgery. In post-traumatic syringomyelia surgery, the surgery usually focuses on the initial injury. Syringomyelia is typically only treated when symptoms affect daily life. If no symptoms exist, the syringomyelia will be left alone. Occasionally a shunt may also need to be used to drain the cyst and relieve pressure. Other times, the surgery will instead expand the size of the hole surround the cyst to alleviate pressure.

Post-Traumatic Pain (Spinal)

Cause: Post-traumatic spinal pain may have a number of causes, including failed fusion (or other surgery), whiplash, and more. If an injury is never treated – or improperly treated – then post-traumatic pain could result.

Diagnosis: Your Phoenix-area provider at Hedley Ortho may perform a physical evaluation, investigate into your medical history or use diagnostic imaging tools to try to diagnose your spinal pain.

Treatment: Treatment for post-traumatic spinal pain largely depends on the underlying cause. You can learn more about specific causes of neck and back pain on this page.

Ruptured/Herniated Disc

Cause: A ruptured or herniated disc occurs when a disc (which acts like a cushion between vertebrae in the spine) bulges out or slips out of place. The damaged disc may pinch a nerve, causing pain in remote areas, such as the legs or fingers. In some instances, the disc space may be a cause of localized pain in the back.

Diagnosis: Providers at Hedley Orthopaedic Institute frequently diagnose and treat ruptured discs. The diagnostic process may begin with a physical examination, thorough medical history evaluation, and diagnostic imaging (after an area of the spine is identified as a probable source of discomfort).

Treatment: Many patients find relief from disc pain through non-surgical means, including physical therapy, pain medication, and injections. If these non-surgical treatments are not successful, then your orthopaedic physician may perform a microdiscectomy (to remove a portion of the disc) or a spinal fusion (to eliminate motion in the damaged disc space).

Sciatica

Cause: Tingling, numbness, weakness, and pain that travels down the lower back and into the leg are four of the primary symptoms that often get labeled as “sciatica.” However, sciatica is not actually a diagnosable condition. Rather, it is a term used to describe a collection of symptoms caused by injury to the sciatic nerve

Diagnosis: Understanding the cause of sciatic pain can be complex, as there are many possible causes. SI joint dysfunction, spinal stenosis in the lower back, disc herniation and degenerative disc disease, and piriformis syndrome could be a few of the potential causes behind a patient’s sciatic pain. At Hedley Orthopaedic Institute, providers begin diagnosis with a physical exam and full medical history. These two steps can help direct more specific diagnostic tests.

Treatment: Treatment for sciatica varies as greatly as the symptoms’ causes. Many patients find relief through exercise and nonsurgical means, including pain medication, epidural steroid injections and heat/ice therapy. Some patients elect to have surgery to treat their sciatica. Surgery may be used to remove material pinching the nerve root and causing the pain.

Spinal Deformity (Kyphosis, Scoliosis, Spondylolisthesis)

Cause: There are many kinds of spinal deformities; some are present at birth, while others are the result of damage to the spine. Kyphosis, scoliosis, and spondylolisthesis are three common spinal deformities. Kyphosis describes an exaggerated forward curvature of the thoracic region of the spine, scoliosis is a side-to-side curvature, and spondylolisthesis occurs when one vertebra slips forward over the vertebra beneath it.

Diagnosis: Some spinal conditions, such as kyphosis, may be diagnosed close to birth. Other conditions (kyphosis included) can develop later in life, as a result of osteoporosis or some other cause. Scoliosis, for example, may not manifest itself clearly until teenage years. Orthopaedic providers at Hedley Ortho may perform a physical exam, evaluate a patient’s medical history, and use one or more diagnostic imaging tests to establish the existence of a spinal deformity.

Treatment: Treatment varies, depending on the spinal deformity. Patients with minor spinal deformities may defer treatment. Other patients may find a brace or some similar orthopaedic device successfully corrects the spine’s curvature. Some spinal deformities may be treated through surgery, injections, or other means.

Spine Fractures

Cause: Spinal fractures are serious injuries that should receive immediate treatment. Typically, they occur as a result of sudden impact (car crash, sports injury, or fall, etc.) or osteoporosis (more common in seniors).

Diagnosis: In the case of acute spinal fractures, patients should be transported to the emergency room for imaging and treatment. In the case of vertebral compression fractures caused by osteoporosis (which may develop gradually), it’s important to see an orthopaedic physician for care as soon as possible. Your Phoenix-area provider at Hedley Ortho may begin by evaluating the patient’s physical condition, symptoms, medical history, and family history. As other possible causes are ruled out, the physician may determine a probable fracture area in the spine. An x-ray may be ordered to confirm the diagnosis; additional diagnostic tests may be ordered.

Treatment: Oftentimes, fracture care includes non-surgical components, such as rest, heat/ice, pain medication, and bracing. Some patients may undergo vertebroplasty or kyphoplasty. Both minimally invasive procedures restore loss of height in the damaged vertebra, stabilizing the fracture and providing pain relief.

Sports-Related Injuries of the Spine

Cause: Unfortunately, athletes can be just as susceptible to spine injuries as non-athletes. Certain competitive sports, such as football and wrestling, actually put athletes at greater risk for spinal injuries. Spondylolisthesis (described on this page) is one common sports-related spinal injury. It can occur as a result of hyperextension in the back.

Diagnosis: Sports-related spinal injuries are diagnosed in the same way as other types of spinal injuries. Your Phoenix orthopaedic physician at Hedley Ortho will begin with a physical exam and thorough medical history evaluation. Depending on the results of these investigations, your provider may order imaging tests for a closer look at the spine.

Treatment: Without exception, a spinal injury will necessitate time off from athletic activity. Mild and moderate back injuries might resolve through rest, ice/heat, and physician-recommended use of pain medication. More severe back injuries could require injections or surgery. Your physician at Hedley Orthopaedic Institute will tell you more.

Thoracic Disc Degeneration

Cause: Thoracic (or upper back) disc degeneration occurs when a disc, which serves as a cushion between two vertebrae, becomes inflamed and unstable. As a result, the disc wears down and no longer serves its proper function: absorbing stress on the spine. While this degenerative process, when it occurs in the neck or lower back, can be quite painful, many patients with thoracic disc degeneration experience no symptoms at all.

Diagnosis: Thoracic disc degeneration is oftentimes discovered during an MRI scan that has been ordered for the diagnosis of other symptoms. Oftentimes, thoracic disc degeneration is not the cause of the back pain that prompted the patient to see an orthopaedic physician.

Treatment: Treatment is not always necessary for thoracic disc degeneration. Rest, non-steroidal anti-inflammatory drugs, and basic over-the-counter analgesics, such as acetaminophen, may be successful in treating thoracic disc degeneration. In some cases, surgery may be necessary to repair a thoracic disc herniation. See below.

Thoracic Disc Herniation

Cause: Disc herniation in the upper back occurs when the gelatinous material within a disc in the upper back begins to leak outside the disc. While herniation does not typically cause back pain in this region of the spine, thoracic disc herniation may cause radiating pain (sometimes in the chest). Some patients find pain worsens when they cough or sneeze.

Diagnosis: Diagnosing thoracic disc herniation can be difficult, as the symptoms patients tend to report could have a root cause in other areas of the body besides the spinal cord. At Hedley Orthopaedic Institute, providers begin the diagnostic process with a review of medical records, a physical exam, and an imaging test, if warranted.

Treatment: Treatment may not be necessary for thoracic disc herniation – especially if symptoms are mild or nonexistent. If the ruptured disc is putting pressure on the spinal cord, causing pain or numbness, then surgical intervention may be necessary to relieve pressure from the spine.

Thoracic Instability

Cause: Thoracic instability is a condition in which joints in the spine have too much flexion. While an increased range of motion might sound favorable, it can actually cause significant pain in the back. Some patients with thoracic instability develop bone spurs in the spine; these spurs can cause additional pain by irritating nerve roots and the spinal cord. Additionally, thoracic instability may cause surrounding muscles to become overworked, leading to muscle knots and tension.

Diagnosis: Diagnosing thoracic instability can be challenging. At Hedley Orthopaedic Institute, providers carefully consider a patient’s medical history, flexion, symptoms, and all past trauma and treatments. Imaging tests may be used to evaluate bone and muscle structures. Other tests, done as part of a physical exam, can help determine strength and mobility. If a provider suspects thoracic instability, then he or she may recommend a brace. If the patient finds symptomatic relief through wearing the brace, then it may be helpful for determining an underlying cause of the instability.

Treatment: Treatment for thoracic instability may include physical therapy and strengthening exercises, patient education, NSAIDs, and pain medication. Fusion procedures are sometimes used when non-surgical treatments are unsuccessful.

Thoracic Radiculopathy

Cause: Thoracic radiculopathy is a very rare spinal condition that occurs when a nerve root in the thoracic (mid-) region of the chest is pinched or compressed. This nerve compression can cause pain in the chest, abdomen, or elsewhere. Patients with thoracic radiculopathy may describe a band-like pain around the chest. Radiculopathy is much more likely to occur in the lumbar (lower back) or cervical (neck) region.

Diagnosis: Your Phoenix area orthopaedic physician at Hedley Ortho may begin the diagnostic process with a full physical exam, evaluation of symptoms and medical history, and imaging tests.

Treatment: Treatment for thoracic radiculopathy may include physical therapy, pain-relief medication and/or injections and surgery. Surgery, depending on the cause of thoracic radiculopathy, may be used to stabilize the spine or relieve pressure from nerves.

Thoracic Spinal Stenosis

Cause: Spinal stenosis in the thoracic (upper/middle back) region is much less common than stenosis of the lower back or neck. However, this condition does affect adults in the Valley every year, causing pain in the back and legs; in some cases, patients may have difficulty with balance or even experience incontinence. Spinal stenosis occurs when the spinal canal narrows or becomes obstructed, putting pressure on the spinal cord.

Diagnosis: Diagnosis of thoracic spinal stenosis begins with a physical exam and evaluation of medical history and symptoms. Your orthopaedic physician at Hedley Ortho may use a diagnostic imaging test to search for spinal cord compression.

Treatment: Early treatment for thoracic spinal stenosis is typically non-surgical, starting with rest, NSAIDs, physical therapy, and epidural steroid injections. If these non-surgical therapies do not improve symptoms, than your physician may use surgical methods to remove the disc or bone spurs impinging on the nerve root.

Traumatic (Fractures, Dislocations, Muscle Strains, Ligament Sprains)

Cause: Trauma to the spine and surrounding structures should be taken very seriously. In the case of spinal fracture, for example, urgent care is required. In the case of muscle strain or ligament sprain, professional medical care can sometimes be delayed. Low-grade sprains and strains may be treated at home through rest, ice, compression, and elevation (Learn more about R.I.C.E.)

Diagnosis: Diagnosis of a traumatic injury may be done with the aid of a physical examination, medical history evaluation, and the use of imaging tools, such as x-ray, MRI, or CT scan (depending on the nature of the injury).

Treatment: Some traumatic injuries may be successfully treated through non-invasive methods, such as NSAIDs (e.g. ibuprofen), pain medication, R.I.C.E., and physical therapy. Bracing may be required as well. Other injuries could require injections or even surgery. Your orthopaedic physician at Hedley Ortho can tell you more.

Spine-Related Symptoms: Back Pain, Neck Pain & More

Not all spinal conditions present pain in the neck or back. Some spinal conditions cause loss of dexterity, pain that radiates into the arms or legs, loss of bladder or bowel control, and other symptoms. Treatment options are available for many causes and symptoms of spinal-related pain. Learn more about some of the symptoms treated at Hedley Orthopaedic Institute below. This list is not comprehensive; treatment may be available for additional symptoms by your specialist at Hedley Orthopaedic Institute.

Arm/Leg Numbness and/or Weakness

Cause: Numbness and weakness in the extremities (arms, legs, fingers, and toes) is sometimes rooted in spine-related problems. A herniated disc, for example, may put pressure on the spinal cord. This pressure, in turn, manifests itself symptomatically via pain, numbness, or weakness in an extremity. Other possible causes of numbness or weakness include bone spurs, spinal tumors (rare), spinal stenosis, degenerative disc disease, spondylolisthesis, and other spinal health issues. Disc herniation and other forms of spinal cord or nerve root impingement in the upper back or neck can cause symptoms in the arms and fingers. Impingement in the lower back (lumbar region) may cause weakness, numbness, or tingling in the buttocks, legs, feet, or toes.

Diagnosis: Your provider at Hedley Orthopaedic Institute may begin the diagnostic process by performing a physical exam and evaluating your medical history. Your strength, range of motion, and sensitivity may also be tested. If your orthopaedic physician has reason to believe the numbness or weakness is caused by a spinal problem, then a diagnostic imaging test may be called for. Such tests include x-ray, MRI, CT scan and nerve tests.

Treatment: Treatment for numbness or weakness in the extremities can vary greatly, as these symptoms can have many different causes. Oftentimes, numbness or weakness is caused by pressure on the spinal cord or nerves. As such, your Phoenix-area orthopaedic physician at Hedley Ortho may refer you to a physical therapist to relieve pressure from the nerve. Other options may include pain medication or injections. If these methods are unsuccessful – or if the symptoms are severe – then you may be a candidate for spinal surgery.

Back Pain

Cause: According to NIH, four out of five adults suffer back lower back pain at some point in their lifetimes. Back pain is one of the most common sources of discomfort in people from all backgrounds. The pathologies of upper, mid-, and lower back pain are wide and varied. Causes may include, but are not limited to, sprains and strains, disc herniation, radiculopathy, spinal stenosis, spondylolisthesis, disc degeneration, traumatic injury, and spinal deformities.

Diagnosis: A full medical history and physical exam, during which your provider asks about your symptoms and present and past health conditions, can be very helpful in diagnosing the cause of your back pain. In some cases, an imaging test may be necessary to confirm a diagnosis. These tests (x-ray, MRI, CT scan, etc.) allow the provider to see bone structures that may be causing pain or discomfort.

Treatment: Before treating your back pain, your provider at Hedley Orthopaedic Institute will identify your pain as either acute or chronic. These types of pains are treated differently. Typically, providers start with conservative treatment, which may include heat/ice, rest, physical therapy and strengthening exercises, over-the-counter pain medications or anti-inflammatory drugs, and pain management via injections. If there is evidence that further nerve damage or spinal degeneration is possible, then your Phoenix-area orthopaedic physician may recommend spinal surgery. Surgery may be employed to provide stability, limit range of motion, or restore loss of vertebral height.

Gait Disorder (Walking Difficulty, Clumsy Walking, Loss of Balance)

Cause: “Gait Disorder” is a clinical term that encompasses many different difficulties with walking, balance, and stability. Some gait disorders are caused by problems in the spine. Other disorders, like foot drop, may be caused by muscular problems.

Diagnosis: Your physician at Hedley Ortho may diagnose a gait disorder by performing a full medical history and physical examination. Gait and balance tests may be performed in office to determine a cause and treatment plan. Imaging tests may also be used to examine the spine.

Treatment: Your health care provider at Hedley Orthopaedic Institute may recommend physical therapy, a special brace, medication, or other therapies in the treatment of gait disorder. Ask your physician for more information. If nerve compression is severe enough, surgery may be required.

Hand Dexterity Problems (Difficulty Buttoning Shirts, Grip Loss, etc.)

Cause: Hand dexterity problems are sometimes caused by damage to nerves in the cervical (neck) region of the spine. Nerves may be compressed by degenerative disc disease, irritated by osteophytes (bone spurs), or otherwise adversely affected.

Diagnosis: If you are having difficulty gripping items or performing simple daily tasks with your fingers, let your physician know. An orthopaedic specialist at Hedley Orthopaedic Institute may begin diagnosing the cause of your dexterity issues by performing a full medical history and physical examination.

Treatment: Treatment may focus on the symptoms, the underlying cause, or both. If physical therapy and strengthening exercises are not effective in improving dexterity issues, your orthopaedic physician may recommend injections or surgery. By eliminating nerve impingement, dexterity problems may improve.

Loss of Control of Bowel & Bladder

Cause: Incontinence (of bladder and/or bowel) is sometimes a symptom of spinal issues. Cauda Equina Syndrome, a neurological disorder of the nerve roots at the end of the spinal cord, is sometimes a cause of incontinence. Certain ruptured discs can also cause nerve problems that lead to incontinence.

Diagnosis: Your provider at Hedley Orthopaedic Institute may begin the diagnostic process with a full medical history and physical examination. Diagnostic imaging tests may be ordered to evaluate the vertebrae.

Treatment: If spinal cord or nerve compression is the cause of your incontinence, then your orthopaedic physician may recommend physical therapy, injections, or surgery (among other treatment options) to relieve pressure from the spinal cord or nerves.

Neck Pain

Cause: Neck pain is a common source of discomfort for many people in the Valley area. Neck pain is commonly caused by sprain or strain or sudden impact. In some patients, however, neck pain may find its source in spinal issues. Degenerative disc disease, spinal stenosis, and disc rupturing are all possible spine-related causes of neck pain.

Diagnosis: At Hedley Orthopaedic Institute, your provider will use a full medical history and physical exam to begin the diagnosis of your neck pain. Mobility tests may also be used to aid in diagnosis. In some cases, an x-ray, MRI, CT scan, or other imaging test may be used to confirm a diagnosis.

Treatment: Oftentimes, neck pain can be treated non-surgically through heat and ice, rest, physical therapy, strengthening exercises, and over-the-counter pain medications or anti-inflammatory drugs. If the condition causing neck pain has the potential to worsen, causing neurological damage or long-term damage to the spine, then your orthopaedic physician at Hedley Ortho may recommend a surgical procedure to bring stability to the neck.

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To schedule your appointment with an orthopaedic specialist in Phoenix, call Hedley Orthopaedic Institute, contact us.

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