The Medical Center has an excellent choice of Visiting Specialists, diagnostic equipment such as MRI, CT Scanner, X-ray, and a Physical Therapy & Sports Medicine program to assist with analyzing the causes of neck and back pain.
In a recent interview with Visiting Specialist and Neurosurgeon Dr. Nancy Epstein, she answers some of the most frequently asked questions:
What is causing my neck/back pain and what should I do about it?
“As we get older, everything starts to hurt,” she said. “This is not surprising. However, if you feel pain going down an arm or leg, with numbness and tingling, or even weakness, it is time to see a doctor. The first thing the doctor will do is take a history, which includes your medical conditions, medications, allergies, and prior surgery. Next, they should perform a neurological exam to document possible problems; that is, weakness, loss of sensation, etc. This exam will determine what studies (e.g., X-rays, CAT scan, MRI scan), if any, are needed.”
What are the causes of pain?
“Neck and back pain are commonly due to normal osteoarthritic changes (arthritis) associated with age,” Dr. Epstein said. “However, these ‘arthritic’ changes can also contribute to narrowing of the spinal canal (spinal stenosis), the bony structure that houses the spinal cord and nerves. These ‘arthritic’ changes can cause compression of the spinal cord and nerves resulting in neck, back pain, etc. In addition, these same symptoms may be caused by herniated discs with or without the accompanying stenosis.”
How do we tell what is causing the pain?
“To determine the cause of the pain, X-rays followed by magnetic resonance (MRI) exams are usually performed. But X-rays have limited value; they just show whether the bones are aligned properly. However, the MRI documents if there is pressure on the spinal cord or nerves, along with other possible causes that include blood clots or tumors. CT scans are sometimes used to show bony changes,” she said.
What should be done?
“Most neck and back problems can be managed without surgery,” she said. “Surgery should only be considered if the MRI findings are consistent with the neurological exam. In particular, the site of the pain or weakness or sensation loss on the exam must correlate with the abnormal MRI findings. Finally, pain alone is not a sufficient reason for surgery.”
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