Conditions

Some Common Conditions

What is Back Pain?

First of all, back pain is a symptom of an underlying condition or injury. Acute pain occurs when the nerve(s) in the spinal column become impinged or pinched. This is commonly caused by a disc or bone spur pushing into the canal. This canal houses the spinal cord, the cauda equina, and the nerve roots.

At birth, discs are comprised primarily of water. However, they tend to dry and shrink as we age. When this occurs, it causes changes in the spinal column. Further changes can also occur when a disc ruptures or herniates (protrudes.) Typically due to injury. Although, often in response to these changes, tissue around the spinal canal thickens. Reducing the space in the spinal canal. This narrowing is called stenosis. Additionally, when the facet joints degenerate, they become larger. Eventually forming spurs. And can pinch the nerve roots or even the spinal cord.

Common Back Pain Causes

Back pain that comes on abruptly can last up to six weeks. This is called acute pain. Often caused by a fall or lifting a heavy object. When pain persists for more than three months (chronic pain) is not as likely as acute pain.

List of common causes

Upper Back

Cervical Stenosis

Degenerative Disc

Facet Disease

Herniated Disc

Kyphosis

Pinched Nerve

Slipped Disc

Whiplash

Lower Back

Diagnosis

Our doctor will first examine your back and assess your discomfort level. Then your ability to sit, stand, walk and lift your legs. This information will help the specialist determine the origin of the back pain and how it affects your everyday life. There are many different tests that can be done to provide imaging, including:

X-rays
MRICT scan
Blood tests
Bone scan
Nerve studies

X-rays show bone alignment, arthritis or fractured bones. However, an MRI or CT scan reveals herniated disks, problems with bones, tendons, muscles, nerves, and ligaments.

Common Back Pain Treatment

For acute back pain, your doctor may recommend over-the-counter pain relievers and the use of heat. If home treatments aren’t working after several weeks, stronger medications may be recommended. Such as:

Muscle relaxants
Anti-inflammatories
Physical therapy
Cortisone injections

If you are unable to function, or your neurological deficit is becoming progressively worse, then surgery may be recommended. In some cases, however, modern spinal surgery is extremely successful in alleviating pain and restoring mobility.

There are a number of different surgical approaches to relieving back pain though. The following is a general description of some of the most commonly performed procedures:

Discectomy – The removal of all or part of the offending disc
Decompression – The removal of bone spurs
Corpectomy – The removal of a vertebra
Spinal Fusion – The joining of discs to prevent motion in the affected area

What Causes Knee Pain?

First and foremost, we need to understand that knee pain is one of the most common musculoskeletal conditions. It’s common because the knee joint is particularly vulnerable to damage. However, the function is in taking full body weight and force when running or jumping.

However, when a knee becomes injured or diseased, the patient can experience severe pain. Unfortunately, it’s common for this to limit mobility. Knee pain can originate from any of the bones compromising the knee joint (femur, tibia, and fibula), the kneecap (patella), or the meniscus (ligaments and cartilage of the knee).

When determining the cause of knee pain, it is usually comprised of three types, such as:

Injury: a broken bone or fracture, torn ligament, or meniscus tear.
Medical Conditions: arthritis or infections.
Overuse: osteoarthritis, patellar syndromes, tendinitis, and bursitis.

Common Knee Pain Diagnoses

Knee Bursitis is the inflammation of small fluid-filled sacs (bursa). These sacs are located near your knee joint. And they serve as cushion pressure points between bones, tendons, muscles, and skin.

Osteoarthritis of the knee is the most common form of arthritis. When osteoarthritis occurs, cartilage begins to break down. Therefore, causing damage.

Patellofemoral Pain Syndrome is described as pain in the front of the knee and around the patella. Typically, this type of injury is due to overuse or issues with kneecap alignment.

Meniscus tears occur during an activity, which causes your knee to forcefully rotate or twist.

Knee dislocations occur when the thighbone position gets bumped out of place. And the knee ligaments begin to tear.

Signs you need a doctor

Swelling
Deformity
Pain
Stiffness
Inability to bend
Unable to walk (or discomfort)

Knee Pain Treatment

The type of treatment determined by your orthopedic specialist will depend upon the severity and cause of your pain. When visiting any of our offices in Broward and Palm Beach to treat your knee pain, the first approach is always a non-invasive option. Your knee specialist may prescribe medications to help with the inflammation and pain in the case of conditions such as gout or rheumatoid arthritis.

Physical therapy may also be recommended to strengthen the muscles around the knee joint. Therefore, focusing on the quadriceps and/or hamstrings as well as a routine to improve balance. Your doctor may also recommend knee injections that go directly into the knee joint. The medications injected usually contain corticosteroids (a potent anti-inflammatory), hyaluronic acid (to lubricate the knee joint and to improve overall mobility.) And/or platelet-rich-plasma or PRP (contains different growth factors that help to reduce inflammation and to promote natural healing.)

If moderate treatment doesn’t yield results and/or the condition or knee injury is too severe, you may require knee surgery. Regarding knee surgery, the options available nowadays vary from minimally invasive knee surgery to a total surgical joint reconstruction. Among the knee surgical options, the most common is knee arthroscopy, partial knee replacement, total knee joint replacement.

What is a Scoliosis?

Scoliosis is the most common abnormal curvature of the spine. It is most common in adolescent females.Scoliosis is a genetic condition that frequently runs in families. Small curves usually cause no pain.

The curve is commonly in the upper back. The patient may have one hip higher than the other, and frequently one shoulder blade appears more prominent than the other.

Scoliosis Symptoms & Signs

One hip may be higher than the other
One shoulder blade appears more prominent
Small curves in the back; usually upper back
Deformity in back
Cork screwing effect from rotation

Causes of Scoliosis

There is no known cause for Scoliosis
Scoliosis tends to run in families

Recommendations for Treatment of Scoliosis

It is worth mentioning that 90% of scoliosis cases are moderate and do not require any type of treatment or intervention, expect for recurring observation by a doctor every 4 to 6 months (in most cases) until the patient reaches his/her full skeletal growth.

If the curves in the spine are big and growing rapidly, bracing is often recommended. As a matter of fact, the use of braces for scoliosis is the most recommended treatment. Spine surgery for Scoliosis is the last resort and only recommended if bracing is not effective after prudent observation.

Several people claim that physical therapy and/or manual manipulation can help restraining the progression of the curve; but, as of now, there is little to none scientific proof to back up these claims. On the other hand, your doctor may recommend exercise to keep the back flexible and strong.

Factors to determine proper treatment

Patient age and gender
Bone maturation
Location of the curve in the spine
Degree of the curvature
Progression of curvature
Related symptoms: back pain, shortness of breath, others

What is Neck Pain?

The part of the spine that supports your neck is called the cervical spine. In addition to supporting the weight of the head, the cervical spine must allow for a significant amount of movement. Unlike the rest of the spine, which is relatively protected from injury, the cervical spine has a relatively small number of muscles and ligaments. These muscles and ligaments surround and protect the spine from being injured.

Causes of Neck Pain

Many people experience neck pain occasionally. In most cases, their pain or stiffness is due to poor posture, overuse, a fall, or sports injuries.

Muscle strains. Overuse injuries, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting your teeth, can strain neck muscles.
Worn joints. Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain.
Nerve compression. Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord.
Injuries. Rear-end auto collisions often result in a whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
Diseases. Certain diseases, such as rheumatoid arthritis, meningitis, or cancer, can cause neck pain.

Neck pain isn’t typically something to worry about. In fact, most people find relief in a few days. However, in some cases, it can indicate serious injury or illness and require medical care.

When to Seek Medical Attention

When neck pain continues for more than a week, is severe, or is accompanied by other symptoms, immediate medical attention is recommended.

You need to seek treatment when the neck pain may result from abnormalities in the soft tissues (muscles, ligaments, or nerves) or in the vertebrae or joints of the cervical spine. The most common causes are degenerative diseases (such as arthritis) or soft tissue abnormalities following injury. In some individuals, neck problems may cause pain felt in the upper back, shoulders, or arms.

What is hip pain?

Hip pain involves any pain in or around the hip joint. In fact, you may not feel pain from your hip directly over the hip area. Instead, you might feel it in your groin or pain in your thigh or knee. However, hip pain may be caused by problems in the bones or cartilage of your hip.

What causes hip pain?

• Osteoarthritis

Osteoarthritis occurs after bone cartilage is worn away or damaged and hip bones no longer move smoothly. Osteoarthritis is common in those over 50. It causes pain in the groin area and the front side of the thighs. However, osteoarthritis is a chronic condition that causes pain and stiffness and is usually worse after activity. Due to friction, swelling, and stiffening, the hip joint may become deformed. In severe cases, however, a total hip replacement is required.

• Hip Fracture

Those suffering from osteoporosis, especially the elderly, fracture their hips often. In fact, a hip fracture is a common occurrence during simple daily activities. Surgery is required for a hip fracture.

• Muscle strains, tendonitis, or bursitis

Overusing the hip muscles can result in small tears. Although strains can happen in the lower back after quick turning, twisting, or pulling. Tendons are the tissues that connect muscles to hip bones and joints. Inflammation of the tendons occurs from frequent strenuous activity. Bursae are fluid-filled sacs that cushion the bones, tendons, and muscles near the joints. And bursitis is the painful inflammation of these sacs.

• Inflammatory Conditions

There are many inflammatory conditions, such as rheumatoid arthritis or polymyalgia rheumatica. Early diagnosis of inflammatory diseases is vital. Considering some conditions are treatable and can prevent more severe complications.

• Infection or malignancy

Acute infections need urgent diagnosis and care. Considering, they can cause joint destruction. In fact, they can cause an overabundance of harmful bacteria and toxins if left untreated.

Dr T Majojo

Orthorpaedic & Trauma Surgeon

Conditions

Some Common Conditions