Anatomy of the Spine

The pinched nerves are usually caused due to inflammation of the nerve roots near the spinal cord where they exit. The inflammation, once improved, causes relief in the pinched nerve. This improvement in inflammation can be caused rest, anti-inflammatory medication, steroid medications or cortisone shot. Occasionally the cause of inflammation may be persistent compression over the nerve, which may not get better with all form of conservative management.

Back sprain means injury to the ligaments or the muscles of the back. It can usually happen due to certain activity or may be with a fall or accident. The underlying cause of a back sprain may be weakening of the muscles of the back which may predispose the person to develop back sprains. If a back sprain is recurrent, then they may need physician medical attention to take care of their back so as to prevent further recurrences.

An episode of back sprain can usually be treated with short term rest for one to two days along with anti-inflammatory medications and use of ice or heat to decrease the pain. This should be followed by usual activity as well as exercises involving strengthening and stretching of back muscles.

If jogging causes worsening of the back sprain, then it should better be avoided. If comfortable, one can try to do walking or fast walking too in place of jogging.

Low back pain can usually be treated with short period of rest for one to two days along with anti-inflammatory medications followed by stretching and strengthening exercises of the back. These exercises can be done at home or at the gym with or without supervision of a personal trainer. If the patient has recurrent episodes, then they should seek medical attention to learn a specific type of exercise and to rule out other possibilities or reason for recurrence of back pain.

The patient with low back pain may have difficulty sleeping in specific positions. They should try avoiding that and may sleep by the side. They should also try to keep pillows between the legs while sleeping by the side or under the knees when sleeping on the back.

For a sore back or low back pain, a short term rest for one to two days may be helpful. Rest for longer periods have not been found to cause much effect in the long term and should be avoided. Prolonged rest can cause weakening of the muscles which may predispose to recurrence of back pain.

Most patients who have pinched nerve in the lower back present with sciatica or pain radiating down the leg. This may or may not be associated with tingling or numbness. Such patients are usually treated with medications and exercises. If the pain, tingling, and numbness are not relieved with conservative means, then these patients may need to undergo advanced imaging in the form of MRI to rule out disc disease and be treated accordingly.

C5 and C6 nerves innervate the muscles of the shoulder and the elbow. The patients who has involvement of C5 and C6 will have pain over a shoulder and the upper arm and going up to the outer side of the forearm and the thumb. These patients may have tingling and numbness of the same area and may have weakness in the shoulder and the elbow presenting in the form of elevating the shoulder and bending the elbow.

There are usually no restrictions with regards to the sleeping habits after back surgery. The patients can sleep in comfortable position either on the back or by the side as they feel more comfortable. They may need to use multiple pillows to make them comfortable in bed.

Spinal fluid leak after a spine surgery usually happens due to the injury to the set of the nerve roots of the spinal column. If the spinal fluid leak is detected during the surgery, it is usually sutured and treated accordingly. If the spinal fluid leak is not detected during the surgery or if the repair not water tight then the patient may have headache especially while sitting and standing.

These patients are usually treated with medications and IV fluids. If the patient failed to improve with conservative means, then they may need to undergo surgery for the repair of the leak.

Patients who undergo back surgery are asked not to drive until they are off pain medications as well as they are comfortably sitting in a car, in a chair for prolonged period.

Patients with neck pain can usually be treated with short period of rest along with antiinflammatory medications. They can also wear a soft collar if that is helpful in pain relief. Patients are encouraged to strengthen their neck muscles over a period of time with or without supervision of a physical therapist so as to treat neck pain as well as prevent recurrences.

About neck pain which is not improved with over-the-counter medications and or is worsening or causes radicular pain around the arm or the leg, electric shock-like sensations down the body or associated with tingling, numbness, weakness, or involvement of bowel or bladder can be serious and these patients should seek medical attention so as to rule out other possible causes of neck pain. if the patient has fever with or without chills or has a history of malignancy in the past, then the patient should also seek medical attention to rule out infection or malignancy involving the bones.

Patients with neck pain usually have sore muscles of the neck and they may need special pillows so as to prevent awkward positioning of the neck. They should avoid multiple pillows and should try to sleep by the side or use a contoured pillow so as to keep the neck straight.

Exercise are of tremendous help in patients with neck and back pain. They help in strengthening the muscles and thereby improving the health of the muscles. Strong muscles offload the bones of the neck and help in relieving the neck pain.

Spondylosis is another term for degeneration or osteoarthritis of the bones of the neck. They usually present with neck pain with or without radiating pain down the arms. X-rays of the neck may show signs of osteoarthritis in the form of leaking or bone spurs.

Though a rare cause, but there is a possibility for a cause of neck pain. Any patient who has longstanding neck pain which is not relieved with conservative needs or has a history of malignancy in the past or have unintentional weight loss should seek medical attention to rule out the diagnosis.

Most of the patient’s with pinched nerve usually improves over time and pressure of the nerve is decreased due to the healing mechanism of the body. Only if the patient is not relieved of symptoms of pain, tingling or numbness, or there is worsening of symptoms and pain with or without involvement of muscles in the form of weakness or bowel or bladder, then these patients should seek medical attention.

Pinched nerve in the neck usually presents with radicular pain going down their arms. This may or may not be associated with tingling or numbness. If the pain is associated with weakness of the muscle, then the patient should seek urgent medical attention