Wednesday, January 5, 2011

If YOU have Neck Pain, You have Options

Neck pain is a common problem, with two-thirds of the population having neck pain at some point in their lives.

What Causes Neck Pain?

Causes of neck pain include:
  • Abnormalities in the bone or joints
  • Trauma
  • Poor posture
  • Degenerative diseases
  • Tumors
  • Muscle strain

What Causes Shoulder Pain?

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:
  • Strains from overexertion
  • Tendonitis from overuse
  • Shoulder joint instability
  • Dislocation
  • Collar or upper arm bone fractures
  • Frozen shoulder
  • Pinched nerves (also called radiculopathy)
    • Other medical conditions, such as fibromyalgia
    • Cervical arthritis or spondylosis
    • Ruptured disk
    • Small fractures to the spine from osteoporosis
    • Spinal stenosis (narrowing of the spinal canal)
    • Infection of the spine (osteomyelitis, diskitis, abscess)
    • Cancer that involves the spine

How Are Neck and Shoulder Pain Diagnosed?

  • X-rays: Plain X-rays can reveal narrowing of the space between two spinal bones, arthritis-like diseases, tumors, slipped discs, narrowing of the spinal canal, fractures and instability of the spinal column.
  • MRI:Magnetic resonance imaging is a noninvasive procedure that can reveal the detail of neural (nerve-related) elements.
  • Myelography/CT scanning: Sometimes used as an alternative to MRI
  • Electrodiagnostic studies:Electromyography (EMG) and nerve conduction velocity (NCV) are sometimes used to diagnosis neck and shoulder pain, arm pain, numbness and tingling.

How Are Neck and Shoulder Pain Treated?

The treatment of soft tissue neck and shoulder pain includes the use of anti-inflammatory medication (such as Aleve or Motrin) and/or acetaminophen (Tylenol). Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injection is often helpful for arthritis of the shoulder. For both neck and shoulder pain movement exercises may help. Sometimes neck pain can signify something more serious. Seek immediate medical care from our Austin Pain Doctors if you experience:
  • Shooting pain into your shoulder or down your arm
  • Numbness or loss of strength in your arms or hands
  • Change in bladder or bowel habits
  • Inability to touch your chin to your chest
Chronic back or neck pain, on the other hand, often has to be managed. This is because what can cause chronic pain may be difficult to determine. The treatment plan may require multiple and/or combined therapies. The complexity of chronic pain may mean it takes a patient longer to find relief from their symptoms. Pain management specialists have many different therapies from which to create a chronic pain treatment plan. Such as:

Injection Therapies
There are many types of spinal injections available to diagnose and treat different disorders. A sampling includes:
Epidural Injections and Nerve Root Blocks consist of anesthetic and steroid medications that are injected into the epidural space of the spine. Such injections are used to help diagnose a condition and/or relieve pain. An epidural injection is often performed to ease pain that radiates into the arms or legs.
Facet Joint Injections and Medial Branch Blocks help to determine if the facet joints are the source of pain. Besides their value diagnostically, such injections may help reduce cervical (neck), thoracic (chest area), and lumbar (back) pain.
Sacroiliac Joint Injections target relief at the joints in the lower back where the pelvis and spine join. The injection offers a two-fold purpose. First, the medication (anesthetic and steroid) helps to reduce joint inflammation and pain. Second, it can help determine if the sacroiliac joint(s) are the pain source.
Other Invasive Options
Pulsed Radiofrequency Neurotomy (PRFN) is a minimally invasive procedure that disables spinal nerves and prevents them from sending pain signals to the brain.
Rhizotomy is a procedure that 'turns off' pain signals by using heated electrodes applied to specific nerves that carry pain signals to the brain.
Spinal Cord Stimulation (SCS) and Intrathecal Pumps are advanced invasive pain management options. These are usually performed on a trial basis first to determine if the patient will benefit from treatment.
Spinal Cord Stimulation (SCS) produces electrical impulses to block pain from being perceived in the brain.
An Intrathecal Pump is a surgically implanted device that delivers a measured amount of pain medication within the spinal canal.
Surgical Interventions
Surgery is always the last resort, unless the patient's condition warrants immediate surgical intervention (e.g. bowel, bladder or profound neurologic dysfunction). When non-surgical treatments are not effective, spine surgery may be considered. Percutaneous Discectomy/Nucleoplasty is a minimally invasive surgical procedure that removes disc tissue and relieves pressure from spinal nerves. There are other types of spine surgery; some are complicated and may require spinal instrumentation and fusion procedures.

To learn more call our office make your appointment.
New patients are roughly one hour [ yes, one hour ] and you can go over your pain, medical history and options with a neck pain specialist.