Back and neck pain
There are many causes of back and neck pain. Most episodes are trivial and will settle with pain relief, rest, and some time.
Spinal wear and tear
As we all get older, there is a degree of wear and tear that sets in. Wear and tear in the spine is sometimes also referred to as ‘degenerative spinal disease’ or ‘spinal spondylosis’. The actual changes in the spine that occur as a result of wear and tear include the formation of osteophytes, or bony overgrowths, disc bulges, and enlargement of joints (facet hypertrophy). These changes in themselves do not need treatment, but they can sometimes cause troublesome pain. There are a variety of treatments that can alleviate back and neck pain, including medication, physiotherapy, and injections. Sometimes the wear and tear changes can cause compression of nerves, which may result in pain, weakness, numbness or tingling in the arms or legs, and sometimes unsteadiness and continence issues. In these situations, surgery to treat the nerve compression may be helpful. Wear and tear is diagnosed by scanning the spine, typically with MRI.
Lesions in the spine
Lesions in the spine such as tumours are rare causes of back or neck pain. They can be benign or malignant, and may cause similar symptoms to those caused by wear and tear and disc prolapses as described above. The pain can be severe and persistent, and may continue throughout the night. Early diagnosis is important, both for the condition itself and any nerve compression it may be causing. A MRI of the spine will diagnose tumors of the spine.
Disc prolapses
Disc prolapses in the spine can result from trauma, wear and tear, an underlying condition, or a combination of these factors. The symptoms that arise as a result of a prolapsed disc depend on whether the disc is in the cervical spine, thoracic spine or lumbar spine.
Lumbar disc prolapse may cause lower back pain. The disc may also compress a nerve, and if this is the case then pain, numbness or tingling in the legs may occur. Disc prolapses may cause excruciating leg pain. Most cases get better without surgery in a few weeks, and medication or an injection may help to relieve the pain during this period. If symptoms persist beyond several weeks, surgery to release the pressure on the nerve may be helpful.
If a lumbar disc prolapse is large and the nerve compression is severe, it may cause numbness in the perineum and genital area, and may also cause bladder problems or incontinence in addition to pain in one or both legs. This situation is called cauda equina syndrome, and is a surgical emergency which requires immediate evaluation in an A+E department. Lumbar disc prolapse does not affect the arms or hands.
Cervical disc prolapses can cause neck pain, or pain, weakness, numbness or tingling in one or both arms or hands. If the prolapse is large it may also cause weakness or unsteadiness in the legs, or even issues with continence. Most acute cervical disc prolapses resolve after a few weeks, but surgery may be helpful if the symptoms persist or are severe.
Thoracic disc prolapses are more unusual and may result in back pain, and weakness or unsteadiness in the legs. It may also cause continence problems and altered sensation in the legs and chest or abdomen. Thoracic disc prolapses causing neurological impairment may require surgery.
spinal procedures performed by mr hasegawa
MRI scan
Nerve root injection
Lumbar laminectomy
Lumbar discectomy
Microdiscectomy
Cervical laminectomy
Cervical foraminotomy
Anterior cervical discectomy
Anterior cervical discectomy and fusion (ACDF)
Removal of spinal lesions
Appointments
To book a private appointment with Mr Hasegawa at the Syon Clinic, Clementine Churchill Hospital or Princess Margaret Hospital, please click the button below (redirects to Circle Health Group booking page)
If you'd like to ask a question before booking an appointment, please contact us on info@hasegawaneuro.com