Common Conditions
Sacroiliac Joint Dysfunction
Sacroiliac (SI) joint pain is felt in the low back and buttocks. The pain is caused by damage or injury to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain. Physical therapy, stretching exercises, pain medication, and joint injections are used first to manage the symptoms. Surgery to fuse the joint and stop painful motion may be recommended.
The SI joints are located between the iliac bones and the sacrum, connecting the spine to the hips. The two joints provide support and stability, and play a major role in absorbing impact when walking and lifting. From the back, the SI joints are located below the waist where two dimples are visible. Strong ligaments and muscles support the SI joints. There is a very small amount of motion in the joint for normal body flexibility. As we age our bones become arthritic and ligaments stiffen. When the cartilage wears down, the bones may rub together causing pain. The SI joint is a synovial joint filled with fluid. This type of joint has free nerve endings that can cause chronic pain if the joint degenerates or does not move properly.
Arthritis of the Spine (Spondylosis)
Spondylosis is also known as spinal osteoarthritis. It is common and usually not serious, although it can be quite painful. Spondylosis is a degenerative condition that may worsen as a person grows older. It can affect any region of the spine: cervical (neck), thoracic (upper, mid back), lumbar (low back) or lumbosacral (low back/sacrum). Most patients with spondylosis do not require spine surgery.
Adjacent Segment Disease
Adjacent segment disease (ASD) is a spinal disorder that may develop after spinal fusion (eg, instrumentation, bone graft). Although ASD is widely known to be a potential complication of spinal fusion, it can also be caused by natural degenerative changes that occur in the spine due to aging. ASD is also known as adjacent segment syndrome, transitional syndrome, and adjacent segment degeneration.
Back Pain
Back pain is one of the most common reasons people self-treat and seek medical care. It will affect approximately three in four adults during their lifetime. When we speak about “back pain” we mean pain that originates in the spine anywhere between the upper and lower back.
Brain Aneurysm
A brain aneurysm (AN-yoo-riz-um) is a bulge or ballooning in a blood vessel in the brain. It often looks like a berry hanging on a stem. This can can leak or rupture, causing bleeding into the brain (hemorrhagic stroke). Most often a ruptured brain aneurysm occurs in the space between the brain and the thin tissues covering the brain. This type of hemorrhagic stroke is called a subarachnoid hemorrhage. A ruptured aneurysm quickly becomes life-threatening and requires prompt medical treatment. Most brain aneurysms, however, don't rupture, create health problems or cause symptoms. Such aneurysms are often detected during tests for other conditions.
Cerebral Hemorrhage
Cerebral hemorrhage is uncontrolled bleeding in the brain. It can occur from an injury or as a result of a leaky or burst blood vessel. This can happen when a blood vessel gets weakened enough that its wall can no longer withstand the pressure of the blood flowing through it.
Cerebrovascular Disease
Cerebrovascular disease refers to a group of conditions, diseases, and disorders that affect the blood vessels and blood supply to the brain. If a blockage, malformation, or hemorrhage prevents the brain cells from getting enough oxygen, brain damage can result.
Complex Regional Pain Syndrome (CRPS)
Chronic arm or leg pain developing after injury, surgery, stroke, or heart attack. The exact cause of complex regional pain syndrome isn't well understood but may involve abnormal inflammation or nerve dysfunction. Complex regional pain is characterized by pain that is greater than would be expected from the injury that causes it. Treatment usually consists of medications, heat or cold therapy, physical therapy, and biofeedback.
Chronic Headaches
Most people have headaches from time to time. But if you have a headache more days than not, you might have chronic daily headaches. Rather than a specific headache type, chronic daily headaches include a variety of headache subtypes. Chronic refers to how often the headaches occur and how long the condition lasts. The constant nature of chronic daily headaches makes them one of the most disabling headache conditions. Aggressive initial treatment and steady, long-term management might reduce pain and lead to fewer headaches.
Degenerative Disc Disease
Degenerative disc disease (DDD) is typically associated with aging. As you age, your discs, like other joints in the body, can degenerate (break down) and become problematic: That's a natural part of growing older as your body deals with years of strain, overuse, and maybe even misuse. However, DDD can occur in people as young as 20, so sadly, youth doesn't always protect you from this disc-related spinal condition. In fact, some patients may inherit a prematurely aging spine.
Degenerative disc disease involves the intervertebral discs. Those are the pillow-like cushions between your vertebrae in your spine. They help your back carry weight and allow complex motions of the spine while maintaining stability. As you age, the discs can lose flexibility, elasticity, and shock absorbing characteristics. They also become thinner as they dehydrate. When all that happens, the discs change from a supple state that allows fluid movement to a stiff and rigid state that restricts your movement and causes pain.
Discogenic Low Back Pain
The term discogenic pain means one or more intervertebral discs are the pain source. Gradual changes affect the spine's structures, notably the intervertebral discs. Early disc degeneration may not cause severe pain or other symptoms, but when the degeneration becomes advanced low back pain may occur. Typically, discogenic pain is associated with activities that increase the pressure within the intervertebral disc (called intradiscal pressure).
Failed Back Surgery Syndrome
Simply put, failed back surgery means you have persistent back or neck pain after spine surgery. In other words, your and your surgeon’s expected surgery outcome—that your spine pain would be minimized or eliminated—didn’t happen.
In addition to chronic back pain, other symptoms of failed back surgery include neurological symptoms (eg, numbness, weakness, tingling sensations), leg pain, and radicular pain (pain that spreads from one area of the body to another, such as from your neck down to your arm).
Herniated Disc
Herniated disc is a relatively common condition that can occur anywhere along the spine, but most often affects the lower back or neck region. Also known as a slipped disc or ruptured disc, a herniated disc develops when one of the cushion-like pads between the vertebrae moves out of position and presses on adjacent nerves.
Hydrocephalus
Hydrocephalus is a build-up of fluid in the cavities deep within the brain. The extra fluid puts pressure on the brain and can cause brain damage. It's most common in infants and older adults. Hydrocephalus is characterized by head enlargement in infants. Adults and older children experience headache, impaired vision, cognitive difficulties, loss of coordination, and incontinence.
Treatment is often a tube (shunt) inserted surgically into a ventricle to drain excess fluid.
Lumbar Radiculopathy
Lumbar radiculopathy refers to pain in the lower extremities in a dermatomal pattern (see image below). A dermatome is a specific area in the lower extremity that has nerves going to it from a specific lumbar nerve. This pain is caused by compression of the roots of the spinal nerves in the lumbar region of the spine. Diagnosing leg and lower back pain begins with a detailed patient history and examination
Lumbar Spinal Stenosis
Lumbar spinal stenosis is a common cause of low back, buttock and leg pain in adults 50 years and older. This condition is caused by nerve compression and symptoms may include tingling, numbness and weakness. Leg symptoms are sometimes described as sciatica or lumbar radiculopathy.
Meningiomas
A usually noncancerous tumor that arises from the membranes surrounding the brain and spinal cord.
It isn't clear what causes a meningioma. Radiation therapy, female hormones, and genetics may play a role. In most cases, the condition is noncancerous. Symptoms may include changes in vision, headaches, hearing loss, and seizures. A small, slow-growing meningioma that isn't causing signs or symptoms may not require treatment. When needed, treatment might involve surgery or radiation.
Neck Pain
What is neck pain (cervical pain)? The cervical spine is a marvelous and complex structure. It is capable of supporting a head weighing 15 or more pounds while moving in several directions. No other region of the spine has such freedom of movement. This combination however, complexity and mobility, make the neck susceptible to pain and injury.
Parkinson's Disease
Parkinson's disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination. Parkinson's symptoms usually begin gradually and get worse over time. As the disease progresses, people may have difficulty walking and talking
Sciatica and Sciatic Nerve Low Back and Leg Pain
Sciatica is pain that radiates from the lower back along the sciatica nerve. Sciatica is a type of lumbar radiculopathy; a condition described as pain and/or sensations (eg numbness, tingling) that travels downward into one or both legs. Pain is the hallmark sciatic symptom and classic sciatica radiates below the knee.
Typically, sciatica causes pain, numbness and/or tingling in one side of the lower back and the associated left or right leg. The sciatic nerve has several smaller nerves that branch off from the main nerve and enable movement and feeling (motor and sensory functions) in the thighs, knees, calves, ankles, feet, and toes.
Spina Bifida
Neural tube defects are disorders involving the incomplete development of the brain and/or spine prior to birth. One of the most common neural tube defects is spina bifida, which means split spine. This condition occurs when the bones around the spinal cord fail to close properly during the first month of pregnancy, which puts the baby’s spinal cord and nerves at risk. In mild cases, the disorder causes no symptoms or only minor physical disabilities. However, spina bifida often leads to severe, permanent disability.
Spinal Fracture
A spinal fracture is when you break a bone in your spine—that's the basic definition. Your spinal column is made up of vertebra stacked one on top of each other. (You'll learn more about this in the Anatomy of Spinal Fractures article.) The vertebrae—the bones in your spine—can break, just like other bones in your body. However, spinal fractures can be more severe than breaking other bones in your body because a spinal fracture can cause trauma to the spinal cord.
Spinal Tumor
A spinal tumor is an abnormal growth of tissue. The tumor’s cells may multiple slowly or very quickly. Tumors in the spine are either malignant (cancerous) or benign (non-cancerous). Furthermore, tumors can develop anywhere in the spine: cervical (neck), thoracic (mid back), lumbar (low back), and/or sacral (sacrum).
Spondylolisthesis
Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it. The term is pronounced spondy-low-lis-thesis and is derived from the Greek language: spondylo means vertebra and listhesis means to slip. There are several types or causes of spondylolisthesis; a few are listed below.
Spondylolisthesis usually develops in the spine's low back; your lumbar spine.
- Congenital spondylolisthesis means the disorder is present at birth.
- Isthmic spondylolisthesis occurs when a defect, such as a fracture occurs in a bony supporting vertebral structure at the back of the spine.
- Degenerative spondylolisthesis is more common and is often associated with degenerative disc disease, wherein the discs (eg, due to the effects of growing older) lose hydration and resilency.