Spine Center of Excellence

Our Fellowship-Trained Spine and Physical Medicine & Rehabilitation Specialists

Paul D. Fuchs, DO:  Surgical Treatment of Spinal Disorders
Allen C. Tafel, MD:  Non-Surgical Treatment of Spinal Disorders

Your Spine

Pain in your neck or back from injury or a disorder can make getting through simple tasks like walking or driving a car a challenge, and may even keep you from working. 

Your spine is the main structure for your body, providing support and flexibility that allows you to move, turn, sit, stand, twist, stretch and bend over. It extends from the base of your skull to the tip of your tailbone and is a complicated series of bones, discs, muscles, nerves and ligaments divided into three main areas: cervical, thoracic and lumbar.

The cervical spine is the neck region and contains the first seven spinal bones, or vertebrae. The vertebrae in the cervical spine protect nerves and the spinal cord, support your skull, and give you the ability to move your head. 

The thoracic area is at the same level as your chest and has 12 vertebrae which connect to the ribs, helping protect vital organs.

The lumbar is the lower part of the spine with five vertebrae, the largest and strongest in the spine because they carry the majority of your body's weight. The nerves located in the lumbar area of the spine make it possible for your legs and feet to feel and move. 

Because the spine is a complex arrangement of bones, muscles, ligaments and nerves, successfully diagnosing and treating neck, back and spine conditions requires specialized knowledge and training.

If you are currently living with a neck, back or spine condition, talk with your primary care physician or call for an appointment to our Spine Center of Excellence.

Back Pain May Keep Active Teens from Standing Tall

Back pain in children and adolescents often results from continuous changes as they grow. This is usually very different from back pain in adults.

Back pain in children over age 10 is commonly caused by mechanical or developmental problems. Developing muscles are often weak and provide poor support as a result. It is not uncommon for teenagers to experience low back pain as the result of tight hamstrings and weak abdominal muscles.

Teens, like anyone active in sports, can also experience lower back pain because of a simple sprain or strain.

Treating with rest, heat, rehabilitation and pain medication typically returns injured teens to their game.

However, persistent back pain may be the sign of a more serious condition.

Spondylolysis is a stress fracture in a vertebra, or bone, of the lower spine. This condition is more common in teen athletes, especially those participating in sports requiring repeated hyperextension of the lower back - like football, wrestling and gymnastics. If the fracture continues to develop, it may cause the vertebra to weaken to the point of slipping out of place. This condition is called spondylolisthesis.

In many cases, a teenager could have spondylolysis or spondylolisthesis but with no apparent symptoms. More commonly, though, pain that feels like a muscle strain is felt across the lower back. Spondylolisthesis can cause spasms that may stiffen the back and cause the hamstring muscles to tighten.

Treating spondylolysis usually involves having the teen take a break from his or her sports activity. Rest is usually combined with pain medication, and may also require a back brace or physical therapy.

Most of the time, the teen can return to sports gradually with little complications or recurrences of pain.

If your teen is experiencing persistent back pain, we encourage you to have it checked out. Our full medical and surgical services ensure complete care, from diagnosis to treatment and rehabilitation, and thorough follow-up after treatment.

Common causes of back pain

Nearly 90 percent of all people will experience back pain at one time or another, according to the American Academy of Orthopaedic Surgeons.

The good news is that for most people, back pain usually resolves within a few weeks. Despite this silver lining, back pain is often one of the most difficult conditions to diagnose and treat. The spine serves as the support structure for our bodies, and is made up of a complicated series of bones, discs, muscles, nerves and ligaments.

The most common causes of back pain include:

Arthritis: This disease can affect any joint in the body, including the small joints in the spine. Anklyosing spondylitis and cervical arthritis are two types of arthritis that affect the spine. Anklyosing spondylitis is a chronic inflammatory arthritis in the spine and cervical arthritis affects the upper spine, causing pain in the neck and shoulders.

Discogenic Back Pain: Also known as disc degeneration, this is a common reason for low back and neck pain. Discogenic back pain is caused by "wear and tear" damage to a disc in the spine. The wear and tear is typically the result of normal aging. This does not mean, though, that a person with disc degeneration will forever have to deal with pain. Despite being a degenerative disease, discogenic back pain may improve over time with simple treatment options.

Herniated Disc: Discs are located between the bones, or vertebrae, of the spine and act as pads that protect the vertebrae and allow the spine to move and bend. The outer portion of a disc is made up of thick cartilage and the inner portion is comprised of a gel-like substance. When a disc is herniated, or ruptured, the gel-like substance is pushed out of the inner portion of the disc and puts pressure on the surrounding spinal nerves. When this happens in the lumbar, or lower, spine pain, numbness, tingling or weakness in the legs is usually the result. This is also called sciatica. When a disc in the cervical, or neck area, of the spine ruptures the result is pain, weakness or numbness in the neck, shoulders and arms.

Muscle Sprain or Strain: As with any other muscle, the muscles in the back can be sprained or strained during activity. A sprain means you've stretched or torn a ligament, which is a band of tissue connecting bones together. A strain occurs when you pull or tear a muscle or tendon, a thick cord of tissue that attaches muscle to bone.

Osteoporosis: Our bones are hard, providing structure for our muscles and protecting our organs. Despite their apparent rigidity, bones are living tissue in a constant state of change. Our body continually removes old bone while new bone is produced to replace it. Until about age 30, our body removes old bone and replaces it with new bone at a nearly equal rate. After 30, and especially in women following menopause, the rate of absorbing old bone begins to occur more rapidly than the rate of new bone being produced. Over time, the result is weakened bones, or osteoporosis, and an increase risk of fractures, including in the vertebrae.

Spinal Stenosis: The spinal canal is the protecting home of the spinal cord and nerves. Spinal stenosis occurs when the canal begins to narrow and pinch the nerves in the spine, which causes pain and loss of muscle control in the lower back and legs. Aging, arthritis or heredity can all be causes of spinal stenosis.

Spondylosis and Spondylolisthesis: Spondylolysis is a stress fracture in a vertebra, or bone, of the lower spine. Spondylolysis is more common in teen athletes, especially those participating in sports requiring repeated hyperextension of the lower back - like football, wrestling and gymnastics. If the fracture continues to develop, it may cause the vertebra to weaken to the point of slipping out of place. This condition is called spondylolisthesis.

Easing Lower Back Pain

Chronic low back pain can get in the way of simple, everyday tasks. Driving, bending to get a load of laundry out of the dryer or reaching for a plate on the top shelf of a kitchen cabinet can be unbearable. Persistent low back pain can also interfere with therapy and rehabilitation exercises intended to treat the pain.

Epidural steroid injections are a non-surgical solution for managing pain in the lumbar spine, or lower back, and returning people to the activities of everyday living. Pain in the lower back is often caused when the nerve roots are irritated or inflamed. Other common causes of lower back pain include a herniated lumbar disc or a degenerative disease such as lumbar spinal stenosis.

To treat lower back pain with spinal injections a steroid, often cortisone, is injected into the epidural area in the spine. The cortisone coats the nerve roots, sacroiliac joint or facet joints of the spine near the injection area, relieving pain and inflammation.

Injections may also be used to help determine the direct source of pain in the lower back. Once the source is located, our physicians are better able to diagnose the pain and determine the best treatment program for your specific needs.

Because the spine is a complex arrangement of bones, muscles, ligaments and nerves, when diagnosing and treating back pain there is no single treatment that works for all patients. Your Orthopedic Specialists spine specialist will work with you to determine the best course of treatment for your condition.

Cervical Disc Replacement for the Spine

The cervical spine makes up the neck region of your backbone and contains the first seven spinal bones, or vertebrae. The vertebrae in the cervical spine protect nerves and the spinal cord, support your skull, and give you the ability to move your head.

Your vertebrae are cushioned by discs that act as pads, protecting your vertebrae and allowing your spine to move and bend. The outer portion of a disc is made up of thick cartilage and the inner portion is comprised of a watery gel-like substance.

When discs in your cervical spine degenerate, the padding wears down and the vertebrae move closer together triggering pain in the neck and shoulders. This is similar to cartilage wearing down in an arthritic knee joint causing painful bone-on-bone rubbing.

"Wear and tear" degeneration of the discs in the spine is a normal part of aging. But degenerative disc disease, injury or a herniated disc can also cause deterioration.

Cervical disc replacement may help you if you are suffering from disk disease, injury or a herniated disc. Talk to us about your disk condition to learn more about the treatment options available to you.