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The spine is one of the most important parts of your body. Without it, you could not keep yourself upright or even stand up. It gives your body structure and support. It allows you to move about freely and to bend with flexibility.

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Dr. Glenn E. MacNichol

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A diagnostic nerve block is used to determine sources of pain. These blocks typically contain an anesthetic with a known duration of relief. A sympathetic nerve block is performed to determine if the pain has a sympathetic component. This is a network of nerves extending the length of the spine. These nerves control some of the involuntary functions of the body, such as opening and narrowing blood vessels.



A discography is a diagnostic test and in some cases the best way to make an accurate diagnosis of a disc problem. The physician inserts a needle into the intervertebral disc, and contrast, or a dye, is injected into the disc. During the contrast injection, the patient is asked to report if the additional pressure on the disc reproduces his or her pain. This lets the physician know which particular discs are painful.

Once the procedure is completed, the patient is taken to a diagnostic center for a CAT scan of the area, which will reveal any disc that is disrupted. A disrupted disc indicates there may be tears in the outer ring of the disc that was not seen on an MRI scan or other test.



The purpose of an epidural steroid injection is to try to provide a nerve block and to suppress the inflammation that is affecting the nerves that are carrying the painful nerve signal to the brain. For most spinal conditions, this is a very effective way to decrease pain.

An epidural steroid injection is a procedure performed under fluoroscopic guidance where the physician inserts a needle into the spinal canal and injects a cortisone-type medication and local anesthetic. The epidural space is a space inside the spinal canal between the bony canal of the vertebrae and the sac that contains the nerves, spinal cord, and spinal fluid. There are several different approaches to this space that the physician may use.

The relief period varies but injections typically last from three months to one year. Depending on the medical problem, the injection may completely stop the pain and it may never have to be repeated. If the pain returns, injections can be performed in a series of two or three injections 2-3 weeks apart.



Rupturing of the tissue that separates the vertebral bones of the spinal column. The center of the disc, which is called the nucleus, is soft, springy, and receives the shock of standing, walking, running, etc. The outer ring of the disc, which is called the annulus (Latin for ring), provides structure and strength to the disc. The annulus consists of a complex series of interwoven layers of fibrous tissue that hold the nucleus in place.

A herniated disc is often referred to as a slipped disc. This term came from the action of the nuclear tissue when it is forced from the center of the disc. The nuclear tissue located in the center of the disc can be placed under so much pressure that it can cause the annulus to rupture.

When the disc has herniated or ruptured, it may create pressure against one or more of the spinal nerves which can cause pain, weakness, or numbness in the neck and arm. Other names for herniated discs are prolapsed and ruptured discs.



This is a medication that is injected into the knee joint only for osteoarthritis of the knee. Hyaluronate is a protein substance that provides lubrication to the knee, and thus pain relief. It is extremely effective. Hyaluronate injection relief periods are variable – usually from about six months to upwards of two years.



Spinal stenosis is when pressure is put on the nerves traveling through the spine due to the narrowing of spaces in the spine. Symptoms may not occur or patients can experience pain, tingling, numbness, and muscle weakness. Spinal stenosis can be alleviated by non-surgical treatments. Surgery should be considered if non-surgical treatments did not relieve pain, the pain has lasted for a long period of time, the sensation has been lost in the arms or legs, bladder control is lost, and motor strength in the arms has decreased. The goal of this surgery is to create space for the spinal cord and the nerve roots. This helps decrease the pain from nerve inflammation. Spinal stenosis surgery should also help increase motor strength in the arms and legs.



Pain in the lower back area that can relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area.  Low back pain can start in a person’s early twenties and continue throughout adulthood. Studies have shown that up to 80% of the general population are affected by low back pain (LBP) at some time during their lives. Learn to prevent lower back pain by knowing what activities could be putting you at risk.

Low back pain symptoms range from sharp and stabbing to a dull ache. The pains can be constant or intermittent and positional. Acute low back pain can appear suddenly after an injury. Chronic back pain is defined as pain lasting more than three months. Consult a doctor if you have prolonged back pain longer than 72 hours. Severe back pain after an injury should be evaluated by a healthcare professional. Warning signs of more serious injury include pain with coughing or urinating, loss of control of the bowels or bladder, new leg weakness, and fever. These additional symptoms require medical evaluation. Back pain that occurs after excessive exercise or heavy lifting is frequently a strain injury. However, occasionally these activities cause disc injury and rupture or herniation. When a herniated disc irritates the sciatic nerve, it can cause back pain.

Low Back Pain


Brace therapy may be the treatment a patient needs in order to heal correctly. The brace will help stabilize and immobilize the spine in the area where surgery was performed. Usually, braces are categorized as being soft, flexible, rigid, and semi-rigid. Flexible braces are pre-made in different sizes, so the doctor may make simple adjustments for the proper fit.

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