When to Suspect that You Might Be Suffering from Spinal Cord Injury
A traumatic, acute spinal cord injury is associated with an incident that causes injury to the spine causing it to be fractured, dislocated, crushed, or compressed, such as in a car accident, gunshot, or knife wound.
Anyone who has experienced injury to the head or neck should be immediately assumed to have a spinal cord injury because:
No obvious signs and symptoms may always accompany a serious spinal cord injury. Once neglected, it may progress to a more serious injury.
Numbness or paralysis may immediately follow a spinal cord injury.
It’s critical to immediately treat a patient because it will determine the severity of complications and how a person may recover from the spinal cord injury.
Similarly, non-traumatic spinal cord injury may also occur, caused by a debilitating, spinal cord disease like arthritis, cancer, inflammatory disorders like ankylosing spondylolisthesis, infections, or slipped disc.
Spinal Cord Injury: When to Seek Help from Gramercy Pain Center
Not all spinal cord injuries are associated with any signs and symptoms. However, if apparent, signs and symptoms that are red flags that warrant emergency care include the following:
Severe pain or pressure at the neck, head, or back;
Weakness, loss of coordination, or paralysis in one or both halves of the body;
Tingling or numbing sensation or loss of sensation in the upper and lower extremities;
Uncontrollable urge to pee or pass stools;
Loss of balance and inability to walk;
Difficulty of breathing;
Dislocated neck or back.
Moreover, despite continuous recovery, spinal cord injury patients should still watch out for signs and symptoms of long-term complications associated with a spinal injury. You should immediately consider going to your doctor when you observe the following signs and symptoms:
Infections manifested as skin sores, fever, cough, or others;
Difficulty breathing;
Severe headache that may be signs of brain injury;
Difficulty urinating and passing stools;
Muscle pain, cramps, or spasms;
Pain that’s increasing in severity.
Diagnosis of Spinal Cord Injury
At the emergency room, assessments of a patient who has experienced a car accident, gunshot, or knife wound may be assessed for their neurological functions and rated based on their level of eye opening response, verbal response, and motor response per the Glasgow Coma Scale.
If the patient with injury experiences neck pain, unconscious or can’t be conversed with properly, or manifest other signs of neurological injury like weakness, diagnostic tests such as the following may be warranted to determine the extent of spinal cord injury:
Blood tests
X-ray
CT scan
MRI
How We Can Help Manage Your Spinal Cord Injury at Gramercy Pain Center
At Gramercy Pain Center, our medical group of spinal cord injury specialists headed by Ajay Varma, MD, DABA, DABAPM is here to help you with an effective spinal cord injury rehabilitation.
We offer the best spinal cord treatment procedures guaranteed to bring you back into good shape after your spinal injury. We offer good rehabilitation programs and may prescribe you with medications that may help you manage the signs and symptoms of spinal cord injury.
1) Rehabilitation
Our rehabilitation doctor guides the physical therapy sessions with a team that may compose of a physical therapist, occupational therapist, and other experts in the field of spinal cord injury rehabilitation.
This team of experts will guide you towards a life where you can return to your normal activities if possible.
By regaining the strength of your muscles to facilitate fine motor skills;
Empowering and educating you regarding your condition; and
Helping you gain new skills in order for you to return to your normal activities.
2) Medications
Medications that may help manage the complications associated with spinal cord injury may be prescribed. These medications include those that can control pain and muscle spasticity, against incontinence, and return to good sexual health and functioning.
FAQs About Spinal Cord Injury and Management
Q: Aside from accidents and underlying diseases, who are at risk of getting spinal cord injury?
A: Spinal cord injury is also associated with other risk factors aside from accidents and underlying diseases. These include the following:
Being male - Traumatic spinal cord injuries occur more with men than in women, because they’re more likely than women to engage in risky behaviors like dangerous driving, male rage, and reckless decisions.
Age - An increase in injury in the spinal column occurs between the ages of 16 and 30 (may be due to risky behaviors associated with this age group) and the elderly aged 65 years or older (may be due to this age group being more susceptible to diseases and falls)
Alcohol misuse - Alcohol misuse is often associated with reckless behavior and thus is implicated in 25% of traumatic spinal cord injuries.
Q: What’s the prognosis for spinal cord injury patients?
A: Spinal cord injury recovery is facilitated by long-term care by a team of healthcare professionals.
Physical therapy is an important aspect of recovery to prevent worsening of symptoms like progressing into muscle wasting and permanent immobility. Occupational therapy is also helpful for you to regain new skills that may help you cope with your physical limitations.
Continuous monitoring through assessments and medical evaluations should be carried out to observe if you’re progressing towards the better with your spinal cord injury treatment program.
Psychiatrists and psychologists may also be on board to help you with your condition as anxiety or depression may also accompany your spinal cord injury. Psychiatrists may prescribe antidepressants complemented with talk therapy from psychologists.
Q: What are the new technologies available to help a patient with spinal cord injury be more independent and mobile?
A: Spinal cord research offers hope for patients with spinal cord injury as experts find ways to help these patients be more independent and mobile. Patients may use the following devices to help them maintain an active lifestyle despite their physical limitations:
Modern wheelchairs - Modern wheelchairs include smart wheelchairs, which can adapt with the behavior and environment of its users through sensors and cameras connected to the device. It can also help the patient’s therapist gain an insight as to how the patient drives the device, which is also important in clinical decision-making.
Computer adaptations - Key guards and voice recognition in computers can help patients with limited mobility be able to use the computer.
Electronic aids to daily living - Voice-controlled devices like in light switches may help a spinal cord injury patient be more independent in doing their daily activities.
Electrical stimulation devices - Functional electrical stimulation (FES) involves the delivery of small electrical impulses to stimulate parts of the body for regained function, such as enabling the patient to stand and walk. It also helps block pain signals and help the patient regain better control in urination and passing stools.
Experience the Best Spinal Cord Injury Care at Gramercy Pain Center
Despite spinal cord injuries currently being incurable, you don’t have to live a life within the shackles of your injury. At Gramercy Pain Center, our spinal cord specialty program that includes spinal cord injury stimulation is guaranteed to help our patient live with utmost comfort especially after a spinal cord injury. Start your journey towards healing and getting your life back by getting the best spinal cord injury treatment program that suits your needs. Contact us today or visit one of our branches to learn more about our services.
Herniated Discs: When to Seek Help from Gramercy Pain Center
Home remedies may be initially done to alleviate the symptom of herniated discs. These include the following:
Rest for at most 3 days to relieve the pain but don’t prolong the period of rest to avoid experiencing stiffness.
Take over-the-counter pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.
Apply heat packs or cold compresses to the area that needs addressing.
However, if the herniated disc pain becomes so unbearable and you can no longer do your usual activities, you must not hesitate to contact our herniated discs doctor immediately. Other reasons related to suspected herniated discs that warrant visiting our spine specialist include the following:
If the herniated disc symptoms don’t go away even after 4 to 6 weeks, making the pain a chronic one;
Symptoms become so severe that they’re already debilitating;
You can no longer control how you urinate or pass stools;
There are noticeable weakness, tingling, or numbness of your arms, hands, legs, or feet;
You can no longer stand or walk.
When to Suspect that You Might Be Suffering from Herniated Discs
A herniated disc or “slipped disc” occurs when a part or whole of the nucleus pulposus, the inner part of the intervertebral disc that serves as a cushion in between the vertebrae to prevent friction, bulges out of the annulus fibrosus, the outer part of the intervertebral disc.
This disorder occurs in 5 to 20 in 1000 adults within the 3rd or 5th decade of life, with the most common being the lumbar disc herniation. Most cases of the slipped disc don’t have symptoms and aren’t found out until an MRI is done.
However, in cases that it presents with symptoms, you may suspect that you might be suffering from disc herniation if you have back pain that doesn’t go away and one part of the body that’s affected by the slipped disc compressing a spinal nerve manifests with symptoms like arm or leg pain, and weakness, numbness, or tingling of the arms or legs.
How We Can Help Manage Your Herniated Discs at Gramercy Pain Center
At Gramercy Pain Center, we first evaluate the source of your pain before we suggest a suitable treatment plan for its underlying cause. We may do a comprehensive history taking and careful neurological examination (e.g., straight leg raise test and contralateral straight leg raise test) to localize where the nerve compression is.
Aside from that, we may also order further tests especially if non-surgical treatments don’t work or the neurological examination has abnormal results. These tests include:
X-rays
CT Scan
MRI
Myelogram
Nerve conduction study
Electromyography (EMG)
Nonsurgical Treatment
At Gramercy Pain Center, we may prescribe neuropathic drugs like gabapentin and pregabalin or muscle relaxers to help ease the back pain due to a bulging disc.
If this doesn’t work, we may also advise giving you an epidural or nerve block, which are cortisone injections around the area of the spinal nerves and spinal cord affected, guided with spinal imaging to help accurately direct the needle.
We may also offer radiofrequency ablative techniques as well, where radiofrequency energy is delivered to the spinal nerves and prevent them from sending pain signals to the brain.
We may also suggest physical therapy and home exercises guided by our pain management specialist Ajay Varma, MD, DABA, DABAPM, to help you gain more flexibility and strength in your back. The sessions will also teach you how to properly position yourself to minimize the pain caused by slipped discs.
Surgical Treatment
Gramercy Pain Center only offers minimally invasive herniated disc treatment and physical therapy to help manage the symptoms of your pain conferred by a slipped disc. However, we may also suggest herniated disc surgery from a trusted orthopedic spine surgeon if your symptoms don’t improve after 6 weeks of the treatment plan. These include spinal decompression surgeries like the following:
Diskectomy where the damaged disc is removed;
Laminectomy that aims to expand the spinal canal by removing a part of the spinal vertebra surrounding the herniated disc;
Artificial disk surgery where an artificial disc replaces the damaged disc; and
Spinal fusion that aims to stabilize the spine by fusing 2 vertebrae together.
FAQs About Herniated Discs and Management
Q: What’s the prognosis for herniated disc patients?
A: A herniated disc injury goes away on its own 90% of time, 6 weeks after the injury. Some individuals may need more aggressive measures and may need surgery, which can make healing faster and with a comparable result with more conservative methods of management.
Q: Will my herniated disc get worse?
A: A herniated disc gets worse if it remains untreated, especially when you endure the pain and continue doing the things that exacerbate the condition. Although rare, herniated discs may progress into a ruptured disc, leading to more chronic pain or complete loss of nerve function due to severe nerve root compression. Rare complications in a herniated disc surgery have also been mentioned in some studies, such as paralysis and death.
Q: Are there lifestyle changes that I should follow in association with herniated discs?
A: To prevent herniated discs from occurring or from worsening, lifestyle changes may be followed to reduce the risk of its development. Recommendable lifestyle modifications to follow include:
Lifting heavy objects properly, in that the abdominal and leg muscles are the ones used to support the load and not the back. Bending the waist should also be avoided and the knees should be the ones bent as well.
Keeping your weight within a normal, healthy range, to reduce any excessive stress to be exerted in the back.
Avoiding slouching, because good posture reduces extra stress exerted on the back.
Stretching, especially when you’re sitting for a prolonged period of time. This helps maintain your flexibility and strengthen your back muscles that can help support your spine.
Avoiding wearing heels as this may misalign your spine.
Exercising regularly to strengthen your back and stomach muscles for adequate spinal support.
Quitting smoking since tobacco products may contribute to the weakening of the discs.
Q: Are there complementary and alternative medicine procedures that I can try for my herniated disc?
A: With the guidance from your doctor, you may consider alternative and complementary treatments to help relieve the chronic back pain associated with herniated discs. These include chiropractic procedures, acupuncture, and massage.
Get the Best Symptomatic Relief from the Care of Experts in Gramercy Pain Center
You don’t have to endure the back pain associated with herniated discs forever. At Gramercy Pain Center, we’re here to help you go back to your normal activities through our expert pain management plan that includes physical therapy and minimally-invasive treatments, guided by our pain specialist Ajay Varma, MD, DABA, DABAPM. Contact us today and visit our pain clinic near you to achieve a pain-free life again.
Upper Back Pain: When to Seek Help from Gramercy Pain Center
Management of upper back pain and even lower back pain may be done through home remedies that can help ease the pain within a span of a few weeks of self-help.
Medications that may be used to offer pain relief include over-the-counter pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium (Aleve) and topical pain relievers that may come in creams or patches.
However, a pain management doctor must already be contacted if the home treatment didn't work and persists longer than expected, making it a chronic back pain
Other warning signs you should watch out for that warrant you visiting an upper back pain specialist include:
Pain that's so severe that it can't be relieved by rest or over-the-counter medications
Pain that extends down the lower extremities, especially when it's below the knee
Weakness, numbness, or tingling sensation may be felt in one or both leg
You unintentionally and suddenly lost weight in addition to your spine pain
Emergency care must also be sought if the following are experienced:
Sudden difficulty in urinating and passing stools
Severe pain that awakens you at night
Fever accompanying the pain
The back pain is felt after experiencing injuries to your back like falling or slipping
Back Pain: What Your Body Might Be Telling You
Back pain can be characterized by a wide variety of symptoms, from muscle pain to feeling as if your back is burning or something’s stabbing you at the back. The pain may also be traveling or radiating from your back to your legs. It may also be exacerbated even by simple movements like bending, standing, or walking.
Back pain may be a symptom of another medical condition like a simple ligament or muscle strain from overwork or more serious conditions like bulging or ruptured discs, arthritis, and osteoporosis.
1) Ligament or Muscle Strain
Strain or sprain of the back may occur due to a sudden wrong lift or overexertion of muscles of the back that cause them to get injured and torn. Long-term stress in the back caused by repetitive back movements may also lead to the wear and tear of back muscles, ligaments, and tendons. Playing sports like weightlifting and football are also common reasons why a patient experiences ligament or muscle strain.
2) Bulging or Ruptured Discs
Disks in between the vertebrae serve as cushions in the spinal canal that prevent friction in between movement of the spine. However, in association with aging, disks may get less flexible and slip out of position (“slipped disc”). This dislocation of the disk may result in a pinched nerve, thus causing the characteristic nerve pain associated with this disorder. Sometimes, though, this doesn’t cause back pain and just accidentally becomes discovered upon spinal x-ray.
3) Arthritis
Osteoarthritis, the most common form of arthritis, typically manifests as lower back pain due to it affecting this part of the body. It’s a degenerative condition in which joint pain is experienced because the joints or the protective cushion in between the bones of the body wears down over time. This causes the ends of the bones to get damaged due to the uncontrolled friction between them.
4) Osteoporosis
Osteoporosis is the weakening of the bones causing them to be more vulnerable to fractures. It occurs when the bone renewal can’t keep up with the bone lost through time. Aside from back pain that’s due to damage to the vertebrae, other signs and symptoms of this disorder include a reduction in height and a stooped posture.
Types of Back Pain
Because back pain is a broad topic that may be caused by a wide range of etiologies, medical conditions that may cause back pain are categorized into 5 primary categories, namely:
Mechanical
- Spinal injuries - Injuries to structures at the back like intervertebral discs or soft tissues - Fractures - Lumbago - Disk herniation (“slipped disk”) - Pregnancy
- Cancers of the marrow - Compression of the nerve due to malignancies compressing the nerve - Lytic lesions that damage the spine
Infectious
- Infections of the structures at the back like spine and discs - Abscesses (epidural, muscular, or soft tissue)
Taking the patient’s history enables a physician to narrow down the possible causes of the back pain of the patient, with the physician determining how intense the pain is or how it feels. Knowing how it’s provoked or relieved may also give clues as to its etiology.
Similarly, physical examination that’s done through inspecting and palpating the affected part and doing relevant tests like provocative maneuvers and neurologic examinations such as deep tendon reflexes also help determine what might be the cause of back pain.
How Back Pain is Diagnosed
Aside from history taking and physical examination, the physician may order other tests to pinpoint the exact cause of the back pain you’re suffering from, especially when it accompanies the common red flags of serious diseases like unexplained weight loss (malignancy), fever (infection), and contusions (fracture).
Tests that a physician may request include the following:
X-ray
MRI or CT scans
Blood tests
Bone scan
Electrophysiological tests like electromyography (EMG)
How We Can Help Solve Your Back Pain at Gramercy Pain Center
Management of the back pain depends on its etiology. Depending on the cause of your back pain, we may be offering you any of the following pain treatment option:
Cortisone injections
Radiofrequency neurotomy
Implanted nerve stimulators
Spine surgery
We may also be suggesting you to go through physical therapy sessions where a physical therapist will teach you exercises for better flexibility, strengthening the back and abdominal muscles, and improving poor posture. These can help avoid exacerbating the pain while maintaining an active lifestyle.
FAQs About Back Pain and Management
Q: Who gets back pain?
A: Anyone can get back pain, but several factors may increase the risk and vulnerability of an individual to getting back pain. These risk factors include the following:
Heredity - Genetics may also predispose a person to develop diseases that can manifest as back pain.
Fitness level of an individual - Individuals with sedentary lifestyles are prone to back pain because their unused muscles of the back and stomach are unable to properly hold the weight of the spine.
Age - Back pain becomes more common as a person ages, typically starting at around age 30 to 40.
Weight gain - Poor dietary habits like eating foods with high calories and fat leads to weight gain and obesity, which can put an additional weight and stress at the back.
Job-related - Weightlifters or anyone who works in a job that requires them to lift heavy objects or push or pull them can lead to back injuries especially if they do it improperly. Desk jobs may also contribute to back pain, especially if a person sits all day with a poor posture.
Psychological conditions - Patients with anxiety and depression are more prone to back pain.
Smoking - Coughing brought by smoking may lead to herniated disks. Blood flow is also impaired due to smoking, making an individual more vulnerable to osteoporosis.
Q: What’s the prognosis for back pain patients?
A: Prognosis of back pain patients heavily relies on the underlying cause of the back pain. For example, pain caused by cancer has a different prognosis than pain caused by muscle strain. Children and adults also have varying prognosis.
Q: What are the possible complications?
A: Complications of back pain also heavily relies on the underlying cause of the back pain. These may be measured physically and socially. Physically, complications may be chronic pain, deformity, and problems in urinating and passing stools. Social impact, on the other hand, is measured on the degree of the severity of disability, decreased income, and increased absenteeism.
Q: Are there any alternative options for upper back pain treatment?
A: Complementary and alternative medicine offers the potential therapeutic benefit of improving the symptoms of back pain. These alternative treatment options include chiropractic care, acupuncture, transcutaneous electrical nerve stimulation (TENS), massage, and yoga.
Q: How can I prevent back pain from occurring again?
A: Lifestyle changes can help prevent back pain from occurring again. These include the following:
exercising regularly to strengthen the back and abdominal muscles and to reduce excess weight;
eating a balanced diet rich in calcium and vitamin D which are known to help in bone health; observing a good posture while sitting and standing; and
lifting with the legs and abdominal muscles when lifting can’t be avoided.
Ease Your Back Pain Away at Gramercy Pain Center
Back pain may be your body’s way of telling you of a medical condition that you might need to address as soon as possible. At Gramercy Pain Center, our team of professionals including a pain doctor and spine specialist is here to help you know the underlying cause and treatment options for your back pain. Contact us today and visit our pain clinic to solve your back problems in no time.