You are in good hands at New York City Spine Surgery, PLLC, regardless of your back problem or spine-related disorder. Drs. Frazier and Carrer have the education, training and experience to treat everything from chronic back pain to vertebral compression fractures.
Certain types of spinal curves are normal and necessary to absorb and distribute body weight at rest and during movement. Scoliosis is an abnormal side-to-side curvature of the spine. Although scoliosis is usually associated with children and adolescents, adults can have scoliosis, too. Adult scoliosis is defined as abnormal curvature of the spine in a patient older than age 18.
If childhood scoliosis was never discovered or was left untreated, the abnormal curve may become larger as the patient ages and degenerative spinal changes occur. Scoliosis that develops during adulthood, without a history of childhood curvature, is usually classified as adult degenerative scoliosis. Adult degenerative scoliosis usually affects the thoracic (mid-back) and/or lumbar (low back) spine. Common degenerative spinal conditions that may contribute to the development of adult degenerative scoliosis include:
Back pain affects eight out of ten people at some point during their lives and is one of the most common health problems besides headache. Symptoms may be sharp pain, pain that makes movement difficult and stiffness. Initially, pain may be so severe that you fear something has broken.
Back sprain or strain is a common cause of spine pain. This means you may have overworked or over-stretched (hyperflexion, hyperextension) a spinal muscle, tendon or ligament. While most cases of back pain resolve without medical treatment, some symptoms suggest seeking a doctor’s help.
Spinal stenosis occurs in the cervical and/or lumbar spine when the spinal canal and/or nerve passageways (called neuroforamen or foramen) become narrow. It is a common cause of neck and low back pain. If the spinal canal is narrowed, the disorder is also called central stenosis. If the foramen is affected, it is referred to as foraminal stenosis. When either condition develops, the spinal cord and/or spinal nerves are compressed. Sometimes patients have both central canal and foraminal stenosis.
Cervical or lumbar spinal stenosis is a compression problem. When the spinal cord and/or nerve roots become compressed, symptoms develop. While some patients are born with spinal stenosis (congenital), most cases develop in people older than age 50. Degenerative spinal stenosis, as it may be called, results from normal aging and spinal wear and tear during life. Injury or trauma can contribute to the development of stenosis symptoms. For example, neck trauma that occurred months or years before may lead to cervical spinal stenosis. Here are the symptoms of spinal stenosis:
Most episodes of mild neck pain can be attributed to muscle strain or postural imbalance and resolve within several weeks. In contrast, cervical radiculopathy can be chronic and sometimes recalcitrant to treatment.
Cervical radiculopathy, or “pinched nerve,” refers to irritation or inflammation of one of the cervical nerve roots. Although the problem originates in the nerve root, the pain radiates away from the source, causing painful symptoms in the shoulder, arm or hand. In addition, neck pain and headaches in the back of the head are common with this condition. The number of nerve roots affected can vary, and symptoms may present on one or both sides of the body. Spine disorders that contribute to the development of cervical radiculopathy include:
Depending upon the extent of nerve irritation or injury, symptoms may vary. The most common symptom is pain that starts in the neck and travels down to the arm(s). Other symptoms include:
Degenerative disc disease describes age-related spine changes. Spinal disorders associated with degenerative disc disease (DDD) include disc problems (bulging, narrowing, herniation), spinal osteoarthritis (spondylosis), bone spur (osteophyte) formation and spinal stenosis.
A degenerating disc may cause mechanical (movement) or structural pain. This type of pain is usually felt in the low back. Pain may feel like it originates from the buttocks or upper thighs. This is called pain radiation. In other words, the pain spreads from one body part to another. As the disc begins to degenerate, the disc itself becomes painful. Movements that place stress on the disc can cause back pain that appears to come from the disc. This is similar to any other injured body part, such as a broken bone. These types of injuries do not cause pain unless you move.
Bulging discs are common in young adults and older people, with or without back pain. Sometimes a bulging disc develops in conjunction with aging and disc degeneration. While the term “bulging” may sound ominous, a bulging disc only becomes serious if it causes narrowing of the spinal canal.
The neck and low back (cervical and lumbar spine) are the most common levels where disc herniation occurs. The neck holds the weight of the skull while being very mobile. The low back supports much of the body’s weight and absorbs and distributes stress. While mid-back (thoracic spine) herniation is less common, it can be quite serious because there is little space surrounding the spinal cord at the thoracic levels (T1-T12). Spinal cord compression here can lead to paralysis.
Rarely does disc herniation occur in children. A true herniated disc is most common in young and middle-aged adults – usually occurring in the low back. Thoracic herniations usually affect people between ages 40 and 60.
A disc may suddenly rupture if too much pressure is applied at one time. Falling from a ladder into a seated position exerts tremendous force on the lumbar spine. Bending forward, especially when lifting something heavy, may create forces that cause disc rupture. Even small forces or repeated injuries add up over time and contribute to disc herniation. Symptoms include:
In layman’s terms, adult kyphosis is referred to as a dowager’s hump. Kyphosis is an abnormal forward curve in the thoracic spine (upper back). Degenerative disease, vertebral compression fractures or trauma can cause spinal misalignment, leading to the development of kyphosis. In some cases, mild kyphosis causes few problems; however, kyphosis may sometimes indicate multiple vertebral compression fractures. In severe cases, a kyphotic deformity can reduce the space in the chest cavity, making it difficult to breathe, eat or sleep normally. Conditions that may contribute to the development of kyphosis include:
Kyphosis symptoms may include:
Neck sprains and strains are common. Although the symptoms are similar, sprains and strains are distinctly different soft-tissue disorders.
Sprain: injury to a ligament caused by overuse or trauma
Strain: injury to a tendon or muscle caused by overuse or trauma
Whiplash is a soft-tissue injury that occurs following sudden extension and flexion of the neck. The exaggerated back-and-forth head movement frequently associated with an automobile accident can injure vertebrae, surrounding muscles, ligaments and nerve roots. The onset of symptoms may be immediate or appear several days later. Whiplash is considered a neck sprain. Most patients with whiplash recover within three months after the injury, although in some cases, neck pain and headache persists.
Muscle pain that develops from cradling the phone between the ear and shoulder is an example of a neck strain. Both sprains and strains can cause severe pain and are sometimes temporarily disabling. Typical symptoms include:
Sciatica is a catchall term for symptoms brought on by compression of the sciatic nerve. Spine disorders such as herniated disc or spinal stenosis are what cause compression of the nerve. Understanding this is important, because management of the condition may involve surgical correction of the underlying disorder as well as nonsurgical treatment to alleviate symptoms.
The sciatic nerve is the largest nerve in the human body. It starts in the lower back and travels downward behind the hip, through the buttocks and along the back of each leg. When the sciatic nerve is irritated or compressed, numbness, burning and/or tingling sensations travel along the nerve pathways, causing considerable discomfort and sometimes affecting movement. Approximately 40 percent of adults experience this painful condition during their lifetime. Typically, sciatica affects only one side of the body.
Depending upon the underlying disorder and degree of nerve compression, symptoms can range from mild to severe. Certain activities may make the pain worse, or the pain may only become noticeable after sitting or standing for long periods of time. Symptoms include:
*Loss of bowel and/or bladder control may be a symptom of cauda equina syndrome, a serious medical condition. If control is lost, seek medical care immediately.
Certain spine disorders or medical conditions can put pressure on the sciatic nerve and/or pinch the nerve roots, including:
In some cases we find no cause for sciatica, although there is evidence to suggest that a sedentary lifestyle, long-term tobacco use or alcohol abuse may contribute to its development.
A spinal tumor can develop within the spine or travel (metastasize) to the spine from another area in the body. Like other tumors, the growth can be cancerous (malignant) or noncancerous (benign). The concern with a tumor in the spine is that it has the potential to put pressure on nerves or destroy bone, leading to pain, spinal misalignment and sometimes paralysis.
Tumors that originate in the spine are relatively uncommon; however, individuals with a history of breast, lung, prostate cancer or multiple myeloma should be especially vigilant to new or unusual back pain, as this may indicate the cancer has metastasized. Cancerous tumors tend to grow more quickly than noncancerous tumors.
The hallmark symptom of a tumor in the spine is back pain. Most cases of back pain are not caused by a spinal tumor; rather, episodes of back pain are usually brought on by aging, strain or other noncancerous spine disorders. Symptoms of a spinal tumor vary, depending on the location and type of growth. Symptoms may include:
Spinal Tumor Types
Tumors are classified by where they originate in the spine or by cell type (eg, hemangioma, osteoblastoma)
Extradural tumor – most common type of spinal tumor; affects the bones and cartilage of the vertebrae. Most often develops as a result of cancer that originates elsewhere in the body.
Intradural extramedullary tumor – occurs outside the spinal cord but within its protective covering (arachnoid membrane), e.g. meningioma
Intramedullary tumor – develops within the spinal cord; can be cancerous or noncancerous. Often seen in children and young adults.
The word spondylolisthesis comes from the Greek “spondylos,” meaning “vertebra” and “olisthesis,” meaning “dislocation.” With this condition, one of the vertebrae in the spinal column slips out of alignment and is displaced forward onto the vertebra below. If the vertebra is displaced too far forward, it can narrow the space in the spinal canal as well as put pressure on adjacent nerves. The low back (lumbar spine) is most commonly affected. There are several different types of spondylolisthesis. The three most common types are:
Degenerative spondylolisthesis — Generally occurs after age 40 and most commonly seen in female patients over age 60. This type is caused by degenerative changes to the vertebrae/discs. Over time, the discs lose their cushioning effect and become less resistant to movement by adjacent vertebrae. Displaced vertebrae can narrow the space in the spinal canal, leading to spinal stenosis.
Isthmic spondylolisthesis — Most often caused by a stress fracture (crack) to a vertebra. A fracture of the pars interarticularis (small bone that connects the facet joints) can cause the vertebra to disconnect from the facet joints (the hinge-like joints that link the vertebrae together). Sports that involve repetitive stress to the lumbar vertebrae and/or hyperextension of the spine increase the risk for stress fractures and vertebral slip. Weightlifters, football players and gymnasts may suffer from this disorder because of considerable spinal stress. In addition, some individuals are born with slight malformations in the spine, predisposing them to stress fractures.
Congenital spondylolisthesis — This type is present from birth and is caused by abnormal bone formation in the spine. The spinal misalignment puts the vertebrae at greater risk for slipping out of place.
Other, less common types of spondylolisthesis include:
Pathological spondylolisthesis – This condition is brought on by disease (e.g. osteoporosis), infection or abnormal growths (e.g. tumors) that cause bone weakness.
Postsurgical spondylolisthesis – Vertebrae can become displaced as a result of surgery.
Traumatic spondylolisthesis – Direct injury to the spine can cause spinal fractures or displacement of vertebrae.
Not all patients find the condition painful. Some people are symptom-free and only discover the disorder when seeing their doctor for another health problem.
Symptoms of spondylolisthesis may include:
With age, the spine can begin to show signs of deterioration. Over time, the joints, ligaments and intervertebral discs undergo changes that may disrupt normal spinal structure and function.
Spondylosis is a general term for a degenerative process that can strike any region of the spine. The degenerative process usually begins in a disc. Damage to the disc reduces the space between vertebrae, which in turn leads to excessive wear and tear on adjacent spinal structures. Spondylosis mainly affects the intervertebral discs and facet joints, causing spinal instability and nerve damage. Advanced spondylosis may cause thickening of the spinal ligaments, contributing to nerve compression and pain. Sometimes degenerative disc disease and spondylosis are used interchangeably; both terms describe age-related changes in the spine. Factors that contribute to the development of spondylosis include:
Symptoms of spondylosis are in keeping with the spinal disorder (e.g. herniated disc, spinal stenosis) and the spinal region affected. Common symptoms include:
*Loss of bowel and/or bladder control may be a symptom of cauda equina syndrome, a serious medical condition. If control is lost, seek medical care immediately
A vertebral compression fracture (VCF) occurs when one of the spine’s vertebral bodies cracks, collapses and/or becomes misshapen by compressive force(s). The front, back and/or side of the vertebral body may become wedge-shaped, with loss of height on one or more sides. Compression fractures affect thousands of people every year. Many people do not realize sudden and intense back pain may be the first sign of a compression fracture. Although back pain is common, it is not always part of simply growing older. If you experience sudden back pain, have lingering back pain or suspect spinal fracture, seek qualified advice from a spine specialist. Whether painful or not, compression fracture can lead to new or adjacent fractures, spinal deformity and loss of function. The causes of vertebral compression fracture:
Discover the many ways New York City Spine Surgery, PLLC can help you with your back pain and dysfunction. Call (212) 506-0240 or use our convenient Request an Appointment form. Our service area includes Morristown, NJ, Denville, NJ, Manhattan, NY, Jamaica Estate, Queens, NY, New York City, NY, Westchester, NY and close-by areas.
Saint Barnabas Medical Center
Formerly St. Luke’s-Roosevelt
Hospital in Manhattan
Formerly Lenox Hill Hospital