Back and Leg Pain
“Mechanical” or “Acute” back pain comes from some dysfunction in the structures that connect to your back, such as the spin, muscles, soft tissues, and discs. Mechanical back pain can happen at any time in your life and the pain can generally come quickly, lasting for a short period or up to a few months. Healthcare practitioners such as a physiotherapist can often help relieve symptoms.
There are terms used to diagnose the cause or name of this mechanical pain syndrome, such as:
- “Sciatica” or Lumbar Radicular Pain
- Sacroiliac Joint pain
- Lumbar Facet Joint pain
- Disc Herniation or Disc Bulge in the Lumbar spine
- Degenerative Disc Disease or Discogenic Pain
The terms listed above can also be triggered by an inflammatory response.
Inflammatory back pain is a chronic condition caused by an autoimmune response. The inflammation and pain are caused when your body’s immune system attacks and destroys healthy body tissues by mistake which can cause inflammation and pain. The pain comes on slowly and persists for many months or years.
The etiology is generally associated with a precipitating systemic inflammatory response, which means you may experience pain or swelling in different parts of your body such as the eyes, ankles and neck. The inflammatory response could cause structural changes. Inflammation can be localized to your back and hips.
Inflammatory back pain diseases include several related conditions, which are also caused by exposure to mechanical stress. The conditions are classified as:
- Spinal Stenosis
Knee pain is a common complaint that affects people of all ages. It can be associated with injury, such as a ruptured ligament or torn cartilage, or by an underlying condition, such as arthritis. Knee problems can occur as a result of the aging process and continual wear and stress on the knee joint. Other medical inflammatory diseases and infections such as gout, can also cause knee pain and accelerate joint damage. Genetic and lifestyle factors also play a role.
There are several other conditions that can cause knee pain, such as:
- Fractures or dislocations
- Meniscal tear
Knee pain is diagnosed through a complete medical history and physical exam, along with other diagnostic imaging tests and procedures including X-ray, Magnetic resonance imaging (MRI), Computed tomography scan (CT scan), Arthroscopy, and Radionuclide bone scan.
Both non-operative and surgical treatment options are available to treat knee pain, depending on the type and severity of the knee condition. Exercise is still considered one of the best ways to manage knee conditions, such as osteoarthritis. Treatment will vary depending on the condition of the knee. Minor knee pain responds well to self-care measures. Knee braces and physical therapy also can help relieve knee pain. If initial treatment methods do not provide relief, your doctor may recommend surgical repair or total joint replacement, also referred to as knee replacement.
The conditions listed above may vary in the location and severity of the knee pain. Some of the signs and symptoms that accompany knee pain include:
- Stiffness and swelling
- Locking of the knee
- Crunching noises
- Inability to extend the knee
- Limping due to discomfort
- Redness and warmth to the touch
- Weakness and instability
Neck and Arm Pain
Neck pain is a common pain syndrome and complaint for a large portion of the population at any age. Neck pain can make performing the simplest tasks extremely difficult. Any pain or movement limitation in the neck can be severely disabling. The pain starts in the neck and can be associated with pain radiating down one or both arms.
If there is a problem in the cervical spine, it can cause pain in the neck as well as numbness and weakness in the arms. Several disorders or diseases can cause neck pain and involve any of the tissues in the neck, nerves, bones, joints, ligaments or muscles. Abnormal muscle spasms can also contribute to pain in the neck and arm.
Several disorders and diseases can affect the cervical spine and may be the potential cause of neck pain, such as:
- Whiplash injury
- Pinched nerve
- Bone spurs
- Cervical spinal stenosis
- Herniated and bulging discs
- Disc degeneration
- Narrowing of the spinal canal
- Muscle inflammation
- Strain or trauma
Pressure on a nerve root or spinal cord by a herniated disc or bone spur may result in neck pain along with:
- Pain in the arm
- Numbness or weakness in the arm
- Tingling in the fingers or hand
- Weakness in the arms or legs
Identifying the underlying cause of your neck and arm pain is key for proper diagnosis and optimal treatment. Some patients may undergo imaging studies if medications are ineffective. Diagnostic imaging tests may include:
Most causes of neck pain are not life-threatening and improve with conservative medical treatment. Nonsurgical treatment strategies for neck and arm pain depend mainly on identifying the location and cause of the pain. The doctor might prescribe medications to relieve symptoms of the pain or inflammation and muscle relaxants to allow time for healing to occur. Nonsurgical treatment options such as physical therapy, cervical spine traction, medications, and neck movement exercises may help treat neck pain. However, reducing physical activity and reducing the mobility of the neck can decrease pain and irritation. If you are experiencing any weakness or numbness in the arms or legs, seek medical attention immediately.
Seek medical care if the conservative treatments fail to relieve your symptoms. If conservative treatments fail to improve symptoms and provide relief, surgery may be needed. There are different surgical procedures which can be utilized, depending on the factors. Several factors that help determine the type of surgical treatment include the specifics of the disc disease, age, how long the patient has had the disorder and other medical conditions. Surgeries designed to relieve neck and arm pain include cervical discectomy or a cervical artificial disc replacement and spinal fusion.
The shoulder, just like the knee, is a highly mobile and functional joint. It is not surprising that shoulder pain increases as we age because the soft tissues surrounding the shoulder tend to degenerate. Excessive or unusual activity could increase the risk of developing shoulder pain over the years. The pain may be constant, or only when the arm is moved. It is possible that patients experience shoulder pain from other parts of the body, which could be the source of the pain, especially in the absence of injury to the shoulder. The source of the pain in other parts of the body, such as the neck or biceps, can radiate to the shoulder. If your shoulder feels numb with a tingling sensation, it is most likely damaged or pinched nerves caused by the shoulder injury.
A variety of factors and common conditions can contribute to shoulder pain such as:
- Rotator cuff tendonitis
- Cervical radiculopathy
- Winged scapula
- Calcific tendinitis
- Impingement syndrome
- Arthritis or Rheumatoid arthritis
- Torn cartilage or tendon
- Bone spurs
- Pinched nerve
- Dislocated or fractured shoulder/arm
- Spinal cord injury
- Adhesive capsulitis or “Frozen shoulder”
- Heart attack
Medical history and a physical examination from your healthcare provider will be the initial diagnosis. Diagnostic imaging tests such as X-ray, Computed tomography (CT scan), or Magnetic Resonance imaging (MRI), can produce detailed pictures of the shoulder. This will help your shoulder condition get diagnosed accurately.
Treatment options such as physical or occupational therapy, shoulder immobilizer, and surgery may be needed depending on the cause and severity of the shoulder pain. Performing simple stretches provided by your doctor or therapist can help stretch and strengthen the muscle which will help with managing the pain. often patients find that shoulder pain is limiting many tasks, which could weaken the shoulder muscles. The pain will get worse if the muscle is weakened. Therefore, performing simple stretches or exercises is necessary if it is recommended or provided by the health care provider.
You should seek medical help if you experience fever, unable to move your shoulder, lasting bruising, heat and tenderness around the shoulder joint area, or if the pain persists and keeps getting worse. If your shoulder pain is not related to any injury and is sudden, it may be a sign of a heart attack. Call 911 immediately. Also, if the shoulder injury led to bleeding and exposed tissue, seek medical attention immediately.
The contents contained within this page are not a substitute for health professionals’ advice, diagnosis, or treatment. We advise that you seek advice from a qualified healthcare practitioner. We fully disclose that any surgical or invasive procedures come with risks.
For more details on how to relieve or treat chronic pain, you can reach out to one of our pain specialists at any of our pain care clinic locations. We establish a caring relationship and provide patients with pain relief when needed the most.