There are many causes of spine disorders; some common, some rare. The causes may be grouped into broad categories as outlined below.
The links in the text below connect to information about specific spine conditions provided by the American Academy of Orthopaedic Surgeons. This will give you useful background information and will help you to ask the right questions when you see us. To understand the basic way a spine is ‘built’ and to learn how it works, click here.
This is the commonest group of clinical problems and is essentially caused by the ‘wear and tear’ changes of ageing and arthritis in the spine. Another name for this is Spondylosis. The usual sorts of symptoms that patients suffer include Low Back Pain or Neck Pain (Arthritis of the Neck), the symptoms of which often come and go in cycles, gradually worsening over time. The other main category of symptom is pain in either the arm or leg which is usually as a result of nerves or even the spinal cord itself being compressed somewhere in the spine. The pain can really be very severe depending upon its cause.
One of the most common is Intervertebral Disc Herniation (or Prolapse) which can occur anywhere in the spine but is most common in the lower lumbar spine and in the lower cervical spine. If the pain is in the legs, this is called Sciatica, if it is in the arms, then it is called Brachalgia. In most cases, the pain will settle down over a few weeks or a month or two and surgical intervention is not needed and Exercises for Low Back Pain treatment can help. In a small proportion the pain is so severe that patients would prefer not to wait a month or two for things to settle down and opt for early surgery, and in some, the pain simply doesn’t settle down after a month or two and then surgery may also be appropriate. In a very small proportion, Disc Prolapse can be an emergency if the disc compromises the nerve function to the bladder, bowel and legs together (Cauda Equina Syndrome).
Other causes of ‘pinched nerves’ in the spine, commonly found in those over fifty years old, are Cervical Myelopathy (when occurring in the neck), and Lumbar Spine Stenosis (when occurring in the back). They have different and complex symptoms but are again typified by symptoms associated with changing or deteriorating nerve function in the arms and/or legs. Lumbar Stenosis is quite frequently accompanied by Degenerative Spondylolisthesis (Spondylolisthesis in Adults) — a medical word that simply means that one vertebra is slipping either forward or backward on another usually due to arthritis changes. Many cases of Degenerative Spondylolisthesis if stable do not need to undergo fusion surgery, but great care must be taken when performing Decompressive Surgery as it can be easy to make the slip worse.
In general, the results are better for patients with symptoms that are worse in the arms or legs than in the neck or back. Some patients with principally neck or back pain however may be helped by fusion or disc replacement surgery and some patients may be considerably helped by Spinal Injections.