Herniated Disc:

• The spine itself is made of many components.  The bones in the back are called vertebrae.  Between the vertebrae are disc that act as cushions.  Each inter-vertebral disc is made of two parts.  The inner part is a gelatinous material, called the nucleus pulposus, which is held in my bands of fibrous tissue, called the annulus fibrosis.  As aging occurs, the discs become dehydrated and are at a higher risk of injury.  Tears and cracks can occur in the annulus fibrosis, allowing the nucleus pulposus to move from its proper location and irritate other structures associated with the spine, such as nervous tissue.

• Common causes of a herniated disc include repetitive or prolonged flexing of the trunk, lifting, twisting and sitting.  All of these activities can add stress put pressure on inter-vertebral disc causing the annulus fibrosis to potentially tear.

• Symptoms of a herniated disc can vary. If the disc herniated near a structure such as a nerve, the symptoms can include back pain, numbness or tingling, or muscle weakness into the extremities.  If the disc herniated without irritating the nerve the main symptoms is back pain, although pain many not always be present.

Degenerative Disc Disease (DDD):

• Degenerative disc disease is not really a disease but a term used to describe the normal changes in the inter-vertebral discs as you age.  Inter-vertebral discs are soft, compressible discs that separate the vertebrae that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. As aging occurs the inter-vertebral disc naturally losses fluid and develops small tears which can lead to further damage to the spine.

• The most common cause of DDD is natural age related changes that occur to the inter-vertebral disc.

• The symptoms of degenerative disc disease can vary depending on if any other structure associated with the spine is involved.  Pain can vary from minimal to severe located in the back or neck. Symptoms, including numbness, tingling, and weakness, may also occur in the extremities.

Spondylolysis:

• The vertebrae of the spine consist of many bony projections that actually make many small joints between two individual vertebrae.  A spondylolysis occurs when one or two of the wing like projections on the bottom of a vertebra becomes fractured. Spondylolysis is usually detected sometime during childhood.

• It may occur due to defects in the bone from birth, overuse injury, or normal changes associated with aging.  This may progress into a spondylolisthesis.

• The main symptom of a spondylolysis is back pain, most commonly in the low back.

Spondylolisthesis:

• Spondylolisthesis occurs when one vertebra slips forward on the vertebra below it in the spine.  Between two vertebrae in the spine there are many small joints that all interact with each other to keep the spine in proper alignment.  Spondylolisthesis occurs when one of these joints become damaged, allowing for the anterior translation to occur.

• This can be caused by defects in the bone since birth, injury or trauma, or overuse injury.  This type of injury is commonly seen in sports such as gymnastics or weight lifting.

• Symptoms of spondylolisthesis may include pain in the back, buttocks, or legs, numbness, weakness, difficulty walking, loss of bladder or bowel control.  Pain may increase with movement.  However, sometimes spondylolisthesis can have no symptoms.

Spondylosis:

• Spondylosis is more commonly known as arthritis of the spine. As aging occurs normal wear and tear can occur at all the joints within the spine, causing a degeneration of these joints.  This may include damage to the cartilage within the joints.  It is most common in the neck region.

• Spondylosis can be caused by changes that occur during the natural aging process, previous injuries to the spine, and behavior patterns of movement.

• Symptoms of spondylosis can vary depending on the involvement of other structures associated with the spine.  If the spinal cord/nerves are not involved symptoms may include pain, stiffness, headaches, pain into the arms, and a grinding noise or sensation with movement.  When the spinal cord becomes irritated, possibly due to compression, it is know called a cervical myelopathy. The symptoms of cervical myelopathy may include tingling, numbness, weakness, lack of coordination, difficulty walking, abnormal reflexes, muscle spasms and loss of bowel or bladder control.

Spinal Stenosis:

• Each vertebra that makes up the spine has a large hole in which the spinal cord can course through.  Spinal stenosis occurs when this hole becomes narrower, which can compress the spinal cord and the spinal nerves.

• Spinal stenosis can be caused by changes that occur during the natural aging process, arthritis, defects in the bone from birth, instabilities in the spine, tumors, or injury.

• Symptoms of spinal stenosis can vary depending on which structures associated with the spine become involved.  Common symptoms can include back pain.  If the spinal cord or nerves become involved symptoms can include tingling, numbness, weakness, and abnormal reflexes.

Radiculopathy (Sciatica or Pinched Nerve):

• Radiculopathy is the damage or disturbance of nerve function.  With a radiculopathy the nerve is no longer working properly, which can give symptoms throughout the body.

• A common cause of a radiculopathy is an injury to an inter-vertebral disc, such as a herniation or bulge.

• A true radiculopathy must have one of three main symptoms including decrease reflexes, decrease sensation, and/or muscle weakness to the areas innervated by that specific nerve root.  Other symptoms include pain, numbness, and tingling in the back or extremities.

Radiculitis (Pinched Nerve):

• Radiculitis is an irritation of a nerve at the nerve root, located in the inter-vertebral foreman which is where the nerve exists in the spine.

• This irritation can be caused by compression, constriction, or stretching of the nerve. Unlike a radiculopathy, with a radiculitis the nerve is still functioning properly.

• The symptoms include pain, numbness, tingling in the back or extremities.

Hypermobility:

• Hypermobility is a condition where synovial joints move beyond normal limits.  Specifically related to the spine, hypermobility is where the inter-vertebral disc and ligaments do not maintain the appropriate axis of the spine.  This can lead to excessive movement between two vertebrae.

• Hypermobility may be inherited or acquired. Acquired hypermobility can be due to excessive stretching, such as in dancers or gymnast.  Hypermobility may also be caused by connective tissue disease or damage.

• Hypermobility may cause no symptoms. When symptoms, such as wide spread pain, feeling of stiffness, clicking/popping, or dislocations, do occur hypermobility can be classified has Joint Hypermobility Syndrome.  Hypermobility may further lead to a radiculitis or radiculopathy.

Cervicogenic Headaches:

• Cervicogenic Headaches, in comparison to other forms of headaches, are usually related to a musculoskeletal impairment in the cervical spine.

• Cervicogenic headaches may be caused by external pressure or and awkward position of the neck.  It is commonly related to trauma, degenerative changes, or postural strain.

• Cervicogenic headaches generally start in the posterior aspects of the base of the skull and travel up the head.  Cervicogenic headaches may also adversely affect neck mobility. Symptoms may fluctuate in intensity.  Symptoms are also usually unilateral.

Temporomandibular Joint (TMJ) Dysfunction:

• TMJ dysfunction is a term given to describe a group of conditions involving the TMJ.  The TMJ is a small joint that connects the mandible and the temporal bones in the head.

• The cause of TMJ dysfunction include damage/strain to the muscles surrounding the joint, whiplash, grinding/clenching teeth, dislocation of the disc within the joint, arthritis, and stress.

• TMJ dysfunction can cause pain that is worse during or after eating or yawning. It can cause limited jaw movement and clicks/pops during chewing.  In severe cases, pain can radiate into the neck, shoulders and back.