Saturday 23 July 2016

Basics Relating To The Management Of Shoulder And Spinal Pain

By Margaret Rogers


There is a wide range of causes of shoulder and neck pain. Among the commonest causes of shoulder and spinal pain is a condition known as cervical spondylosis or neck arthritis. This is a degenerative condition commonest in the seventh decade of life. The underlying problem is gradual wear and tear of connective tissues such as cartilage and bone. Whereas about 85% of seniors in Greenbelt, MD, have the problem, a majority do not exhibit any symptoms.

Cervical spondylosis can be treated in a number of ways. The treatments are broadly divided into conservative and invasive (or surgical options). Both options are designed to provide symptomatic relief and to prevent disease progression Physical therapy is one of the most useful conservative approaches that exist. The treatment involves the performance of passive and active physical exercises that mainly involve the stretching of neck and shoulder muscles.

There are several pharmacological agents that are used either singly or in combination. They include, for example, muscle relaxants, anti-epileptic drugs, narcotics and steroids among others. Surgical options are only considered if the medical therapies fail to yield the expected results. Surgery is most effective for conditions such as abnormal anatomical structure of vertebral bones, prolapsed discs and bony spurs among others.

Spinal stenosis is also a fairly common cause of pain in these regions. Stenosis is a condition in which the spinal canal is abnormally narrowed such that it compresses on the spinal cord and nerve roots found in the area around the narrowed region. Associated symptoms include pain, tingling and numbness in the upper limbs. For most of the cases, there is underlying arthritis or bony spurs.

A clinical history, a physical examination and several investigations are needed to make a diagnosis of spinal stenosis. X-rays are particularly useful here. They help in assessing the bony components for conditions such as fractures, bony spurs and bone infections among others. If there is a need to evaluate the soft tissues as well, other modalities such as CT scan and MRI have to be used.

Conservative treatments may be considered in patients with stenosis but the definitive management remains surgery. The objective of the operation is to create more space within the canal for the cord. This is why the surgeries of these nature are generally known as decompression operations. There are many sub-types that exist and are named based on the part that is removed. Removal of the lamina is known as laminectomy and that of the vertebral body is known as corpectomy.

Herniation of inter-vertebral discs is another well-known cause of pain. The herniation may occur in any region of the spine including the neck. When the disc herniates, it impinges on the nerves within its vicinity. Symptoms will be experienced in the areas innervated by these nerves such as the shoulder, the arm and the hands. Treatment is through traction or surgery.

Pain in the shoulder and neck has numerous other origins. The fortunate thing is that most are usually managed with conservative approaches without any major consequences. It is important that one consults a doctor if the symptom persist after the use of home based therapies. This will help rule out any serious underlying conditions before they advance.




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