Category: Conditions

The carpal tunnel located in the wrist. It is a structure that contains the median nerve and tendons that are associated with the tendons of the fingers and hand. When the carpal tunnel is too small or if there is inflammation of the structures, the median nerve becomes compressed which results in symptoms of numbness, tingling in the wrist, palm, and first 3 ½ digits. Symptoms are usually worse during the night or the morning. If severe weakness of the hand can occur as well as atrophy of musculature that the median nerve feeds. Nonsurgical treatments include but not limited to bracing/splinting, rest, ice, medication, and injections. Severe cases may require surgical carpal tunnel release.

The spine is a bony structure that starts from the base of the skull and ends at the tailbone. Consists of the cervical spine (neck), thoracic spine (mid-back), lumbar spine (lower back), tailbone (sacrum and coccyx). This bony structure is interconnected via joints, discs, ligaments, nerves, tendons, muscles, and vascular network that work together to provide support, flexibility, and strength. Any of the components of the spine and its surrounding structures are susceptible to injury and can become pain generators.

The piriformis muscle is located in the buttock region on each side. The sciatic nerve is in close proximity to the muscle. Piriformis syndrome is causes by irritation of the muscle which in turn leads to buttock pain. If the close by sciatic nerve is irritated as well, symptoms can include tingling, numbness sensations in the affected lower extremity in the distribution of the sciatic nerve. Symptoms can be treated with non-surgically with supportive care, medication, therapy, piriformis injection, and botulinum toxin to name a few.

Facet joints are small joints found at almost each spinal level (cervical, thoracic, lumbar). These joints aide in twisting motion and associated stability in the spine. The angles of the facet joints vary at each spinal level to provide limitations to excessive rotational forces that can lead to instability and injury. Symptoms can include back pain that may/may not radiate into posterior aspect of lower extremities or neck pain that may/may not radiate to the head and shoulders. Symptoms can be treated with non-surgically with medication, therapy, and facet joint injections, facet blocks, radio frequency ablation to name a few. In some cases of destabilizing spine injury, surgery may be an option.

Nerve damage, usually in the hands and feet with symptoms of weakness, numbness, and pain. Peripheral neuropathy can occur from disease such as diabetes mellitus. Can also result from injuries, toxins, and or infections. It is important to seek out the underlying cause of the neuropathy. Treatment is inclusive of medications, supportive care and treating the underlying condition.

Pain that persists after adequate healing of spine surgical site. Despite the surgery being successful, one may experience unchanged or worse pain. Also there may have been post procedure complications such as infection, nerve damage, or failure for the surgery to achieve the intended anatomical goal. This condition is referred to as post-laminectomy syndrome. With cervical post laminectomy syndrome, the symptoms can involve the neck and upper extremities. With lumbar post laminectomy syndrome, symptoms can involve the lower back and lower extremities. Treatments are inclusive but not limited to medication, therapy, biofeedback, injections, and spinal cord stimulation.

Pressure on sensitive points in the muscle results in pain. Myofascial pain syndrome can occur after repeated injury or overuse of muscles. Sometimes it manifests a tender muscle knot and pain can be persistent. Treatments include therapy, medication, trigger point injections, relaxation techniques.

Inflammation in the bursal sac. A bursa is a thin sac around a joints that serves as a shock absorber between bone and surrounding soft tissue. The bursal sac is made up of a membrane that contains fluid. Trauma, friction, repetitive use can result in swelling that is localized, tenderness, pain in the affected area. Examples are bursas in the hip, knee, shoulder, or elbow areas. Can be treated with supportive care, rest, ice, medications, and injections just to name a few.

A type of headache that can vary in intensity. It can be associated with nausea and sensitivity to light as well as sound. Some times migraines are preceded by warning symptoms, known as an “aura”. Some triggers include certain foods or drinks, stress, exercise, and hormonal changes. It is important to rule out other causes of headaches.

Pain in the upper or lower extremities that may or may not develop after an injury. The exact cause of complex regional pain syndrome isn’t well understood but may involve abnormal inflammation or nerve dysfunction. Complex regional pain is characterized by pain that is greater than would be expected from the injury that causes it. Treatments include but are not limited to medications, heat or cold therapy, physical therapy, biofeedback, sympathetic blocks, and spinal cord stimulation.