Spinal pain, whether cervical, thoracic, or lumbar likely represents the largest group of patients suffering disability and chronic pain. This pain can lead to difficulty maintaining the ability to work, it can interfere with family relationships, it can tear the whole fabric of your life apart causing social isolation and depression. Many of us suffer traumatic events such as motor vehicle accidents or lifting injuries, which lead to chronic pain through a failure of conservative therapy or surgery. Others of us suffer from age related breakdown determined by our genetics that results in degeneration of specific components of our spines and leads to disabling pain.
Successful treatment of spinal pain requires a very precise diagnosis. This can be a difficult process due to the similarities in the experience of the pain caused by injury to completely different structures, and of course your treatment needs to be to the proper structure at the proper level of your spine to achieve a good outcome. Not infrequently, this requires an element of persistence for both the patient and the treating physician to achieve a successful outcome.
Post Surgical Pain
Mrs Jones (not her real name), 55 years old, came to a musculoskeletal specialist seeking advice for a 3-year history of progressively worsening pain in both knees. Her knees were stiff for about 20 minutes when she arose in the morning and for a few minutes after getting up from a chair during the day. She had difficulty walking > 30 minutes because of pain, and her symptoms were exacerbated by kneeling, squatting, or descending stairs. Although sitting, resting, and reclining relieved her pain, she became stiff if she stayed in one position for too long. Her symptoms were worse on humid or cold days, and she occasionally felt as if one of her knees would “give out.”