MDNews - Minnesota

++++++++++++++++++++++ +++ +++ ++++++++++++++++++++++ SPINAL COLUMN + + NOT JUST A PROBLEM FOR THE ELDERLY By Dr. Stephen Knuff, Midwest Spine Institute D EGENERATIVE CHANGES IN the spine are a widespread process that occurs with nor- mal human aging. Symptoms of spinal degeneration manifest as axial neck or low back pain. Because neck and low back pain can have numerous causes, an accurate diagnosis is imperative to properly treat and manage the pain. Common causes of spinal degen- erative pain are the intervertebral disc, facet joints and sacroiliac joints. With aging, the intervertebral disc experiences progressive dehydration, changing spinal biomechanics and predisposing to annular tears of the disc. This leads to an inflammatory response and disc-generated pain. Facet and sacroiliac joints are true synovial joints and bear much of the load of the lumbar spine and pelvis, respectively. These joints can develop osteoarthritic degenerative changes similar to hip and knee joints. Often anatomical images, such as X-ray fi lms and MRI studies, show multiple degenerative changes and can make proper diagnosis diffi cult. In fact, studies have shown MRI evidence of spinal degeneration in 75% of the population at age 50. Thus, arthritis of the spine is not necessarily limited to those of old age, and proper diagnosis can be challenging. Midwest Spine Institute practitioners pride themselves on first correctly identifying the pain generator and then offering a comprehensive, individual- ized, step-wise treatment approach. Identifying the actual cause of pain consists of piecing together the patient's history, performing a thorough physical exam, ordering and interpreting imaging studies, and performing diagnostic, fl uoroscopically guided injections. These diagnostic injections deliver local anes- thetic medication to small nerves feeding the facet joints, blocking their ability to sense pain or deliver the medication directly into the sacroiliac joint. Once a proper diagnosis is made, the treatment plan ensues. Midwest Spine Institute's pain man- agement philosophy starts with the most conservative treatments, including medications, physical therapy and home exercise programs. If adequate pain management is not achieved through conservative methods, more aggressive options are undertaken and include therapeutic fl uoroscopic injections and possibly ablation of the pain-generating nerves via radiofrequency. Often, these interventions provide pain relief for several months and sometimes even years. Lastly, if the above noted treat- ment measures provided inadequate pain relief or the patient is experiencing neurologic defi cits, referral to a surgeon may be warranted. In summary, degenerative changes of the spine are common and occur frequently in middle-aged, as well as elderly, patients. A precise diagnosis and conservative treatment approach are keys to alleviating pain while optimizing function, activity and quality of life. For more information, please contact Midwest Spine Institute or Dr. Stephen Knuf f at (651) 430-3800 or vi s i t www.MidwestSpineInstitute.com. n KEY STATISTICS + More then 65 million Americans suffer from lower back pain annually. + By the age of 50, 75% of the population will show evidence of disc degeneration. The vast majority of these cases are asymptomatic. CAUSES + Aging is the most common cause of disc degeneration. + As the body ages, the discs in the spine dehydrate or dry out, and lose their ability to act as shock absorbers between the vertebral bodies. + The bones and ligaments that make up the spine also become less fl exible and thicken. + Unlike muscles, there is minimal blood supply to the discs, so they lack reparative powers. SPINAL DEGENERATION:

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