Spine pain (back and neck pain) is a common condition for many people, and one of the most difficult to diagnose and treat. At Texas Orthopedics, our spine doctors have the expertise and experience to help you find the right treatment plan to help end your back and neck pain.

Our physical medicine and rehabilitation physicians Dr. Kenneth Bunch, Dr. Vishal Kancherla and Dr. Ai Mukai specialize in non-surgical spine care using conservative treatments, such as physical therapy, injections delivered under X-ray or ultrasound guidance, and non-narcotic medications.

Our spine surgeons perform surgeries only after all conservative treatment options have failed. Our fellowship-trained orthopedic spine surgeons include Dr. James Smith, Dr. Atilla Onan, and Dr. Alex Cruz.

What Are the Most Common Spinal Conditions?

Pain can be from acute or chronic issues.  If you sustain an injury to the spine, it is important  to make sure that you quickly get it evaluated and treated.  Imaging is usually needed to make sure you didn’t fracture your bones and you need a good physical exam to make sure you are not having any signs of nerve injury.  

Chronic conditions can be present for many years and can have periods of increased pain.  These are a few of the most common chronic spinal problems that we see:

Degenerative Disc Disease

The disc is the shock absorber of the spine and it can start wearing out from years of wear and tear or from old injuries.  Degenerative discs can cause pain and reduced mobility.  Typically, there is also degeneration in other parts of the spine, including the joints in the back of the spine called facet joints. These joints can crack and pop like your knuckle joints and can become thick and arthritic like your knuckles.  If it causes narrowing of the space where the spinal nerves live, there can also be nerve pain into the arms and legs.

Slipped Vertebrae or Spondylolisthesis

Slipped bones can occur when there is either a defect in the bone or an old fracture (usually during your adolescence) in the thin ring in the back of the vertebral body.  Since the ring is no longer intact that keeps the vertebral body in place, that bone can start sliding back or forward, called spondylolisthesis.  This can also pinch the nerves in the back of the spine.  

“Slipped disc” or “Herniated disc”

Herniated discs occur when the softer filling of the discs (cushioning) leak out of the disc (usually through a tear of the cartilage) and come into the space where the nerves live.  This is very inflammatory and can cause intense pain and mobility issues. It also can result in numbness and tingling for many patients.

Spinal Stress Fractures

Spinal fractures can be from acute injuries but it can also be from decreased bone density. Many people over the age of 60 will develop small hairline fractures in their spinal column, and these tiny cracks can build up over time causing a “wedge” shape of the vertebral body.  This can cause loss of height, pain, and stiffness. People with thin bones (osteoporosis) are at higher risk of sustaining a compression fracture from relatively minor falls and injuries.

Common back conditions and treatments:

• Degenerative Disc Disease
• Herniated Disc
• Low Back Pain
• Osteoporosis
• Pinched Nerves
• Sciatica
• Spinal Stenosis
• Slipped Vertebrae - Spondylolisthesis
• Pars Fracture - Spondylolysis
• Facet Joint Syndrome
• Coccydynia - Tailbone Pain

Non-surgical Procedures:

• Lumbar Epidural Steroid Injections
• Radiofrequency Ablation/Neurotomy
• Lumbar Transforaminal Epidural Steroid Injections
• Intercostal Nerve Blocks
• Caudal Epidural Steroid Injections
• Sacroiliac (SI) Joint and Ligament Injections
• Sacroiliac Radiofrequency Ablation
• Medial Branch Nerve Block
• Trigger Point Injections
• Epidural Steroid Injections  
• Spinal Cord Stimulator trials

Surgical Procedures:

• Discectomy: Microdiscectomy and Traditional Discectomy
• Spinal Fusion: Posterior and Anterior
• Lumbar Disc Replacement
• Laminectomy (Decompression)
• Facetectomy
• Foraminotomy
• Kyphoplasties and vertebroplasties
• Spinal Cord Stimulator Implants

How Do I Know If I Need Back Surgery?

Many times, surgery is not needed for back and neck pain because there are a number of very effective, non-invasive and non-surgical treatments. Conservative treatments, such as medication, physical therapy and injections, typically resolve back pain. However, if these approaches do not work, then you may consider back surgery. 

There are also some back problems that can only be corrected with surgery. For example, if you have severe spinal stenosis (narrowing of the space where the nerves and spinal cord live) with compression of the nerves and spinal cord, then a surgery called a laminectomy may be necessary to open the space and give you relief.

At Texas Orthopedics, we have both non-surgical specialists and fellowship-trained spine surgeons on staff. This allows us to offer many different kinds of treatment for your back or neck injury or chronic pain. And with seven locations, we make it more convenient to get the care you need for your back and neck pain.

What are the Symptoms of Spine Injury that requires seeing a doctor?

Back and neck pain may not show up for 24-48 hours after an injury. The pain may get worse if you move, and you may also notice numbness and tingling in the area. Additionally, you may have pain that radiates to other parts of the body such as the arms and legs.

A severe back injury can cause more serious symptoms. This includes bowel or bladder incontinence and numbness and weakness in the arms and legs. If you notice any of the symptoms, then you will need to seek medical attention as soon as possible.

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Visit our patient education library to learn more about back problems and treatments.