Monday, July 18, 2016

Basics Relating To The Management Of Shoulder And Spinal Pain

By Margaret Rogers


Cervical spondylosis is one of the cause of pain in the neck that may be referred to the shoulder. It is also referred to as neck arthritis or cervical osteoarthritis. It is regarded as a degenerative condition resulting from the wear and tear of connective tissues of the neck including the bones and the cartilage. It is estimated that at least 85% of persons aged above 60 years in Greenbelt, MD, have varying degrees of shoulder and spinal pain but the majority do not show 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.

A number of medical treatments can be used for this condition either singly or in combination. Examples include muscle relaxants (cyclobenzaprine), narcotics, anti-epileptic drugs and steroid injections among others. It is only when the medical treatment proves to be ineffective that surgical intervention should be considered. Surgery is indicated in cases such as bony spurs, herniated discs and abnormal vertebral bones. Fortunately, most patients tend to show improvement with conservative treatments.

Spinal stenosis is another common cause of pain whose effects are similar to those of spondylosis. Stenosis denotes the narrowing of the spinal canal for one reason or the other. For most cases, there is underlying arthritis of the affected regions. Bony spurs are also a common finding in some of the persons suffering from the problem. Stenosis usually results in compression of the spinal cord and nerve roots.

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 are commonly used here but most patients end up in surgery to relieve the pressure on the spine. Operations done for this condition are collectively known as spinal decompression procedures. There are many sub-types that exist and the choice is dependent on the exact problem that exists. For instance, if the operation involves the removal of a vertebral body it will be termed corpectomy and if it involves just the lamina, laminectomy.

Inter-vertebral disc prolapse is a fairly common problem that may result in pain as well. A prolapsed disc compresses nerve roots and causes symptoms along the region that supplied by affected nerve or nerves. If the disc affected is found in the cervical region, possible symptoms include a tingling sensation and numbness in the shoulder, the arm, forearm and the hand. Traction or surgery may be required.

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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