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Writer's pictureAkshay Patil
Jun 183 min read

Intolerable Pain After an Accident: Simplifying Neck and Back Pain



Introduction

We frequently encounter individuals experiencing severe neck and back pain, often due to slips and falls or serious car accidents. Other contributing factors to upper, middle, and lower back pain include degenerative diseases, aging, overuse, and heavy lifting. These factors can lead to inflammation and debilitating back pain, impacting daily activities. Since accident-related neck and back pain tends to be more acute, upsetting, and disruptive, we will concentrate on the main causes of this condition in this piece.

 

Anatomy and physiology for neck and back pain-

The human vertebral column is made up of a series of 33 bones called vertebrae, which are separated by intervertebral discs. This includes 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccyx vertebrae, providing natural protection to the spinal nerve. When nerve endings in the spinal cord are affected by damaging stimuli, they respond by producing pain in the affected areas, leading to neck and back pain.

 

Initial signs and symptoms-

The impact of a moving object can cause severe damage to the vertebral column, including trauma, sprains, strains, ligament or muscle tears, and fractures. This traumatic damage can lead to severe pain radiating to the upper and lower limbs. Patients might also report experiencing throbbing, numb, achy, dull, burning, sharp, and tingling pain. Tenderness is occasionally observed upon palpation in the cervical, thoracic, and lumbar areas during patient examinations. Additionally, the pain is associated with muscle weakness and decreased strength.

 

Diagnosis of origin of neck and back pain-

In modern medicine, there are various advanced diagnostic methods available for spinal condition assessment. These include X-rays to examine the cervical, thoracic, and lumbar spine, as well as MRI scans specifically of the cervical and lumbar spine. Additionally, computed tomography (CT) scans can be used for further evaluation. These imaging methods can provide an in-depth analysis of spinal conditions and identify potentially suspect injuries. In cases where the spinal nerves are suspected to be involved, an electromyography (EMG) or a nerve conduction study (NCS) may also be performed to assess nerve function and activity.


Findings and impressions of imaging tests-

Here are some common findings and impressions often observed that help identify the origin of neck and back pain and determine possible treatment methods.

1. Radiculopathy: Radiculopathy refers to a range of symptoms caused by the pinching of a nerve root in the spinal column. This pinched nerve can occur in different areas along the cervical, thoracic, or lumbar spine.



2. Disc herniation: A herniated disc is a condition that affects the spine, in which the annulus fibrosis is damaged, allowing the nucleus pulposus (normally located within the center of the disc) to herniate, potentially compressing the nerves or spinal cord, causing pain and spinal cord dysfunction.

 3. Myelopathy: Myelopathy is an injury to the spinal cord due to severe compression, which may result from trauma, congenital stenosis, degenerative disease, or disc herniation. When any portion of the spinal cord becomes compressed or constricted, the resulting symptoms are known as myelopathy.

4. Disc desiccation, disc height loss, and disc bulges: These are degenerative diseases often caused by wear and tear of vertebral bones and discs. Sudden injury can exacerbate these conditions, making them more painful than before.

 

Available treatment options to reduce the pain scale-

Several treatment options are available to manage and alleviate pain:

1.  Medication - Common over-the-counter drugs such as Acetaminophen, diclofenac, and tramadol are typically prescribed as the initial treatment for neck and back pain.

2.  Therapeutic Injection Procedures - If pain persists, corticosteroid injections such as Cervical epidural steroid injection, Radiofrequency ablation (RFA), and Trigger point injection may be administered.

 3. Therapy options - Treatment options include physical therapy, acupuncture, massage therapy, chiropractic treatment, hot and cold treatments, and regular exercise.

 4. Surgery - Surgical options for treatment include cervical discectomy and fusion (ACDF), cervical artificial disc replacement (ADR), and Posterior cervical laminectomy.


References-

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