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Spine Care

Spine Conditions & Treatments (Patient Education)

Back and neck pain can feel confusing because the spine has multiple moving parts—discs, joints, nerves, muscles, and ligaments—all capable of creating similar symptoms. This page is a general educational guide to help you understand common spine conditions, what the diagnostic process often includes, and how treatments like epidural steroid injections and radiofrequency ablation are typically used to reduce pain and restore function.

Common Spine Symptoms by Condition

Spine problems don’t always present as “back pain.” You may notice pain that travels from shoulder to arm or leg to foot or pain in your neck. The following conditions and symptoms examples are some of the most common.
 

  • Muscle strain and ligament sprain
    Often triggered by lifting, twisting, overuse, or sudden movement. Pain may feel sore, tight, or sharp with certain motions.
     

  • Degenerative disc disease
    Discs naturally change with age. Some people have minimal symptoms; others feel persistent stiffness or pain, often worse with prolonged sitting or activity.
     

  • Herniated disc (bulging/slipped disc)
    When a disc irritates a nearby nerve, symptoms can include radiating pain, numbness/tingling, or weakness (for example, sciatica).
     

  • Spinal stenosis
    A “crowding” of space around nerves, commonly causing pain with walking/standing and relief when sitting or leaning forward. Some describe heaviness or fatigue in the legs.
     

  • Facet joint arthritis (facet arthropathy)
    Small joints in the spine can become inflamed or arthritic and cause localized pain, may worsen when extending (leaning back) or twisting.
     

  • Radiculopathy (pinched nerve)
    A nerve root becomes irritated, commonly felt as pain, tingling, or weakness traveling into the arm/hand or leg/foot.
     

  • Spondylolisthesis
    One vertebra shifts relative to another, sometimes creating back pain, nerve symptoms, or activity limitations.
     

  • Sacroiliac (SI) joint pain
    Pain where the spine meets the pelvis. It can mimic low-back pain and sometimes refer into the buttock or upper leg.
     

  • Compression fractures
    More common with osteoporosis or trauma. Pain can be sudden and severe, especially after a fall.

When Spine Symptoms Need Urgent Evaluation

Seek urgent medical care if you have any of the following:

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  • New bowel or bladder changes

  • Numbness in the “saddle” area (groin)

  • Rapidly worsening weakness, foot drop, or loss of coordination

  • Fever, chills, unexplained weight loss with spine pain

  • Significant trauma (fall, car accident), especially with severe pain

How Spine Problems Are Usually Diagnosed

A spine evaluation usually starts with your history—how it began, what worsens/relieves it, what you can’t do now, and whether pain/numbness travels into an arm or leg. Then your provider does a focused physical + neurologic exam (posture/gait, range of motion, strength, reflexes, sensation, and nerve-provocation tests). Imaging is used when it adds value—often X-rays, sometimes MRI/CT, and occasionally EMG/NCS—and in select cases, diagnostic injections to confirm the pain source and guide the next step.

Treatment Options

Most spine care follows a progression from least invasive to more targeted when needed—based on symptoms, function, and diagnosis.

 

Conservative (non-procedure) options

Many people improve with a plan that includes:
 

  • Activity modification (keeping you moving without flaring symptoms)

  • Guided physical therapy (mobility + strength + mechanics)

  • Home exercise program (consistency matters most)

  • Anti-inflammatory or pain-relief medications when appropriate

  • Heat/ice strategies

  • Posture, desk setup, and lifting mechanics coaching


Spine Injections and Procedures

These procedures don’t “erase” degeneration, but they can reduce inflammation, calm irritated nerves, and help you participate in rehab—often the key to long-term improvement.
 

  • Epidural steroid injection (ESI)
    A spine injection that places anti-inflammatory medication (steroid, often with anesthetic) into the epidural space to calm irritation around spinal nerves.

    • Interlaminar epidural: Medication is delivered more centrally into the epidural space.

    • Transforaminal epidural: Medication is delivered more directly near a specific nerve root.
       

  • Selective nerve root block
    A targeted injection placed next to one specific spinal nerve root, usually with numbing medicine (sometimes with steroid), to identify and/or reduce symptoms from that nerve.
     

  • Facet joint injection
    An injection placed into a facet joint (the small joints in the back of the spine) to reduce inflammation and pain coming from that joint.
     

  • Medial branch block
    An injection that numbs the medial branch nerves—the tiny nerves that carry pain signals from the facet joints—to test whether the facet joints are the pain source.
     

  • Radiofrequency ablation (RFA)
    A procedure that uses heat generated by radiofrequency energy to disrupt pain signaling from specific nerves (most commonly the medial branch nerves) after blocks suggest they’re the pain generator.
     

  • SI joint injection
    An injection placed into the sacroiliac (SI) joint (where the spine meets the pelvis) to confirm the joint as a pain source and/or reduce inflammation and pain.


When Surgery May Be Considered

Surgery is typically discussed when:
 

  • There is persistent nerve compression with significant symptoms

  • Weakness is progressing

  • Pain/function limitations persist despite well-directed conservative care

  • Imaging findings match the symptom pattern
     

Common surgical procedures (depending on diagnosis) include spinal decompression procedures, disc procedures, and stabilization procedures. A spine specialist can explain which—if any—fits your situation.

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