cause disc herniation and bone spurs to form as well. As disc
disease progresses, the neck will become less flexible, and
you will feel pain towards the end of the day, or a stiffness in
your neck. When one of these discs presses on one or more of the
many nerves running through the spinal cord, you may also develop
pain, numbness, or weakness radiating down your shoulder, arm, and
hand. Pressure on the spinal cord in the cervical spine can cause
problems throughout your whole body. Almost all the nerves that
reach throughout the rest of the body pass through the neck on their
way to the extremities, abdomen, and chest.
Dr. Berti will perform a thorough review of the patient's medical
history, symptoms, and will also perform a physical examination that
will include testing the neck's flexibility and extension. Imaging
studies will also be performed where warranted, and will include
x-rays, MRIs, and CT scans. The doctor may opt for a diagnostic
selective nerve root block in some cases, as well.
Dr. Berti will determine a treatment plan based on the cause of the
nerve irritation. His first
recourse is, in
most cases, conservative treatment. He might suggest
over-the-counter pain medications, including acetaminophen
(Tylenol), nonsteroidal anti-inflammatory medications such as
ibuprofen (Motrin, Advil) and naproxen (Aleve). These medications
can help reduce pain and inflammation and allow time for healing. He
might prescribe steroids or narcotic painkillers if over-the-counter
medications aren't working.
Dr. Berti may also prescribe rest or a cervical collar, and
potentially, physical therapy appropriate for cervical disc disease.
Your therapist may use cervical traction, or gently massage your
muscles and joints to reduce your pain and stiffness. The physical
therapist can also help you increase your range of motion and show
you exercises and correct postures to help improve your neck pain.
Dr. Berti may also recommend epidural steroid injections to
temporarily relieve pain.
Surgery is also a treatment option, depending on whether you and Dr.
Berti decide on it. The most common surgery for degenerative disc
disease is a discectomy (link to this page). Spine fusion may also
be used (link to this page.)
Dr. Berti treats:
Herniated Disc: A herniated disk is a disk that slips out of place
or ruptures, potentially putting pressure on the spinal cord or
nerves, causing back pain or sciatica. It is also known as a
"slipped disc", and can occur quickly due to an injury or trauma to
the neck or spine- or gradually, from wear and tear on the disc.
Herniated discs usually occur in the lower spine, but sometimes
occur in the cervical spine. It is rare to have a herniated disc in
your upper back.
When you have a herniated disc in your cervical spine, you may feel
pain in you rneck that radiates to the shoulders and upper arms. If
the herniated disc is in your lower back, you may feel pain that
begins in your back then spreads to your buttocks and legs (this is
also known as sciatica). You may feel tingling or numbness and have
muscle spasms or weakness.
Treatment for herniated discs follows treatment for degenerative
disc disease, including rest, over-the-counter pain medications,
anti-inflammatory medicine to help with pain and swelling, physical
therapy, losing weight, and potentially, surgery if conservative
treatments don't alleviate pain after at least six weeks. Surgeries
include discectomy, laminectomy, and spinal fusion. (link to
appropriate procedure on procedures page)
Spondylolisthesis is a disease which occurss when one's vertebra
(usually in the lower back) slips over the vertebra below it. The
most common cause in adults is arthritis, although it is associated
with those who partake in sports such as gymnastics, football, and
weight lifting. A stress fracture from one of those sports can cause
the vertebra to crack and shift out of place.
A person with spondylolisthesis may not exhibit any symptoms for
years, if ever. If one does have symptoms, they may include pain in
the lower back and buttocks, numbness, stiff hamstrings, a limp, and
tenderness in the area of the disc that slipped. If there is nerve
compression, then a patient might feel numbness, slow reflexese,
tingling, and weakness in the lower legs. The condition can produce
swayback (or lordosis), but in later stages may result in roundback
(or kyphosis) as the upper spine falls off the lower spine.
If Dr. Berti determines that a spondylolisthesis is causing your
pain, he will first employ nonsurgical treatments. These may include
a short period of rest, anti-inflammatory medications (orally or by
injection) to reduce the swelling, analgesic drugs to control the
pain, bracing for stabilization, and physical therapy and exercise
to improve your strength and flexibility so you can return to a more
normal lifestyle. You will also be educated in how to perform daily
activities without adding stress to your lower back.
Depending on your grade of spondylolisthesis, Dr. Berti may
determine that spine fusion or a laminectomy are needed for either
stabilization or to relieve. (link to spine fusion, laminectomy on
Spinal stenosis refers to a narrowing of the canal surrounding the
spinal cord. The condition may occur naturally with aging as the
discs become drier and start to shrink. It is associated with
middle-aged or elderly people; their arthritis may cause bones and
ligaments of the spine to become inflamed or swell. Other possible
causes include spine tumors, infections, injuries that cause pressur
on the nerves or spinal cord, and birth defects.
Patients may experience weakness in the legs and leg pain while
standing up; this pain is often relieved simply by sitting down.
They may also experience numbness, cramping, and pain in
corresponding parts of their bodies. For example, if you have spinal
stenosis in your lower back, you will feel cramping in the back,
buttocks, thighs, etc...More serious symptoms can include difficulty
or imbalance when walking, incontinence, and constipation.
Interestingly, patients with spinal stenosis may be able to ride a
bicycle with little or no pain.
Again, Dr. Berti stresses a conservative approach to treatment,
which will first include medication, physical therapy, and daily
changes to his patient's lifestyle routine. If these approaches
don't work, he may consider surgery of the neck or lower back to
relieve the pain of nerve compression.
Please click on the links below to learn more about those
Osteoarthritis: Osteoarthritis, also known as degenerative joint
disease or osteoarthrosis, is the most common form of arthritis
caused by the slow, gradual wear and tear on one's joints. The cause
of osteoarthritis is often unknown, but it is thought to be mainly
related to aging, as the symptoms usually appear in middle age. Some
factors that can cause or lead to osteoarthritis include heredity,
obesity (especially for the hip, knee, ankle, and foot joints),
joint injury, and long-term overuse at work or sports. Various
medical disorders, such as bleeding disorders or rheumatoid
arthritis, can lead to osteoarthritis as well. Symptoms include pain
(especially after exercise or any pressure on the joint), swelling,
tenderness, joint stiffness, bone spurs, and inflexibility.
Dr. Berti will recommend various treatments, such as lifestyle
changes, physical therapy, over-the-counter medication such as
acetaminophen or topical analgesics, non-steroidal anti-inflammatory
drugs (NSAIDs), braces, steroid injections in the joint and, if all
else fails, surgery. Lifestyle changes include getting proper rest,
water exercises, changes in diet, losing weight, and rearranging
your home. Dr. Berti will consult with you to determine whether
surgery is the correct route for your improvement.