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Patient Education


What is Spondylolisthesis?

Spondylolisthesis is a condition in which a vertebra in the spine slip out of the proper position onto the bone underneath it. In children, spondylolisthesis usually takes place between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area. It is frequently a result of a birth defect in that area of the spine or sudden injury (acute trauma). In adults, the most common trigger is abnormal wear on the cartilage and bones (such as arthritis). Bone disease and fractures can also produce spondylolisthesis. Certain sport activities, like gymnastics, weight lifting, and football, put a large amount of strain on the bones in the lower back. They also require that the athlete constantly overstretch (hyperextend) the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can trigger a spinal bone to become vulnerable and move out of place.SymptomsSpondylolisthesis may range from mild to severe. An individual with spondylolisthesis may have no symptoms. The condition can produce increased lordosis (also called swayback), but in later stages may result in kyphosis (roundback) as the upper spine slips off the lower spine.Symptoms may include things like:

  • Lower back pain
  • Muscle tightness (tight hamstring muscle)
  • Pain, numbness, or tingling in the thighs and buttocks
  • Stiffness
  • Soreness in the area of the slipped disc
  • Weakness in the legs

Exams and Tests

Your doctor or nurse will examine you and feel your spine. You will be asked to raise your leg straight out in front of you. This may feel uncomfortable or painful. X-ray of the spine can indicate if a bone in the spine is out of position or broken.


Treatment procedures depend on how severe the slippage is. Many patients get better with exercises to stretch and develop lower back muscles. If the slippage is not serious, you can play most sports if there is no pain. Much of the time, you can restart activities slowly. You may be asked to avoid contact sports or to adjust activities to protect your back from being overextended.

You will have follow-up x-rays to make sure the issue is not getting worse.

Your healthcare provider may additionally recommend:

  • Back brace to limit spine motion
  • Pain medicine
  • Physical therapy

Surgical treatment may be needed to fuse the slipped vertebrae if you have:

  • Severe pain that does is not better with treatment
  • A severe slip of a spine bone
  • Fatigue of muscles in one or both of your legs

There is a potential of nerve trauma with these types of procedures. However, the results can be very successful.

Spinal Stenosis

What is Spinal Stenosis?

Spinal stenosis is a narrowing of the open spaces within your spine, which can place stress upon your spinal cord and the nerves that travel through the spine. Spinal stenosis takes place most frequently in the neck and lower back.While some individuals have no signs or symptoms, spinal stenosis can result in pain, numbness, muscle weakness, and problems with bladder or intestinal function.Spinal stenosis is most commonly caused by wear-and-tear changes in the spine associated with aging. In severe cases of spinal stenosis, doctors may suggest surgery to produce extra room for the spinal cord or nerves.

Spinal Stenosis (Cervical)

What is Spinal Stenosis (Cervical)?

Cervical spinal stenosis is the constricting of the spinal canal in the neck. The spinal canal is the open area in the bones (vertebrae) that make the spinal column. The spinal cord is a group of nerves that run through the spinal canal from the base of the human brain to the lower back. These nerves allow you to feel, to move, and to control the intestinal, bladder and various other body functions. In cervical spinal stenosis, the spinal canal narrows and can pinch and compress the nerve roots exactly where they exit the spinal cord, or it may irritate or injure the spinal cord itself. The seven vertebrae between the head and the chest compose the cervical spine. Squeezing the nerves and cord in the cervical spine can change specifically how the spinal cord functions and can trigger tightness, pain, and numbness in the neck, hands, and legs.What causes cervical spinal stenosis?Cervical spinal stenosis is usually caused by age-related changes in the structure of the spinal canal, and so is most common in people older than age 50. The aging process can cause a “bulging of the discs”, when the spongy discs between the bones of the spine bulge out farther than normal, or a thickening of tissues that connect bones (ligaments). Aging can additionally lead to break down of tissues that cover bones (cartilage) and excessive expansion of the bones in joints. These conditions can reduce the area within the spinal canal (spinal stenosis).Numerous people older than age 50 have some narrowing of the spinal canal but do not display symptoms. Cervical spinal stenosis does not trigger symptoms unless the spinal cord or nerves becomes compressed.

What is Scoliosis?

Scoliosis is a sideways curvature of the spine that occurs frequently during the growth period slightly before puberty. While scoliosis can prove to be brought about by conditions such cerebral palsy and muscular dystrophy, the trigger of most scoliosis cases is unidentified.Most cases of scoliosis tend to be mild, but some children develop spine deformities that manage to get a bit more severe as they grow. Severe scoliosis can become disabling. An severe spinal curve can reduce the amount amount of space within the chest, making difficult conditions for the lungs to function well.Young children who have minor scoliosis tend to be monitored closely, usually with X-rays, to see if the curve is getting worse. In numerous instances, no treatment is required. Some children will need to wear a brace to stop the curve from worsening. Others may need an operation to keep the scoliosis from worsening and to straighten severe instances of scoliosis.
Post Laminectomy Syndrome

What is Post Laminectomy Syndrome?

Failed back syndrome (FBS) pertains to chronic back and/or leg discomfort that happens after spinal surgery. Multiple aspects can contribute to the onset or development of FBS. Contributing aspects include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure level on a spinal nerve, diminished joint mobility, joint hypermobility with unstableness, scar tissue (fibrosis), major depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be prone to the development of FBS because of systemic disorders such as having diabetes, autoimmune disease and peripheral blood vessels (vascular) disease. Cigarette smoking can slow the patient’s recovery from this kind of surgery.Typical symptoms connected with FBS consist of diffused, dull and aching pain affecting the back and/or legs. Abnormal sensibility may entail acute, pricking, and stabbing pain in the extremities. Failed Back Syndrome should be evaluated and treated with an interdisciplinary strategy by a group of healthcare experts from diverse fields working together towards a common mission for the good of the individual. The therapeutic approach to FBS may range from non-surgical to surgical intervention. The term “post-laminectomy syndrome” is used by some medical professionals to imply the same condition as failed back syndrome.
Lumbar Radiculopathy/Sciatica

What is Lumbar Radiculopathy/Sciatica?

Lumbar radiculopathy is recognized by leg problems and potentially tingling, numbness or weakness that exists from the low back through the buttock and down the large sciatic nerve in the back of the leg. Many patients with sciatic nerve discomfort encounter improvement over time and choose not need surgical treatments. For other people, however, sciatica can be serious and crippling.Radiculopathy, means that a disc has protruded from it is normal place in the spine and is placing pressure level on the nerve root in the lower back, which ultimately forms a section of the sciatic nerve. Sciatica is only a symptom of an issue of something compressing or aggravating the roots that comprise the sciatic nerve, rather than an actual medical diagnosis or medical disorder. This can be an important distinction because it is the actually problem that often demands to be managed so that sciatic nerve pain can be eliminated. Common causes of sciatica are spinal stenosis, degenerative disc disease, lumbar herniated disc or spondylolisthesis.Sciatica happens frequently in many individuals between 30 and 50 years of age. Frequently a specific event or injury doesn’t cause sciatica. Sciatica is likely to develop as an outcome of wear and tear on of the lower spine and their tissues.
Herniated Disc

What is a Herniated Disc

A herniated disc pertains to a issue with one of the spongy cushions between the vertebrae that stack to make up your spine.A spinal disk is a little like a jelly donut, with a softer location encased within a hard exterior. Occasionally, known as a slipped disk or a ruptured disk, a herniated disk unfolds whenever some of the “jelly” leaks out through a split in the hard exterior.A herniated disc can irritate close nerves and result in sharp discomfort, tingling or weakness in an arm or leg. In other situations, numerous men and women encounter no symptoms from a herniated disk. Many people who have a herniated disc don’t require operation to resolve the issue.
Herniated Disc (Cervical)

What is a Herniated Disc (Cervical)

Arm discomfort from a cervical herniated disc is one of the much more common cervical spine conditions. It generally develops in the 30 – 50 year old demographic. Although a cervical herniated disc may come from some type of injury to the spine, the symptoms commonly initiate unexpectedly.The arm discomfort from a cervical herniated disc results because the herniated disc material presses on a cervical nerve, causing problems to radiate along the nerve pathway down the arm. Along with the arm discomfort, numbness and tingling exist in the arm and into the fingertips. Muscle weakness may be present as a result of a cervical herniated disc.

What is Fibromyalgia?

Fibromyalgia is a disease characterized by body-wide musculoskeletal problems accompanied by exhaustion, sleep, memory and mood instabilities. Experts understand that fibromyalgia amplifies painful sensations by altering the method by which your brain deals with pain signals.Symptoms sometimes begin after a physical injury, medical procedure, infection or significant psychological trauma. In a variety of situations, symptoms progressively gather over duration without an activating event.Women are significantly more susceptible to fibromyalgia than are men. Those with fibromyalgia may also have tension headaches, temporomandibular joint (TMJ) disorders, irritable intestinal syndrome, anxiety and misery.While there is in fact no treat for fibromyalgia, a wide variety of medications can assist in controlling symptoms. Workout, relaxing and stress-reduction steps also may assist.
Facet Joint Syndrome

What is Facet Joint Syndrome?

The facet joints connect the bones of the spine. The nerve roots then pass through these joints into the hands, legs and different parts of the body.These joints enable the spine to bend and twist, and they keep the back from slipping too far ahead or twisting without limits. Like the knee joint, they have cartilage to enable smooth motion in which two bones meet. The joints tend to be lined with the synovium and have lubricating joint fluid.These joints may get inflamed because of injury or joint disease causing pain. If the suffering joint is in the neck, it may trigger headaches and difficulty moving the head. If the problem is in the back, it will cause discomfort in the lower back, buttocks or thighs.Symptoms –Men and women with this condition usually complain that they have to turn their complete body to look to the left or right. The discomfort and tightness associated with this condition can prepare it difficult to stand up directly or get out of a chair. The patient may walk in a hunched over manner. The particular symptoms are determined by the the specific joint and where it is located.If the facet joint becomes too inflamed and enlarged, it may block the openings through which the nerve roots pass, causing a pinched nerve. This condition is labeled facet hypertrophy.Treatment –A shot of steroids into the facet joints can assist soothe discomfort for a long period of time and help reduce swelling. Different conventional ways consist of anti-inflammatory medication, physical therapy or the or using braces.For long-term relief and in a bit more extreme instances, cutting the anterior or posterior spinal nerve roots may be done. Different surgical interventions could be effective in alleviating problems.
Degenerative Disc Disease

What is Degenerative Disc Disease?

Degenerative disc disease is not really a disease but a term utilized to describe the way your spine changes as you age. Spinal discs tend to be smooth, compressible discs that separate the interlocking vertebrae the spine is comprised of. The discs act as springs for the vertebrae, allowing the spine to flex, bend, and twist. Degenerative disc disease can affect different spots throughout the spine, but it generally frequents the discs in the lower back (lumbar area) and the neck (cervical area).
The changes in the discs can result in back or neck discomfort and/or: 

  • Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions joints.
  • Herniated disc, an abnormal bulge or breaking open of a spinal disc.
  • Spinal stenosis, the narrowing of the spinal canal, the open area in the spine that holds the spinal cord.

What causes degenerative disc disease?

As you age, your spinal discs break up, or degenerates, which may result in degenerative disc disease in some people. These age-related changes may include:

  • Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions joints.
  • Herniated disc, an abnormal bulge or breaking open of a spinal disc.
  • Spinal stenosis, the narrowing of the spinal canal, the open area in the spine that holds the spinal cord.

These changes are a bit more probably to happen in men and women which smoke cigarettes and those whom have jobs that require heavy lifting. Overweight are also a bit more probably to have symptoms of degenerative disc disease. An injury leading to a herniated disc man additionally start the degeneration process.

As the area between the vertebrae gets thinner, there is less padding between them, and the spine becomes weaker. The body responds to this by constructing bony growths named bone spurs (osteophytes). Bone spurs can place pressure level on the spinal nerve roots or spinal cord, resulting in intense pain and negatively impacting nerve function.

What tend to be the symptoms?

Degenerative disc disease may result in back or neck discomfort, but this changes from person to person. Numerous men and women have no discomfort, while many with than exact same level of disc damage have severe discomfort that limits their activities. Exactly where the discomfort happens depends on the location of the suffering disc. An suffering disc in the neck area may result in neck pain, while an affected disc in the lower back may result in hurt in the back, buttock, or leg. The hurt frequently gets even worse with movements these types of as bending over, gaining up, or twisting. The discomfort may begin after a major injury (like an auto crash), a minor injury (like a small fall), or a normal movement (like picking something up incorrectly). It may additionally begin progressively for no known reason and get even worse over as time passes.

How is degenerative disc disease diagnosed?

Degenerative disc disease is diagnosed with a medical history and physical exam. Your medical provider will ask about your symptoms, injuries or diseases, any preceding procedures, and practices and activities that may have caused pain in the neck, hands, back, buttock, or leg. During the physical exam, your health care provider will:

  • Check the range of movement and pinpoint the exact location of the pain.
  • Check for areas of tenderness, numbness, tingling, or weakness in the suffering area, or changes in reflexes.
  • Have a look at for different conditions, like bone fractures, tumors, and infection.

If your examination doesn’t reveal anything, imaging tests, like an X-ray, generally will not reveal anything else. Imaging tests may be considered whenever your symptoms develop after an injury, nerve damage is suspected, or your medical history show a propensity towards conditions that could affect your spine, like bone tissue disease, tumors, or infection.


What is a Concussion?

A concussion is a traumatic head injury that adjusts the way your brain functions. Symptoms tend to be usually temporary, but can consist of trouble with headache, focus, memory, judgment, balance and coordination.

Although concussions usually result in by a blow to the head, they may additionally manifest whenever the head and upper body are violently shaken. These injuries can result a reduction of awareness, but most concussions don’t. Because of this, some patients have concussions and don’t understand it.

Concussions tend to be common, very common if you play a contact sport, such as rugby. It is important to note that every concussion injures your mind to some extent. This injury demands duration and rest to heal properly. Luckily, many concussive traumatic mind injuries tend to be minor, and those usually recover completely.

Complex Regional Pain Syndrome

What is Complex Regional Pain Syndrome (CRPS)?

Complex regional pain syndrome is an unusual form of repeated discomfort that usually affects an arm or leg. Complex regional pain syndrome typically develops after an injury, operation, stroke or cardio battle, but the discomfort is out of symmetry to the severity of the initial injury, if any.

The result of complex regional pain syndrome isn’t clearly understood. Procedures for complex regional pain syndrome is effective when started early. In these incidences, improvement and additionally remission tend to be possible.


What is Coccydynia?

Coccydynia is pain in or around the area of the coccyx, additionally labeled the tailbone.


Many times, the trigger of coccydynia is unidentified (“idiopathic”). Some other causes offer trauma (for example, from falls and childbirth); abnormal, excessive mobility of the tailbone; and – very seldom – infection, tumor, or fracture.

Signs Or Symptoms:

The classic symptom is pain whenever pressure is used on the tailbone, such as after seated on a firm chair. Symptoms usually improve with relief of pressure level whenever walking or hiking.

Different symptoms:

  • Immediate and serious hurt after moving from seated to standing
  • Problems during intestinal movements
  • Hurt during sex
  • Deep ache in the area of the tailbone


A detailed medical history and physical exam are essential. It is important to note any specific injury, whether latest or in the remote past. A history of prolonged labor or childbirth injury should be noted. A detailed inspection/palpation of this area is required to detect any abnormal lumps or abscesses (problems).

A lateral X-ray of the coccyx is given to assist detect any significant coccygeal pathology, like a fracture. Your wellness care provider might order more tests: CT scan, magnetic resonance imaging (MRI), or a bone scan of this area if this is clinically required.


Procedures most often is conventional and comprises of non-steroidal anti-inflammatory medication (NSAIDs) like ibuprofen and naproxen to decrease inflammation, and the use of a therapeutic seated cushion to take the pressure level off of the tailbone when sitting. It might require numerous days or months of traditional procedures before significant problems relief is actually felt.

Your wellness care provider might give consideration to physical therapy to treat coccydynia. This might offer workout to elongate the ligaments — the tissue that connects bone to bone in a joint — and strengthen the supporting muscles. Modalities these as temperature, massage, and ultrasound might additionally be utilized.

Coccygeal manipulation is utilized to move the coccyx into the proper position and relieve discomfort. Coccygectomy or an operation to remove the coccyx is considered in uncommon cases, and just in very serious circumstances, whenever extensive conventional control does not control the pain of coccydynia. The main risks with surgery tend to be infection and wound healing problems. There is a danger that the procedures will not result in the problems relief.

Cervical Radiculopathy

What is Cervical Radiculopathy?

Cervical Radiculopathy sometimes known as a pinched nerve starts whenever too a great deal pressure level is used to a nerve by surrounding tissues — such as bones, cartilage, muscles or tendons. This pressure level disrupts the nerve’s function, causing problems, tingling, numbness or weakness.

A pinched nerve can happen at some spots in the body. A herniated disc in your lower spine, for example, may place pressure level on a nerve root, causing hurt that radiates along the back of your leg (sciatica). Likewise, a pinched nerve in your wrist can lead to hurt and numbness in your hand and fingers (carpal tunnel syndrome).

With sleep and some other remedies, many patients recover from a pinched nerve within a couple of days or weeks. Occasionally, procedures are essential to soothe problems from a pinched nerve.

Anatomy of the Spine

What is the Anatomy of the Spine?

The typical anatomy of the spine is normally described by splitting up the spine into 3 major sections: the cervical, the thoracic, and the lumbar spine. (Below the lumbar spine is a bone labeled as the sacrum, and is functionally part of the pelvis). Each part is composed of its own bones called vertebrae. There are 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae in the human spine.

A vertebra is composed of several parts. The body of the vertebra is the main area of body weight bearing and creates a resting spot for the fibrous discs, separating each of the vertebrae. The lamina covers the spinal canal, the big hole within the location of the vertebra through which the spinal nerves pass. The spinous procedure is definitely the bone tissue you can easily become whenever running your hands down your in return. The paired transverse processes tend to be driven 90 levels to the spinous process and offer attachment for in return muscles.

These interlock because of the neighboring vertebrae and supply stability to the spine. The vertebrae are really separated by intervertebral discs acting as cushions from the bones. Each disk is composed of two parts. The solid, strong exterior layer also known as the annulus surrounds a soft, wet structure called the nucleus. Whenever a disc herniates or ruptures, the delicate nucleus spurts out through a tear within the annulus, and can compress a nerve root. The nucleus can squirt out on either part of the disk or in some situations both sides.

About Temecula Pain Management

For over a decade, Temecula Pain Management has been proudly serving the Inland Empire through advanced procedural techniques and medicines to help those in need to function better and once again enjoy life. Our highly trained and certified staff have received numerous awards and commendations as leaders in the field of pain management. When you are here, you are family, and as a family member, we will ensure we do everything in our power to help you live a happy and pain-free life.