The Spine

The spine is one of the most supportive but complex structures in the human body. It is composed of many bones, discs, and ligaments that support the weight of the body and allow for movement and posture. Due to the fundamental nature of the spine, it is one of the most frequently injured joints and can easily impact activities of daily living.

If you’re experiencing spinal pain, call one of our offices in San Francisco or book an appointment online to get started.

Spine Anatomy

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The spine consists of 24 bones, also known as vertebrae, that are separated into the cervical, thoracic, and lumbar spine. Each of these vertebrae are separated by an intervertebral disc that protects the bones from rubbing against each other and aids in shock absorption. Around each of these structures, there’s a complex set of ligaments and joints that provide structure.

The cervical spine, also known as the neck, has 7 vertebrae (C1-C7). After the cervical spine are the 12 thoracic vertebrae (T1-T12) that comprise the mid-back. Finally, the lower back, or lumbar spine has 5 vertebrae (L1-L5) followed by the sacrum and coccyx, also known as the tailbone. A healthy functioning spine typically has an S-shaped curve to allow for proper range of motion of the back.

What causes spinal pain?

What causes spinal pain?

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Neck and back pain are some of the most commonly treated conditions in orthopedics. They vary from simple muscular pain that can come from a muscle spasm, exercise, poor posture, or stress to more complex issues such as fractures of the vertebra or a herniated disc. These can present as localized neck and back pain or radiating pain down the arm or leg.

Common Conditions

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Neck and back pain are quite commonly due to a muscular cause, especially in a younger population. Muscular pain can be caused by a muscle spasm or strain that results in acute stiffness or pain in the neck or back. Additionally, poor posture (especially in a work setting), repetitive use, and stress can be causes of chronic neck or back pain. These are diagnosed with a physical examination by a provider. There are various treatments including physical therapy (to work on posture and muscular strengthening), ergonomic work setups, and stress reduction techniques. Medications such as anti-inflammatories and muscle relaxants are also commonly used.

The intervertebral discs (cartilaginous discs between the vertebrae) can bulge out or herniate, causing a significant amount of back pain. This is typically due to a combination of osteoarthritis in the spine (degenerative disc disease) and repetitive torsional stress put on the spine. This can cause local pain in the neck or back, but also frequently causes pain that radiates down the arm or legs (sciatica). Most patients will improve with non-surgical treatment including rest, anti-inflammatories, and physical therapy exercises that strengthen the back, neck, and core. X-rays and MRIs can be done to confirm the diagnosis but in many cases are not necessary. For more severe cases that are not improving with conservative treatment a steroid injection can be done in the area or a referral can be sent to spine surgery for surgical management.

Disc herniations can vary from mild herniations that can be treated conservatively to cases that need immediate surgical management. We recommend seeking advice from a professional immediately after experiencing radiating pain.

The spine has many intricate structures including vertebrae, intervertebral discs, ligaments, and nerves. With age, these can wear or change positions causing neck or lower back pain. Spinal stenosis is a condition that is caused by a ligament that hypertrophies, causing a narrowing of the spinal canal. Spondylosis is a condition caused by age-related changes to the vertebrae that cause them to move slightly forward or backward. Each of these are quite complex disorders. They are typically diagnosed with a physical examination and, when needed, imaging including X-ray and MRI.

Spinal Stenosis and Spondylosis are both conditions that vary in severity and therefore the treatment varies as well. Typically, they can be treated with conservative measures including rest, anti-inflammatories, oral steroids, and physical therapy. For more complex cases that are refractory to conservative measures, surgery can be done to decompress these areas and aid in pain relief.

Treatment

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At Pacific Crest Orthopedics we customize a treatment plan to meet your individual needs. Most conditions in the spine can be treated with conservative measures including physical therapy, medication management, and activity modification. We also work with you to discuss whether imaging, including X-rays and MRIs, are right for your condition, and order them when needed. For more complex cases where surgery or local corticosteroid injections are indicated as the best option, we work with some great spinal surgeons in the Bay Area to get you in for an appointment as quickly as possible.

Ephraim Dickinson, MD at Pacific Crest Orthopedics has extensive experience treating your neck and back pain and providing therapies to prevent future problems and to keep you active and healthy. Don’t continue to suffer from spine-related pain. If you have questions about your back or neck pain, call Pacific Crest Orthopedics in San Francisco or use the online booking tool to schedule an appointment today.

Need Immediate Care?

If you’re in need of immediate care, please visit one of our Walk-In locations.

Real Stories, Real Recovery.

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“Dr. Dickinson has been super helpful in my recovery and truly cares about the patient in getting back to full range of motion. Great team all around – I highly recommend!”

Chad W.
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Terry B.

“Amazing from the time i walked in the door until the time i left. Everyone is so helpful and a joy to work with. I got the treatment i need fast and efficiently. This place is a must go to when to need to be seen urgently. Skip the ER if they can see you!”

May 28, 2024

Melanie M.

“Loved how accessible this clinic was and how easy it was to book. I looked everywhere for an ortho to see me for days and couldn’t find one available or who look at back issues, and with them I was able to book a same day appointment and got answers to my problems during that one visit. I was seen by Brianna and she was great. She talked me through everything and explained things easily to me where I felt very comfortable and trusting in her diagnosis.”

May 28, 2024

Robert Z.

“Dr. Halbrecht is an extremely talented and professional physician. He takes time to explain all medical terms and procedures and listens to all questions and concerns.”

Apr 4, 2024

Allyssa J.

“Great service: very professional, nice office and location, and excellent staff. I fractured my foot, and they took great care of me!”

Apr 2, 2024

Frank T.

“Great service: very professional, nice office and location, and excellent staff. I fractured my foot, and they took great care of me!”

Apr 2, 2024

Katherine B.

“I came to the office with a huge pain. Dr Ephraim Dickinson not only quickly assist my problem and gave me the treatment plan. He was very nice and explain everything clear and answer all my questions. I recommend Dr. Dickinson and his office!”

Mar 20, 2024

Don’t Wait to Get the Care You Need.
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Don’t Wait To Get The Care You Need. Fix What Hurts, Fast.