Spine Disorders
WHEN TO SEE A SPINE
SPECIALIST You should
seek the advice of a spine specialist if neck or back pain persists for more
than two weeks or if it is progressive in intensity and/or distribution. You
should seek immediate healthcare attention if neck or back pain occurs as the
result of an injury or if it is associated with serious illness and/or a high
fever. Additional signs and symptoms which warrant prompt medical attention
include:
SCREENING AND DIAGNOSIS
Mechanical
(orthopedic) tests are performed to purposely stress a spinal nerve to see how
irritable it is. This can be done by applying positions that stretch and/or
compress the nerve. Nerve root
irritability signs can often be elicited prior to the development of obvious
sensory loss, reflex changes, or muscular weakness. Muscle
stretch reflexes also referred to as deep tendon reflexes are used to evaluate
the integrity of the spinal nerves. The muscle stretch reflex is an involuntary
response produced by tapping on a tendon attached to a muscle. Since the reflex response is normally
present in many muscles, its absence is significant and signifies a
neurological problem. Muscle
weakness can develop secondary to spinal nerve compromise. All of the muscles that receive their
nerve supply from a spinal nerve are collectively referred to as a myotome.
Moderate-to-severe radiculopathy is usually associated with some degree of
muscle weakness. In milder cases
of nerve root compromise the only muscle symptoms may be exertional-induced
fatigue and occasional muscle cramping.
Needle electromyography (EMG) is the gold standard for identifying a
loss of nerve supply to muscle (denervation). |