Q & A with Dr. Michael Sethna

Sethna_Michael_webMichael Sethna, M.D. is a Board Certified Neurologist at Noran Neurological Clinic. In addition, Dr. Sethna spends much of his time researching and diagnosing back and neck pain. Dr. Sethna took the time to do a question and answer session regarding back and neck pain.

What are some possible reasons for back/neck pain?

Although it is easy to understand how a severe accident can cause back or neck pain, back and neck pain often appears in the absence of an obvious triggering event. This probably reflects the fact that as the muscles of the back and neck are in use almost 100% of the time. As these tissues are never truly at rest, even minor back or neck pain can build over time, often to high levels. Many patients get “stuck” in self-sustaining cycles of tight muscles and pain. When these troubles arise as a consequence of a physical injury not associated with damage to the underlying spine, patients are often dismissed as suffering from “soft tissue” injuries alone—as if pain was more real when it arises from the hard tissues of the spine.

The spine itself is a series of block-like bones separated by discs. Were it not for the intervertebral discs, we would not be able to bend or twist our heads or spines. Spinal injuries, except when severe, usually affect the discs much more than the vertebral bones. The tough, leathery outside rim of each disc holds in a jelly-like substance (nucleus pulposis) that serves as a shock absorber between vertebral bones. When a disc weakens with age, or after trauma, disc rims will often bulge out. If the pressure inside a disc becomes extreme (as can happen during physical trauma), or if the rim of the disc becomes very weak, the rim may rip, and disc contents squeeze out, representing a herniated, protruded, ruptured, or “slipped” disc.

What are the symptoms of a herniated disc?

Until they heal, disc herniations can be very painful. Pain is often markedly increased by coughing or straining. If the herniated material contacts one of the nerve roots leaving the spine, in addition to neck or back pain, a patient may suffer pain shooting down an arm or leg. If an existing nerve root is actively compressed by disc material, corresponding muscles in the arm or leg may become weak, and regions of the limb innervated by the compressed nerve may go numb.

What are signs that I would need a doctors’ appointment?

Disc herniation’s in the neck and upper back can be dangerous, as, at times, they can damage the spinal cord. Severe neck or back pain associated with weakness of both legs, or with bowel or bladder dysfunction, is an ominous sign that demands urgent medical assessment. Less serious, but concerning, symptoms that should prompt medical assessment include severe spinal pain with cough or sneeze, and spinal pain associated with limb numbness or weakness.

To learn more about Dr. Sethna, you can visit his Noran bio at http://www.noranclinic.com/providers/michael_sethna.html

If you have any other questions regarding back/neck pain, and would like to schedule an appointment with a neurologist experienced in the management of this condition, please contact Noran Neurological Clinic at 612-879-1500.

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