Calcitonin is a hormone secreted by the thyroid gland that reduces calcium and phosphate levels in the blood.
Calcitonin does this by reducing calcium absorption in the intestines, which leads to more calcium storage in bones and increased calcium excreted through the kidney.
Calcitonin also strengthens bones by keeping osteoclasts from resorbing bone. Because it is also a pain reliever, calcitonin is often prescribed as a medication for patients with osteoporosis and vertebral fractures.
The mesh-like spongy tissue typically found at the core of vertebral bones in the spine, and the ends of the long bones (femur, thigh bone), is called cancellous bone.
Cancellous bone resembles a honeycomb -- but instead of being filled with honey, the interconnecting spaces contain bone marrow.
Cancellous bone marrow supplies osteoprogenitor cells that help stimulate new bone growth. For this reason, bone grafts using cancellous bone are sometimes used in procedures to promote osteogenesis.
Connective tissue surrounding the ends of bones that allow for smooth joint articulation (movement) is called cartilage. This thick, elastic tissue helps to support and cushion the joints.
Cartilage is composed mostly of water but also contains collagen and proteoglycans. Tissue cells that make up cartilage are woven into compact matrices (lacunae) that allow the cartilage to bear tension and pressure.
This tissue may degenerate over time due to wear and tear, often referred to as osteoarthritis.
CAT Scan (Computer Assisted Tomography)
A test that allows the spinal canal to be imaged and evaluated for specific conditions is called a CAT scan (also called a CT scan).
CT scans are performed by shooting an x-ray beam at more than 100 points throughout the body and recording the absorption rates of the various tissues and bone. The scans’ output includes pictures of cross-sections of the body parts being evaluated.
In the spine, CT scans provide excellent visuals of tiny details, like fractures, that are not visible using conventional techniques.
The bundle of nerve roots stretching from the lumbar and sacral levels, then branching off the bottom of the spinal cord, is called the cauda equina. The Latin phrase translates to “horse’s tail” which describes the shape of the nerve bundle.
The cauda equina begins where the spinal cord ends. The spinal cord does not actually extend down the entire length of the spine but only reaches through the top of the lumbar spine.
Starting at this level, the nerves and nerve roots comprising the cauda equina continue down the length of the vertebral column. These nerves provide motor and sensory function to body parts including the legs and bladder.
Cauda Equina Syndrome
When a herniated disc compresses nerve roots in this area -- resulting in low back pain, incontinence and loss of motor and sensory function in both legs -- the condition is called cauda equina syndrome.
Clear, nutrient-rich fluid that courses through the brain and spinal cord is called cerebrospinal fluid -- or CSF.
This fluid is produced by the brain and fills its cavities, as well as those located in the spinal canal. CSF contains nutrients important for brain and spinal cord functioning; it cushions both structures; and is vital for removing cellular waste.
Neurotransmitters and hormones travel through CSF, transmitting messages throughout the central nervous system about things like temperature changes in the brain.
Extracting CSF during a spinal tap procedure (inserting a needle into the spine between two vertebrae) can help to identify infections and neurological disorders like meningitis and multiple sclerosis.
The shock-absorbing, soft pads between vertebrae in the cervical spine (neck area) are called cervical discs. This area of the spine is comprised of six discs.
With time and age, cervical discs tend to degenerate. Some patients experience symptoms while others do not.
In many cases, cervical degenerative disc disease causes pain and can include a stiff neck, numbness, tingling and weakness that may radiate out from the neck to the shoulders and arms.
NSAIDs, physical therapy, exercise and chiropractic care may help with symptoms associated with a degenerated cervical disc, but if the patient does not respond to these interventions over time neck surgery may be necessary.
Compression on the cervical spinal cord due to a disc herniation or cervical spinal stenosis is called cervical myelopathy.
Cervical myelopathy tends to develop over time and, as such, is more common among the elderly population.
Symptoms of cervical myelopathy include inability to coordinate the hands, a heavy feeling in the legs, or numbness and tingling in the legs.
Compression and irritation of a nerve root in the neck is called cervical radiculopathy. It is typically caused by cervical disc herniation or slippage from its normal position in the spine.
Symptoms include pain, numbness and/or tingling in the arm that may extend to the hand and fingers. Which area of the cervical spine is affected determines the specific neurological symptoms.
The cervical spine, also known as the neck, connects the spine to the skull. Seven vertebral bodies (C1-C7) comprise the cervical spine. This region constitutes the uppermost part of the spine.
When the neck region of the spine is compressed due to age-related degenerative changes it is called cervical stenosis. In many cases, this condition is asymptomatic, meaning the condition exists but there are no noticeable symptoms.
In other situations cervical stenosis may result in symptoms like shooting pain in the arms and legs, slowed gait, fine motor skill deterioration, arm pain and/or a heavy feeling in the legs.
Cervical spinal cord dysfunction that is progressive (cervical stenosis with myelopathy) may warrant surgery.
The seven cylindrical bones (C1-C7) that provide support and structure for the cervical spine are called cervical vertebrae.
These bones, also called vertebral bodies, form a large portion of the bone that lies in front of the spinal cord. The vertebrae near the base of the skull are the smallest in this region -- and only the top two segments actually rotate the neck.
Cervical spine segments have openings that allow arteries to carry blood to the brain.
Chemonucleolysis involves injecting an enzyme into the inner part of the spongy discs residing between vertebrae. The goal of this non-surgical treatment is to dissolve the inner part of the disc, called the nucleus pulposus.
One reason for dissolving the nucleus pulposus is to relieve pressure on the spinal nerve, which may be the result of displaced disc material.
When chemonucleolysis works successfully to alleviate back pain from a bulging disc, it obviates the need for more invasive measures such as spinal fusion.
Chemonucleolysis is controversial because its efficacy has not been conclusively determined and serious complications such as paraplegia, subarachnoid hemorrhaging, and adverse reactions to the enzyme being injected may occur.
In the United States, chemonucleolysis is approved only for use in the lumbar spine. Complications associated with the procedure have rendered the procedure largely unavailable in the U.S.
Chiropractic adjustment is a common way chiropractors treat back and neck pain. Chiropractic adjustments are a way of manipulating the spine based on ancient practice. The goal is to restore the spine’s structural integrity and relieve pain. Chiropractic adjustments involve “popping” joints in a way that sounds painful but often is not.
A chiropractor diagnoses and treats back and neck pain and, for some, is the first doctor a patient visits when experiencing pain in these regions.
Also known as a doctor of chiropractic, a chiropractor diagnoses and treats problems associated with the body's muscular, nervous, and skeletal systems, especially the spine.
Chiropractors may also use water, light, massage, ultrasound, electrical and heat therapy, straps, taping and braces to treat back pain.
Chiropractic doctors do not prescribe medications.
Pain that lasts for more than three months is called chronic pain.
Pain is expected to stop once the underlying cause is treated, however chronic pain can persist for no apparent biological reason even after injuries heal. This type of unremitting pain may become progressively worse over time.
Low back pain, headache and arthritic pain are the most commonly reported sources of chronic pain.
Chronic pain is a significant reason reported for long term disability and can have significant psychological and emotional ramifications.
A study designed to test the safety and efficacy of a new drug, device or treatment on humans is called a clinical trial.
Clinical trials involve volunteers whose participation is based on specific inclusion/exclusion criteria such as age, gender, type or stage of disease, treatment history and other medical conditions.
Clinical trial participants may gain access to new treatments before they are available to the public. However, many trials are "randomized," meaning participants may receive the treatment being tested or they may get a placebo, which means not all participants will receive the drug or device being studied.
Trial participants do run the risk of serious or life-threatening side effects to any new treatment. In the United States, clinical trials are overseen by the Food and Drug Administration (FDA) before being made available for general use in healthcare.
Cobalt-chrome is a mix of metals used in many surgical implants. This metal is the preferred material for implant surgeries because it is tolerated well by the body. Cobalt-chrome may be used in the spine alongside artificial disc replacement devices.
Coccydynia is pain originating in the tailbone. Trauma to the tailbone from falling or during an event such as childbirth may lead to coccydynia.
Pain resulting from this condition is thought to be caused by an unstable coccyx, which leads to chronic inflammation of the sacro-coccygeal joint. Women are much more likely to experience coccydynia because their pelvis is wider, which makes the coccyx more exposed.
Coccydynia can be treated with anti-inflammatory drugs, injections, or a special type of pillow called a "donut.” More severe cases may require the coccyx to be removed (coccygectomy).
The coccyx is the bottommost part of the spine consisting of four or more very small bones that are fused together. It is commonly referred to as the “tailbone” because it represents a vestigial tail.
Cognitive restructuring involves altering brain pathways by recasting stressful thoughts into less stressful terms.
Individuals use psychotherapeutic techniques to identify stress-producing thoughts and then modify those unhealthy thought patterns. This process is thought to reduce stress and physical ailments related to it.
Cognitive restructuring is used to treat chronic pain that may be fueled by negative thoughts and emotions.
Collagen is a fibrous protein that forms connective tissue. It acts as a glue that holds tissues together and is an essential part of bone, tendons, ligaments and cartilage.
Collagen is inelastic but has considerable ability to resist stretching. It is also responsible for making the skin elastic; aging skin is due to collagen that is degrading.
A bone that is broken or splintered into more than two fragments is a comminuted fracture. This type of fracture tends to occur after high-impact trauma such as a car accident.
Splints and casts are usually not enough to treat this type of fracture. Repairing a comminuted fracture often requires surgery to restructure the bone.
see Alternative Medicine
When nerve roots in the spinal cord are irritated or pinched they are considered compressed. Sciatica is one condition that involves this type of compression.
In the back, the nerves most often compressed are located at the very bottom of the low back. Low back nerve compression causes pain to radiate out to the buttocks and the back of the thigh and calf, and may extend all the way down to the foot.
Nerve compression in the neck may radiate down the arm.
Numbness, tingling, and burning or prickling sensations are also symptoms of this condition.
When bone collapses, particularly in short bones such as the vertebrae in the spine, it is called a compression fracture.
Osteoporosis most often causes this condition but it may also occur due to back trauma resulting from, for example, a car accident. A compression fracture typically causes pain in the area of the fracture -- and sometimes causes no symptoms at all.
Multiple compression fractures can result in shortened height and kyphosis, a forward curvature of the spine resembling a hump. Compression fractures are most common in older adults, particularly women.
Treatment for a compression fracture tends to be non-surgical, but surgery is sometimes indicated.
see Compressed Nerve
A medical condition that is present at or before birth is called a congenital disorder. Congenital conditions may occur during development in utero or because of genetic issues from the parents.
Congenital disorders are not always hereditary, since infections during pregnancy or injury to the fetus at birth can cause them.
Spina bifida, or the underdevelopment of the lamina (bony arch) is the most common congenital disorder.
Conservative treatments emphasize non-aggressive (typically meaning non-surgical) treatment for back and neck pain. Physical therapy, medication and injections are examples of conservative treatments.
The first line of treatment for back and neck pain tends to involve using several conservative treatments at once to alleviate pain and rehabilitate the patient.
Low back pain is a condition in which conservative treatments are the norm -- with surgery recommended only when all conservative treatment options, over a long period of time, have been exhausted.
Emergency situations often require circumventing conservative treatments.
A surgical procedure involving cutting the nerves of the spinal cord to relieve pain is called a cordotomy. Cutting these selected nerves blocks pain sensation and sometimes temperature perception.
Patients with severe cancer-related pain or pain associated with other non-curable diseases are candidates for cordotomy.
Cordotomy may be performed using a combination of local anesthesia and fluoroscopic guidance, or in concert with laminectomy surgery to access the nerves of the spinal canal.
A surgical procedure to remove a vertebral body is called a corpectomy.
Vertebral bodies and discs are removed during this procedure to alleviate pressure on the spinal cord. A bone graft is then inserted into the space in order to fuse the separate bone segments into one long bone.
This procedure may be used treat fractures, tumors, infections or spinal deformities.
The dense outer surface of bone that protects the internal cavity is called cortical bone.
This type of bone makes up nearly 80% of skeletal mass and is important for body structure and weight bearing because it is highly resistant to bending and torsion.
Cortical bone in the spine, arms and legs is susceptible to damage by trauma or bone diseases like osteoporosis. Cortical bone grafting may be used to treat weakened cortical bone by using synthetic bone material and other surgical implants to reinforce weakened areas of the bone.
The rib joints connecting each rib to vertebrae in the upper back are called costotransverse and costovertebral joints. These joints create stability in the upper back and chest wall. They are supported by ligaments, which strengthen the junction of bones and limit motion in the upper back.
Abnormal motion or dysfunction in these joints may result in upper back pain. The source of the pain is often diagnosed with a costovertebral joint injection.
A relatively new class of non-steroidal anti-inflammatory drugs (NSAIDs) that targets the COX-2 enzyme are called COX-2 inhibitors. They work by stifling inflammation, a common underlying cause of back pain and other types of chronic pain.
The main advantage of COX-2 inhibitors over traditional NSAIDs is they block the action of a specific enzyme associated with inflammation, fever and pain without causing side effects associated with traditional NSAIDs.
As a result, COX-2 inhibitors are often used to treat chronic pain-related inflammation with less risk of gastrointestinal complications. COX-2 inhibitors are only available by prescription and have their own unique potential risks and complications.
Craniosacral therapy is a pain management technique focused on the membranes and cerebrospinal fluid surrounding the brain. It is a combination of alternative healing practice and traditional cranial osteopathy. With this technique the head and spine are massaged with the goal of releasing tension.
Trained chiropractors and physical therapists use craniosacral therapy to treat pain from spine-related problems -- including certain types of neck and back pain -- and brain and spinal cord injuries.
Craniosacral therapy is based on the theory that releasing built up tension in the craniosacral system should improve central nervous system function.
- Cancellous Bone
- CAT Scan (Computer Assisted Tomography)
- Cauda Equina
- Cauda Equina Syndrome
- Cerebrospinal Fluid
- Cervical Disc
- Cervical Myelopathy
- Cervical Radiculopathy
- Cervical Spine
- Cervical Stenosis
- Cervical Vertebrae
- Chiropractic Adjustment
- Chronic Pain
- Clinical Trial
- Cognitive Restructuring
- Comminuted Fracture
- Complementary Medicine
- Compressed Nerve
- Compression Fracture
- Compressive Pain
- Congenital Disorder
- Conservative Treatment
- Cortical Bone
- Costovertebral Junction
- COX-2 Inhibitor
- Craniosacral Therapy