Lordosis

Spinal Diseases

Skeletal spine

Lordosis Lordosis is an increased curving of the spine.

Considerations

The spine has three types of curves:

Kyphotic curves refer to the outward curve of the thoracic spine (at the level of the ribs).

Lordotic curves refer to the inward curve of the lumbar spine (just above the buttocks).

Scoliotic curving is a sideways curvature of the spine and is always abnormal.

A small degree of both kyphotic and lordotic curvature is normal. Too much kyphotic curving causes round shoulders or hunched shoulders (Scheuermann's disease).

Too much lordotic curving is called swayback (lordosis). Lordosis tends to make the buttocks appear more prominent. Children with significant lordosis will have a significant space beneath their lower back when lying on their back on a hard surface.

If the lordotic curve is flexible (when the child bends forward the curve reverses itself), it is generally not a concern. If the curve does not move, medical evaluation and treatment are needed.

Causes

Achondroplasia

Benign juvenile lordosis (not medically significant)

Spondylolisthesis

Home Care

If the back is flexible, lordosis is usually not treated and will not progress or cause problems.

When to Contact a Medical Professional

Call your health care provider if you notice that your child has an exaggerated posture or a curve in the back. The condition should be evaluated to determine if there is a medical problem.

nih

Winter Weather Safety

Be Prepared: Staying Safe and Healthy in Winter Weather

Winter storms and cold temperatures can be hazardous, but if you plan ahead, you can stay safe and healthy. Prepare your home and cars. Keep emergency kits stocked. Be ready for power outages. Wear appropriate clothing. Check on children, the elderly and pets.

Although winter comes as no surprise, many of us are not ready for its arrival. If you are prepared for the hazards of winter, you will be more likely to stay safe and healthy when temperatures start to fall.

Many people prefer to remain indoors in the winter, but staying inside is no guarantee of safety. Take these steps to keep your home safe and warm during the winter months:

• Winterize your home.

• • Install weather stripping, insulation, and storm windows.
  • Insulate water lines that run along exterior walls.
  • Clean out gutters and repair roof leaks.

• Check your heating systems.

• • Make sure that your heating system is clean, working properly, and ventilated to the outside.
  • Inspect and clean fireplaces and chimneys.
  • Install a smoke detector. Test batteries monthly.
  • Have a safe alternate heating source and alternate fuels available.
  • Prevent carbon monoxide (CO) emergencies.
    • Install a CO detector to alert you of the presence of the deadly, odorless, colorless gas.
    • Learn symptoms of CO poisoning: headaches, nausea, and disorientation.
    • Keep grills and generators out of the house and garage. Position generators at least 25 feet from the house.

• Be prepared for weather-related emergencies, including power outages.

• • Stock food that needs no cooking or refrigeration and water stored in clean containers.
  • Keep an up-to-date emergency kit, including:
    • battery-operated devices, such as a flashlight, a National Oceanic and Atmospheric Administration (NOAA) Weather Radio, and lamps;
    • extra batteries;
    • first-aid kit and extra medicine;
    • baby items; and
    • cat litter or sand for icy walkways.

Many people spend time outdoors in the winter working, traveling, or enjoying winter sports. Outdoor activities can expose you to several safety hazards, but you can take these steps to prepare for them:

• Wear appropriate outdoor clothing: layers of light, warm clothing; mittens; hats; scarves; and waterproof boots.
• Sprinkle cat litter or sand on icy patches.
• Learn safety precautions to follow when outdoors.

• • Be aware of the wind chill factor.
  • Work slowly when doing outside chores.
  • Take a buddy and an emergency kit when you are participating in outdoor recreation.
  • Avoid traveling when the weather service has issued advisories.
  • If you must travel, inform a friend or relative of your proposed route and expected time of arrival.
  • Carry a cell phone.

• Prepare your car for winter.

• • Service the radiator and maintain antifreeze level; check tire tread or, if necessary, replace tires with all-weather or snow tires
  • Keep gas tank full to avoid ice in the tank and fuel lines.
  • Use a wintertime formula in your windshield washer.
  • Keep a winter emergency kit in your car in case you become stranded. Include
    • blankets;
    • food and water;
    • booster cables, flares, tire pump, and a bag of sand or cat litter (for traction);
    • compass and maps;
    • flashlight, battery-powered radio, and extra batteries;
    • first-aid kit; and
    • plastic bags (for sanitation).
  • Learn safety rules to follow in case you become stranded in your car.
    • Stay with your car unless safety is no more than 100 yards away, but continue to move arms and legs.
    • Stay visible by putting bright cloth on the antenna, turning on the inside overhead light (when engine is running), and raising the hood when snow stops falling.
    • Run the engine and heater only 10 minutes every hour.
    • Keep a downwind window open.
    • Make sure the tailpipe is not blocked.

Above all, be prepared to check on family and neighbors who are especially at risk from cold weather hazards: young children, older adults, and the chronically ill. If you have pets, bring them inside. If you cannot bring them inside, provide adequate, warm shelter and unfrozen water to drink.

No one can stop the onset of winter. However, if you follow these suggestions, you will be ready for it when it comes.

CDC

Bone Cancer

1. What is bone cancer? Bone cancer is a malignant (cancerous) tumor of the bone that destroys normal bone tissue (1). Not all bone tumors are malignant. In fact, benign (noncancerous) bone tumors are more common than malignant ones. Both malignant and benign bone tumors may grow and compress healthy bone tissue, but benign tumors do not spread, do not destroy bone tissue, and are rarely a threat to life.

   Malignant tumors that begin in bone tissue are called primary bone cancer. Cancer that metastasizes (spreads) to the bones from other parts of the body, such as the breast, lung, or prostate, is called metastatic cancer, and is named for the organ or tissue in which it began. Primary bone cancer is far less common than cancer that spreads to the bones.

2. Are there different types of primary bone cancer? Yes. Cancer can begin in any type of bone tissue. Bones are made up of osteoid (hard or compact), cartilaginous (tough, flexible), and fibrous (threadlike) tissue, as well as elements of bone marrow (soft, spongy tissue in the center of most bones).

   Common types of primary bone cancer include:

   • Osteosarcoma, which arises from osteoid tissue in the bone. This tumor occurs most often in the knee and upper arm (1).

   • Chondrosarcoma, which begins in cartilaginous tissue. Cartilage pads the ends of bones and lines the joints. Chondrosarcoma occurs most often in the pelvis (located between the hip bones), upper leg, and shoulder. Sometimes a chondrosarcoma contains cancerous bone cells. In that case, doctors classify the tumor as an osteosarcoma.

   • The Ewing Sarcoma Family of Tumors (ESFTs), which usually occur in bone but may also arise in soft tissue (muscle, fat, fibrous tissue, blood vessels, or other supporting tissue). Scientists think that ESFTs arise from elements of primitive nerve tissue in the bone or soft tissue (2). ESFTs occur most commonly along the backbone and pelvis and in the legs and arms (3).

   Other types of cancer that arise in soft tissue are called soft tissue sarcomas. They are not bone cancer and are not described in this resource.

3. What are the possible causes of bone cancer? Although bone cancer does not have a clearly defined cause, researchers have identified several factors that increase the likelihood of developing these tumors. Osteosarcoma occurs more frequently in people who have had high-dose external radiation therapy or treatment with certain anticancer drugs; children seem to be particularly susceptible. A small number of bone cancers are due to heredity. For example, children who have had hereditary retinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma, particularly if they are treated with radiation. Additionally, people who have hereditary defects of bones and people with metal implants, which doctors sometimes use to repair fractures, are more likely to develop osteosarcoma (4). Ewing sarcoma is not strongly associated with any heredity cancer syndromes, congenital childhood diseases, or previous radiation exposure (2).
4. How often does bone cancer occur? Primary bone cancer is rare. It accounts for much less than 1 percent of all cancers. About 2,300 new cases of primary bone cancer are diagnosed in the United States each year (5). Different types of bone cancer are more likely to occur in certain populations:

   • Osteosarcoma occurs most commonly between ages 10 and 19. However, people over age 40 who have other conditions, such as Paget disease (a benign condition characterized by abnormal development of new bone cells), are at increased risk of developing this cancer.

   • Chondrosarcoma occurs mainly in older adults (over age 40). The risk increases with advancing age. This disease rarely occurs in children and adolescents.

   • ESFTs occur most often in children and adolescents under 19 years of age. Boys are affected more often than girls. These tumors are extremely rare in African American children.

5. What are the symptoms of bone cancer? Pain is the most common symptom of bone cancer, but not all bone cancers cause pain (1). Persistent or unusual pain or swelling in or near a bone can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause.
6. How is bone cancer diagnosed? To help diagnose bone cancer, the doctor asks about the patient’s personal and family medical history. The doctor also performs a physical examination and may order laboratory and other diagnostic tests. These tests may include (1):

   • X-rays, which can show the location, size, and shape of a bone tumor. If x-rays suggest that an abnormal area may be cancer, the doctor is likely to recommend special imaging tests. Even if x-rays suggest that an abnormal area is benign, the doctor may want to do further tests, especially if the patient is experiencing unusual or persistent pain.

   o A bone scan, which is a test in which a small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it then collects in the bones and is detected by a scanner.

   o A computed tomography (CT or CAT) scan, which is a series of detailed pictures of areas inside the body, taken from different angles, that are created by a computer linked to an x-ray machine.

   o A magnetic resonance imaging (MRI) procedure, which uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body without using x-rays.

   o A positron emission tomography (PET) scan, in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.

   o An angiogram, which is an x-ray of blood vessels.

   • Biopsy (removal of a tissue sample from the bone tumor) to determine whether cancer is present. The surgeon may perform a needle biopsy or an incisional biopsy. During a needle biopsy, the surgeon makes a small hole in the bone and removes a sample of tissue from the tumor with a needle-like instrument. In an incisional biopsy, the surgeon cuts into the tumor and removes a sample of tissue. Biopsies are best done by an orthopedic oncologist (a doctor experienced in the treatment of bone cancer) (1). A pathologist (a doctor who identifies disease by studying cells and tissues under a microscope) examines the tissue to determine whether it is cancerous.

   • Blood tests to determine the level of an enzyme called alkaline phosphatase. A large amount of this enzyme is present in the blood when the cells that form bone tissue are very active—when children are growing, when a broken bone is mending, or when a disease or tumor causes production of abnormal bone tissue. Because high levels of alkaline phosphatase are normal in growing children and adolescents, this test is not a completely reliable indicator of bone cancer (1, 6) .

7. What are the treatment options for bone cancer? Treatment options depend on the type, size, location, and stage of the cancer, as well as the person’s age and general health. Treatment options for bone cancer include surgery, chemotherapy, radiation therapy, and cryosurgery.

   • Surgery is the usual treatment for bone cancer. The surgeon removes the entire tumor with negative margins (no cancer cells are found at the edge or border of the tissue removed during surgery). The surgeon may also use special surgical techniques to minimize the amount of healthy tissue removed with the tumor.

   Dramatic improvements in surgical techniques and preoperative tumor treatment have made it possible for most patients with bone cancer in an arm or leg to avoid radical surgical procedures (removal of the entire limb). However, most patients who undergo limb-sparing surgery need reconstructive surgery to maximize limb function (1).

   • Chemotherapy is the use of anticancer drugs to kill cancer cells. Patients who have bone cancer usually receive a combination of anticancer drugs. However, chemotherapy is not currently used to treat chondrosarcoma (1).

   • Radiation therapy, also called radiotherapy, involves the use of high-energy x-rays to kill cancer cells. This treatment may be used in combination with surgery. It is often used to treat chondrosarcoma, which cannot be treated with chemotherapy, as well as ESFTs (1). It may also be used for patients who refuse surgery.

   • Cryosurgery is the use of liquid nitrogen to freeze and kill cancer cells. This technique can sometimes be used instead of conventional surgery to destroy the tumor (1).

8. Is follow-up treatment necessary? What does it involve? Yes. Bone cancer sometimes metastasizes, particularly to the lungs, or can recur (come back), either at the same location or in other bones in the body (1). People who have had bone cancer should see their doctor regularly and should report any unusual symptoms right away. Follow-up varies for different types and stages of bone cancer. Generally, patients are checked frequently by their doctor and have regular blood tests and x-rays. People who have had bone cancer, particularly children and adolescents, have an increased likelihood of developing another type of cancer, such as leukemia, later in life. Regular follow-up care ensures that changes in health are discussed and that problems are treated as soon as possible.

Selected References

1. Malawer MM, Helman LJ, O’Sullivan B. Sarcomas of bone. In: DeVita VT, Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. Vol. 2. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2004.
2. Pizzo P, Poplack DG, editors. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincott Williams and Wilkins, 2002.
3. Ries LAG, Smith MA, Gurney JG, et al., editors. Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975-1999. Bethesda, MD: National Cancer Institute, 1999.
4. Miller RW, Boice JD, Curtis RE. Bone cancer. In: Schottenfeld D, Fraumeni JF, editors. Cancer Epidemiology and Prevention. 2nd ed. New York: Oxford University Press, 1996.
5. American Cancer Society (2008). Cancer Facts and Figures 2008. Atlanta, GA: American Cancer Society. Retrieved March 13, 2008, from http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf.
6. Fischbach FT, Dunning MB. A Manual of Laboratory and Diagnostic Tests. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2004.

National Cancer Institute

Sports Injuries

Prevention First
Worried about sports injuries? Don't sweat it. Think of avoiding injury as just another part of playing by the rules — only this rule book is the one that keeps you from getting hurt. That's because the best way to deal with sports injuries is to prevent them. Prevention includes knowing the rules of the game you're playing, using the proper equipment, and playing it safe.

But you've practiced with your team, played it safe on the field, and still sustained an injury. Don't worry, it's not the end of the world — just the beginning of a healing process. Read on to find out what this process is and how you can deal with a sports injury.

What Are Sports Injuries?
Sports injuries are injuries that typically occur while participating in organized sports, competitions, training sessions, or organized fitness activities. These injuries may occur in teens for a variety of reasons, including improper training, lack of appropriate footwear or safety equipment, and rapid growth during puberty.

There are two general types. The first type is called an acute traumatic injury. Acute traumatic injuries usually involve a single blow from a single application of force — like getting a cross-body block in football. Acute traumatic injuries include the following:

•a fracture — a crack, break, or shattering of a bone
•a bruise, known medically as a contusion — caused by a direct blow, which may cause swelling and bleeding in muscles and other body tissues
•a strain — a stretch or tear of a muscle or tendon, the tough and narrow end of a muscle that connects it to a bone
•a sprain — a stretch or tear of a ligament, the tissue that supports and strengthens joints by connecting bones and cartilage
•an abrasion — a scrape
•a laceration — a cut in the skin that is usually deep enough to require stitches

The second type of sports injury is called an overuse or chronic injury. Chronic injuries are those that happen over a period of time. Chronic injuries are usually the result of repetitive training, such as running, overhand throwing, or serving a ball in tennis. These include:

•stress fractures — tiny cracks in the bone's surface often caused by repetitive overloading (such as in the feet of a basketball player who is continuously jumping on the court)
•tendinitis — inflammation of the tendon caused by repetitive stretching
•epiphysitis or apophysitis — growth plate overload injuries such as Osgood-Schlatter disease

Often overuse injuries seem less important than acute injuries. You may be tempted to ignore that aching in your wrist or that soreness in your knees, but always remember that just because an injury isn't dramatic doesn't mean it's unimportant or will go away on its own. If left untreated, a chronic injury will probably get worse over time.

You may think of your back or your arms and legs as the only places where you could get hurt while playing, but you can get a sports injury anywhere on your body, including your face, neck, head, back, sex organs, hands, and feet.

Head and Neck Injuries

Head injuries include concussions, contusions, fractures, and hematomas. A concussion is a violent jarring or shock to the head that causes a temporary jolt to the brain. If severe enough, or recurrent, concussions can cause brain damage but fortunately this is not common in teens. A hematoma is a bleeding or pooling of blood between the tissue layers covering the brain or inside the brain.

All of these injuries can be caused by impact to the head from a fall, forceful shaking of the head, a blow to the head, or whiplash. Whiplash is an injury to the neck caused by an abrupt jerking motion of the head.

Always wear helmets for contact sports and when doing activities like biking and in-line skating to prevent head injuries.

Neck injuries are among the most dangerous. You can hurt your neck through a sudden traumatic injury in sports like mountain climbing, skydiving, horseback riding, gymnastics, diving, rugby, judo, or boxing.

Neck injuries include strains, fractures, contusions, and sprains. Another very common sports-related neck injury is a stinger or burner from stretched nerves in the neck. Most neck injuries are caused by impact to the head or neck sustained during a fall or a blow. Your neck can also be injured a little at a time. Too much strain on your neck can cause increasing pain, sometimes only on one side of your neck. Sometimes you may feel only a slight pain when you move a certain way.

If the injury is severe and there is a chance that the neck might be injured, it's very important to keep the injured person still with the head held straight while someone calls for emergency medical help. If the person is lying on the ground, do not try to move him or her. Never try to move someone who may have a neck injury — a mishandled neck fracture could lead to permanent paralysis or even death.

How do these injuries happen?

Serious head and neck injuries occur most often in athletes who participate in contact sports (like football or rugby) or sports with the potential for falling accidents, such as horseback riding.

Back Injuries

Back injuries include sprains, fractures, contusions, stress fractures, and strains and are caused by twists or overexertion of back muscles during bending or lifting movements. These injuries can occur in contact sports like football and ice hockey or in weight lifting, figure skating, gymnastics, dancing, baseball, and basketball.

Sex Organs

When it comes to injuries to the sex organs, guys usually suffer more trauma than girls because the penis and testicles are outside the body and lack natural protection during contact sports. Guys should always wear athletic supporters, or in some sports a cup, to protect the genitals from serious injury.

Injuries to the uterus or ovaries are rare, but breast injuries are common complaints among teen girls. As the breasts develop, they can often be sore, and a blow from a softball or a jab from an elbow, for example, can be painful. Girls should wear supportive sports bras while playing sports or exercising.

Hand and Wrist Injuries

Hand, finger, and wrist injuries include fractures, dislocations, and sprains and often occur in contact sports such as football, lacrosse, and hockey. Hand injuries can result from a fall that forces the hand or fingers backward, a forceful impact to the hands, or a direct blow.

Foot Injuries

Foot injuries can include ligament strains, stress fractures, heel bruises, and swollen growth plates. Because your feet support all of your weight and must absorb a lot of force over and over again, they can be particularly susceptible to injury. Another reason some teens may suffer foot injuries is because of differences in their feet. For example, some people have flat feet or high arches. These differences don't mean that sports should be avoided, but it does mean that precautions, such as a special shoe insert, may be needed.

Taking Care of Sports Injuries

If your pain progressively increases with activity (what sports medicine doctors call an "upward crescendo") and causes swelling, limping, or loss of range of motion, you need to see a doctor as soon as possible.

What kinds of pain should you be on the lookout for?

Any injury that results in swelling, numbness, intense pain or tenderness, stiffness, or loss of flexibility should be taken seriously.

You should also know the difference between soreness and chronic pain. Soreness is temporary, but chronic pain continues over a greater length of time. For example, it's not always necessary to see a doctor right away if your shoulder is sore, but you should schedule an appointment if the pain is worsening at any time or if it persists for a week or more. You should also see a doctor if your pain progresses from happening only after playing to happening during sports or if you notice it when you wake up or are doing daily activities.

The most important thing to do when you suspect you are injured is to stop doing whatever sport has caused the injury right away and go see a doctor. For more severe or complicated injuries, it may be best to see a doctor who specializes in sports medicine.

The doctor will examine your injury and use diagnostic tools such as X-rays and magnetic resonance imaging (MRI) to determine the extent of your injury. MRI allows doctors to see soft tissues more clearly than X-rays or CT scans do.

Once the doctor knows the full extent of your injury, he or she usually will start with conservative treatment techniques such as rest and ice to help decrease swelling. Pain relief and anti-inflammatory medicines such as ibuprofen (like Advil or Motrin) may be prescribed. Splints, casts, and surgery also may be needed, depending on the injury.

One of three things will happen next. Your doctor may:

• 
  
  recommend that you not play while you heal
• 
  
  that you play and use a protective device (a knee brace or wrist guard, for example)
• 
  
  that you undergo rehabilitation (physical therapy)Sports medicine doctors won't let you play if you are at risk for getting another injury or aggravating an injury you are recovering from.

Getting Back in the Game

If your doctor has asked you to stop playing, your #1 question is probably "When can I play sports again?" This depends on your specific injury, so make sure you discuss this with your doctor. There are things you can do while injured to stay fit without making your injury worse — but make sure you check with your doctor first. These activities are known as cross training, and they include using stationary cycles, swimming, water therapy, and rowing machines.

Your rehabilitation program will also help you stay fit as you recover. Rehabilitation, or rehab, is the process that gets you back in shape and ready for action again. Rehab may be part of your treatment program and can include exercise, manual therapy from a physical therapist (a specialist who is trained to help you recover from a sports injury), and technology such as ultrasound. Ultrasound equipment is used to heat the injured area. This heat relieves pain, promotes healing, and increases your range of motion.

Playing Safe

What can you do to protect yourself from getting hurt again?

Use protective gear — such as helmets for contact sports like football — that is appropriate to the specific sport.

When you return to play, you might need some new protective gear, including modified shoes (such as those with inserts or arch supports or those designed for use in a particular sport), tapings (tape used to wrap a knee, for example, to provide extra support), knee and elbow braces, and mouth guards. These devices help support and protect your body part from strains, direct blows, and possible re-injury.

To help prevent re-injury, be sure to warm up adequately before practice and games. Remember to take it slow when you first get back into your sport and gradually build back up to your pre-injury level.

Also, know your limits. If the previously injured part (or any body part) begins to hurt, stop immediately and rest. Don't delay in seeking medical attention if the pain persists. It's your body's way of telling you something is not right.

So, play, but play safe. Try to learn from your experience and do the things that can help you avoid getting hurt again.

MedlinePlus

Whiplash

What is Whiplash?

Whiplash-a soft tissue injury to the neck-is also called neck sprain or neck strain. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion. The disorder commonly occurs as the result of an automobile accident and may include injury to intervertebral joints, discs, and ligaments, cervical muscles, and nerve roots. Symptoms such as neck pain may be present directly after the injury or may be delayed for several days. In addition to neck pain, other symptoms may include neck stiffness, injuries to the muscles and ligaments (myofascial injuries), headache, dizziness, abnormal sensations such as burning or prickling (paresthesias), or shoulder or back pain. In addition, some people experience cognitive, somatic, or psychological conditions such as memory loss, concentration impairment, nervousness/irritability, sleep disturbances, fatigue, or depression.

Is there any treatment?

Treatment for individuals with whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.

What is the prognosis?

Generally, prognosis for individuals with whiplash is good. The neck and head pain clears within a few days or weeks. Most patients recover within 3 months after the injury, however, some may continue to have residual neck pain and headaches.

NINDS

Chronic Pain

Synonym(s): Pain – Chronic

What is Chronic Pain?

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap — sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

Is there any treatment?

Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.

What is the prognosis?

Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.

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NINDS

What is Back Pain?

What is back pain?

Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and range of motion, or an inability to stand straight. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

Is there any treatment?

Most low back pain can be treated without surgery. Treatment involves using over-the-counter pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation.  The goal of treatment is to restore proper function and strength to the back, and prevent recurrence of the injury.  Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies.  Although the use of cold and hot compresses has never been scientifically proven to quickly resolve low back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals.  Bed rest is recommended for only 1–2 days at most.  Individuals should resume activities as soon as possible.  Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles.   In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries.

What is the prognosis?

Most patients with back pain recover without residual functional loss, but individuals should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care.  Recurring back pain resulting from improper body mechanics or other nontraumatic causes is often preventable. Engaging in exercises that don’t jolt or strain the back, maintaining correct posture, and lifting objects properly can help prevent injuries. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, vibration, repetitive motion, and awkward posture. Applying ergonomic principles — designing furniture and tools to protect the body from injury — at home and in the workplace can greatly reduce the risk of back injury and help maintain a healthy back.

NINDS

Cartilage Disorders

Cartilage is the tough but flexible tissue that covers the ends of your bones at a joint. It also gives shape and support to other parts of your body, such as your ears, nose and windpipe. Healthy cartilage helps you move by allowing your bones to glide over each other. It also protects bones by preventing them from rubbing against each other.

Injured, inflamed or damaged cartilage can cause symptoms such as pain and limited movement. It can also lead to joint damage and deformity. Causes of cartilage problems include

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Tears and injuries, such as sports injuries

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Genetic factors

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Other disorders, such as some types of arthritis

Osteoarthritis results from breakdown of cartilage.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Osteonecrosis

Also called: Aseptic necrosis, Avascular necrosis, Ischemic necrosis

Osteonecrosis occurs when your bones lose their blood supply. The bones die and eventually collapse, leading to pain and arthritis. You can have osteonecrosis in one or several bones. It is most common in the upper leg. Other common sites are your upper arm and your knees, shoulders and ankles. The disease can affect men and women of any age, but it usually strikes in your thirties, forties or fifties.

Early in the disease you might not have any symptoms. Later, you will probably have joint pain that becomes more severe as the disease gets worse.

No one is sure what causes the disease. Risk factors include

Long-term steroid treatment

Alcohol abuse

Joint injuries

Having certain diseases, including arthritis and cancer

Treatments include medicines, using crutches, limiting activities that put weight on the affected joints, electrical stimulation and surgery.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Acute Injury Care

The care of the acutely injured is a public health issue that involves bystanders and community members, health care professionals, and health care systems. It encompasses prehospital emergency medical services; emergency department assessment, treatment, and stabilization; and in-hospital care surgery and medical management among all age groups. The importance of acute injury care became increasingly clear in the aftermath of the events of 9/11 and subsequent mass casualty events.

Because CDC recognizes that injuries continue to occur, despite our best efforts at prevention, the Division of Injury Response (DIR) at CDC’s Injury Center seeks to improve outcomes for those who have survived severe injuries and to improve acute injury care practices. To meet this challenge, DIR works with national and international organizations spanning the continuum of injury prevention and acute injury care, including those responsible for emergency medical services and emergency medicine and trauma surgery, other public health organizations, other federal agencies, and the corporate sector.

cdc

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