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Ask Dr. Spight: What Causes Spine Swelling?

Dr. Spight explains why spine swelling is rarer than most people think.

If you have experienced back pain, you aren’t alone. The National Institute of Neurological Disorders and Stroke reports that 80 percent of adults will be afflicted with back pain at least once. Among these back pain sufferers, 95 percent identify their lower back as the source of the pain. Many cite spine swelling among their symptoms.

Physical medicine and rehabilitation physician Dr. David Spight sub-specializes in spine pain. He explains the causes of spine swelling and the steps he takes to evaluate lower back pain. “The first step in addressing spine swelling is to explain the difference between actual swelling of the spine and perceived swelling,” says Dr. Spight. “Often, patients with lower back pain reach back to touch the place that hurts and feel the prominence of the hip bones, which we refer to as the iliac crest. They mistake the bone for swelling.”

The causes of spine swelling

“It’s very rare to have actual swelling in your spine,” states Dr. Spight. “Even when the spine is swollen, it is hard to see or feel. The structure of the spine is covered by muscle, fat, and skin. You can identify spine swelling on an MRI, but it’s very difficult to actually feel it.”

Dr. Spight explains that there are three conditions that cause spine swelling.

The perception of spine swelling

“When people come in with lower back pain and report swelling, I ask them to show me where it feels swollen,” says Dr. Spight. “Inevitably, they point to the posterior superior iliac spine, where our hip bones meet the spine at the waist. We all have that bony prominence at our lower back between the fourth and fifth lumbar. But unless you hurt, you don’t typically touch that part of your back. It’s easy to mistake those bones for swelling.”

Evaluation of perceived spine swelling

In most cases, Dr. Spight explains that lower back pain will resolve on its own within six to eight weeks without medical intervention. “If you are experiencing pain when you bend or lift, or if you are experiencing a strain with mild low-grade pain, you can take a wait-and-see approach,” he says. However, there are certain symptoms that should be medically evaluated immediately.

Treatment for back pain

“Treatment for lower back pain depends on the cause and source of the pain,” says Dr. Spight. “We can use imaging to see what we need to see. However, just because degenerative issues appear on a scan does not mean that those issues are causing the pain.

Our spines start to age in our late twenties or early thirties. Seeing what we call nonspecific age expectancy degenerative changes on a scan does not provide a diagnosis. I have to talk to my patients and examine them. My working diagnosis is the result of the medical interview, the physical examination, and the imaging. Assuming that we don’t see anything alarming on imaging, I begin treatment to help you feel better in the least invasive way, with physical therapy and activity modification. If your symptoms do not respond or worsen, then we can try injection procedures to identify the painful spine structure. The purpose of injections can be diagnostic, diagnostic and therapeutic, or sometimes strictly therapeutic.”

Summit Orthopedics offers comprehensive spine expertise

Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.

Start your journey to a healthy spine. Find your spine expert, request an appointment online, or call us at (651) 968–5201 to schedule a spine consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MNPlymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.

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