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Cervical spinal nerve 4, also called C4, is a spinal nerve of the cervical segment. It originates from the spinal cord above the 4th cervical vertebra (C4). It contributes nerve fibers to the phrenic nerve , the motor nerve to the thoracoabdominal diaphragm .
After age 50 or 60, osteoarthritic degeneration (spondylosis) or spinal stenosis are more likely causes of low back pain or leg pain. 4.8% of males and 2.5% of females older than 35 experience sciatica during their lifetime. Of all individuals, 60% to 80% experience back pain during their lifetime. In 14%, pain lasts more than two weeks.
Sitting and bending or leaning forward tend to provide relief. Patients may also report that pain is worse while walking down stairs and improved while walking up stairs or using a bicycle or shopping cart. [1] A positive "shopping cart sign" refers to the worsening of pain with spinal extension and improvement with spinal flexion. [10]
Back pain is present in 29% of patients with systemic cancer. [19] Unlike other causes of back pain that commonly affect the lumbar spine, the thoracic spine is most commonly affected. [19] The pain can be associated with systemic symptoms such as weight loss, chills, fever, nausea and vomiting. [19]
Thoracic spinal stenosis, at the level of the mid-back, is much less common. [13] In lumbar stenosis, the spinal nerve roots in the lower back are compressed which can lead to symptoms of sciatica (tingling, weakness, or numbness that radiates from the low back and into the buttocks and legs). [citation needed]
The most commonly recommended treatment for long-lasting pain in the lower back are exercises and fitness training usually under the supervision of a qualified clinician. This treatment does help the vast majority of back pain patients but does not have a pain-relieving effect on Modic changes or pain from Modic changes.
Postoperative radiation is delivered within 2–3 weeks of surgical decompression. Emergency radiation therapy (usually 20 grays in 5 fractions, 30 grays in 10 fractions or 8 grays in 1 fraction) is the mainstay of treatment for malignant spinal cord compression. It is very effective as pain control and local disease control.
A modest reduction in pain is seen after 26 weeks, but not after one year (about 52 weeks). [47] If the cause is spondylolisthesis or spinal stenosis, surgery appears to provide pain relief for up to two years. [56] For non-discogenic sciatica, the surgical treatment is typically a nerve decompression. A decompression seeks to remove tissue ...
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