BACK & NECK PAIN: The spine (neck and back) may be thought of as a structural beam that holds the body erect. That beam is comprised of three mechanical elements: the disc-vertebral unit, the facet joint, and the connecting muscles and ligaments. These structures allow us to bend in many directions and also provide protection to the spinal cord and its nerves. Strain, dysfunction and disease may occur at any of these three sites, and can cause significant pain and functional impairment. Surveys show that eight out of ten people will experience back pain at some point in their lives. Although symptoms often improve on their own, they also tend to recur. It is, therefore, important that you find out what can be done about the pain in your neck or back, or why you have limited movement in these areas. Equally important, you should learn what you can do to protect your spine both to maximize function and to prevent those painful recurrences.

GOUT: Gout is a type of inflammatory arthritis that causes sudden episodes of severe, painful swelling in a joint. It may also cause chronic pain in joints. It is caused by excessive amounts of uric acid in the blood which is subsequently deposited in soft tissues as crystals. These crystals can trigger an inflammatory response by the body, resulting in joint swelling and pain. Gout can and should be treated. Persistent inflammation or frequent attacks can cause damage to the bones. There is, however, another type of crystal that can cause similar attacks -- a condition called pseudogout. It is important to know which condition you have because long-term treatments differ for each. Experienced clinicians will look at joint fluid under the microscope to help determine what is causing the joint to swell.

CARPAL TUNNEL SYNDROME: This condition is caused by pressure on the median nerve as it travels through the wrist joint to provide sensation to some of the fingers. This pressure causes symptoms of numbness, tingling, pain and sometimes weakness in the fingers. People with this condition complain of loss of grip strength or difficulty holding objects. They often awaken with pain and numbness. Left untreated, carpal tunnel syndrome can cause permanent nerve and muscle damage to the hand. It is important to evaluate these synptoms carefully as other musculoskeletal conditions may cause similar complaints.

CONNECTIVE TISSUE DISEASES: Connective tissue disease is an umbrella term used to denote a number of rheumatic diseases with certain overlapping features. Included under this umbrella are conditions such as systemic lupus erythematosus, scleroderma, Sjogren's syndrome, polymyositis, dermatomyositis and rheumatoid arthritis. Common features include Raynaud's phenomenon (severe, cold-induced spasms and compromise in the circulation in the hands), joint pain, muscle pain, and some laboratory abnormalities. Because connective tissues are found throughout the body, connective tissue diseases can affect all organ systems, including the joints, muscles, skin and mucous membranes, lungs, cardiovascular system, gastrointestinal system, and nervous system.

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