Lower Back Pain

Lumbar disc prolapse/herniation

 

 

 

 

 

 

 

 

 

What is it?      

A herniated disc refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine.

A herniated disc can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg.

On the other hand, many people experience no symptoms from a herniated disc.

Most people who have a herniated disc don't need surgery to correct the problem.

 

What does it feel like?

  • Leg pain - The leg pain is typically worse than low back pain. If the pain radiates along the path of the large sciatic nerve in the back of the leg, it is referred to as sciatica or a radiculopathy.

  • Nerve pain - The most noticeable symptoms are usually described as nerve pain in the leg, with the pain being described as searing, sharp, electric, radiating, or piercing.

  • Variable location of symptoms - Depending on variables such as where the disc herniates and the degree of herniation, symptoms may be experienced in the low back, buttock, front or back of the thigh, the calf, foot and/or toes, and typically affects just one side of the body.

  • Neurological symptoms - Numbness, a pins-and-needles feeling, weakness, and/or tingling may be experienced in the leg, foot, and/or toes.

  • Foot drop - Neurological symptoms caused by the herniation may include difficulty lifting the foot when walking or standing on the ball of the foot, a condition known as foot drop.

  • Lower back pain - Lower back pain may be present, but not always. The low back pain may be described as dull or throbbing, and may be accompanied by stiffness. If the herniated disc causes lower back muscle spasm, the pain may be alleviated somewhat by a day or two of relative rest, applying ice or heat, sitting in a supported recliner or lying flat on the back with a pillow under the knees.

  • Pain that worsens with movement - Pain may follow prolonged standing or sitting, or after walking even a short distance. A laugh, sneeze, or other sudden action may also intensify the pain.

  • Pain that worsens from hunching forward - Many find that positions such as slouching or hunching forward in a chair, or bending forward at the waist, makes the leg pain markedly worse.

  • Quick onset - Lumbar herniated disc pain usually develops quickly, although there may be no identifiable action or event that triggered the pain.

 

Why does this happen?

A herniated disc is most often the result of natural, age-related wear and tear on the spine. This process is called disc degeneration. In children and young adults, discs have high water content. As people age, the water content in the discs decreases and the discs become less flexible. The discs begin to shrink and the spaces between the vertebrae get narrower. This normal aging process makes the discs more prone to herniation. A traumatic event, such as a fall, can also cause a herniated disc.

  • Men between the ages of 20 and 50 are most likely to have a herniated disc.

  • Using your back muscles instead of your legs to lift heavy objects can cause a herniated disc. Twisting while you lift can also make your back vulnerable. Lifting with your legs, not your back, may protect your spine.

  • Being overweight puts added stress on the discs in your lower back.

  • Many jobs are physically demanding. Some require constant lifting, pulling, bending, or twisting. Using safe lifting and movement techniques can help protect your back.

  • Staying seated for long periods, plus the vibration from the car engine, can put pressure on your spine and discs.

  • Regular exercise is important in preventing many medical conditions, including a herniated disc.

  • It is believed that smoking lessens the oxygen supply to the disc and causes more rapid degeneration.

Lumbar Facet Joint Irritation

 

What is it?      

The lumbar facet joints are part of the posterior part of the lumbar spine can become irritated. Swelling from the surrounding structures, can also cause pain due to an irritation of the nerve roots.

 

What does it feel like?

  • Decreased extension and painful restricted locally to the affected joints

  • Local stiffness

  • Pain when returning from flexion to upright position

  • Sitting, flexion, using a clutch (in a vehicle), coughing and/or sneezing, and walking for a long time

Why does this happen?

The most common cause is repetitive micro trauma and as positive result of this chronic degeneration. In daily living this may occur with repetitive extension of the back. So mostly all movements with the arms above the head.
These recurring injuries can happen in sports were it is necessary to make repetitive powerful hyperextensions of the lumbar spine.
An irritation can also occur when the intervertebral disc is damaged and the biomechanics of the joint have changed. In this case the facet joints are exposed to a higher loading.

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