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While four out of five of us will have an attack of back pain at some point in our lives, here's the good news: 80 percent of the time, back and neck pain is caused merely by a muscle or ligament strain.
The other good news: Even when a back pain attack is cause
by a herniated disc, most of the time these problems can get better without
surgery too, with time, special exercises and an emphasis on getting
back to activity.
Muscle strain | Herniated
and bulging disc | Spondylolisthesis
and spondylolysis | Scoliosis | Kyphosis | Coccygeal
pain | Neck pain | Spine
tumors | Bone spur | Degenerative
disc | Spinal stenosis
 |
Some research studies note that 80 percent of back and
neck pain is caused by muscle strain. Unlike muscles in the legs, which
are long and resistant to spasm, the back is composed of short extensor
muscles that bridge from vertebra to vertebra. Because these muscles
are shorter, they are more prone to spasm.
Physiologically, a muscle spasm occurs when muscle fibers in the back
tighten and convulse involuntarily.
At other times, muscle strain is a result of spinal ligaments near the
vertebral bodies or tendons that become painful due to inflammation.
Ultimately, the muscle spasm is an alert to the body that it has been
pushed beyond the limits. When a muscle spasm occurs, it is a good idea
to gently stretch the injured area to increase circulation. The more
circulation to the area, the sooner the pain will subside.
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The spine is composed of many vertebrae stacked on top of each other. Between these bones are discs, which act as shock absorbers. The shock absorbing discs resemble jelly donuts, each having a jelly-like center. As we age, the discs naturally become less flexible and more brittle. With a fall or heavy strain, these discs can rupture, causing the nucleus to break through the wall of the disc and place pressure on the nerves that branch off from the spinal cord. The result is back or neck pain. The good news is that a herniated disc does not necessarily mean a person needs surgery. In some cases, the symptoms from a minor herniation can go away, and with care, pain recurrences can be minimized.
Click on image to enlarge.
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Click on image to enlarge.
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A bulging disc is when the wall is deformed, but not herniated.
The nucleus is still contained in the wall. You NEVER need surgery to
treat a bulging disc. When the disc nucleus breaks through the surrounding
wall, it is called a herniated disc. While the nucleus escapes through
the wall, the tissue either remains connected with the disc or it can
break from the nucleus and travel away from the disc. Discs can herniate
in any direction: forward, centrally or, most commonly, backward and
sideways in the direction of the spinal nerves.
Sometimes, people mistake excruciating pain for a herniated disc when
the pain might actually be the signal of a muscle strain. The most common
indicator of a herniated disc is when the pain radiates down into the
leg or arm. Having a sedentary lifestyle and then lifting a heavy object
can cause a disc to herniate. Often times, back pain without leg pain
can be from a partial herniation of the disc, or an internal disc disruption.
Special extension exercises can help relieve pain from
a herniated disc. Exercise can work as a vacuum to suck the center of
disc back into place helping to release pressure on the nerve. Surprisingly,
special exercises can actually help to relieve pain during a back attack.
While someone suffering through an attack of pain will probably find
it hard to believe that further movement will help the pain, it has been
shown that specific exercises do just that.
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Spondylolisthesis and spondylolysis
Spondylolysis occurs when the PARS hinge is cracked but
the vertebrae is still in its correct position. With continual stress,
spondylolysis if left untreated can be a gateway into spondylolisthesis.
The onset of the disease can either be hereditary or caused by wear and
tear.
These problems relate to instability in the joints in the low back. Either
from a fall, or a defect, a vertebral bone segment may be in a position
to slip out of position, causing back pain.
This problem relates to instability in specific bones in the low back. As you recall, the rear part of spinal vertebrae have facet joints that act as hinges, allowing our spines to twist and bend. Sometimes, however, the posterior element can crack. Either from heredity, or wear and tear, a specific part of the posterior element called the pars interarticularis cracks which can let the vertebrae slip forward out of its correct position. Spondylolisthesis occurs when the cracked PARS has allowed the vertebrae to slide forward out of its correct position.
Click on image to enlarge.
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Click on image to enlarge. |
Gymnasts, for example, who perform routines that bend and arch the back are often victims of spondylolysis or spondylolisthesis.
While ligaments and muscles can help hold the vertebrae
in place, over time, surgery may be necessary to install surgical instrumentation
or bone grafts that lock the vertebra in place so it does not slide out
of position and damage the spinal nerves. Interestingly, in many cases,
spondylolisthesis may have no symptoms, so most people may not know they
have it. If back pain does not go away on its own over a few weeks, a
spine doctor will check for such instability through X-rays or other
diagnostic test.
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Scoliosis is a curvature of the spine that can first appear in childhood. It is not known why scoliosis occurs, but it does tend to affect women more than men. The curvature of the spine needs to be assessed because in some cases, extreme curves can place pressure on internal organs – which can shorten lifespan if not treated.
A curvature of the spine is referred to as scoliosis. Some
people are born with it and some develop it over time. This might cause
the person to twist and bend in an abnormal way. While the cause of and
cure for scoliosis are still a mystery, it is known that it is more common
in women than men. Sometimes a back brace is used to prevent worsening
of the spine curvature. Sometimes, surgery is needed, particularly when
the curvature puts pressure on internal organs which if left untreated
would shorten life expectancy. Scoliosis surgery is extremely complex
and a person should invest a great deal of time to select an orthopedic
surgeon who sub-specializes in using the most current surgical fixation
rods. If a surgeon tries to correct the curve too much, or with an improper
method, the person could be paralyzed from the surgery.
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Click on image to enlarge. |
Click on image to enlarge. |
Kyphosis
Sometimes, a spinal deformity involves types of abnormal
curves in the spine. When the spine curves too much inward in the low
back, it is called lordosis. When the spine in the shoulder blade area
has too much forward curve, or too much of a hump, it is called kyphosis.
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In rare cases, back pain can originate in the coccyx, the
small section of fused bones at the base of the spine. This pain usually
results from a direct fall onto the buttocks or pressure from sitting.
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Neck pain can be muscle-related, caused by strain from
holding the head in one place for an extended period. Other cases of
neck strain can be caused by an injury involving a sudden jerk to the
neck area, as in a car accident. Also, just as in the low back, a disc
may herniate, which places pressure on nerves branching out from the
spinal cord.
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The presence of a tumor in the spinal area is serious.
It can cause pressure on nearby nerve roots causing pain. Spine tumors
can be benign or cancerous. These may or may not cause pain symptoms.
That is why it is a good idea to go to a spine center with spine specialists
when back or neck pain persists for more than a week. By doing routine
diagnostic tests, the specialist can assure you that nothing serious
is wrong with your spine, and you can proceed with special exercises
or nonsurgical treatments.
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A bone spur is an excess growth of bone around the vertebral body. If they grow too much, they can impinge on nerve roots.
Click on image to enlarge. |
Click on image to enlarge. |
Degenerative disc disease often occurs as we age. The discs become more brittle, less resilient and more prone to herniation. In many cases, the space between vertebrae can narrow, causing pain symptoms.
Another illness leading to degeneration is osteoporosis.
As the bones lose strength from the disease, a person becomes at risk
for vertebral fractures. Since osteoporosis usually comes without any
symptoms, those at risk, particularly older women, should have a bone
density scan to take care of the bones before a problem arises. Sometimes
dietary supplements or medication may be recommended to address the problem.
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Sometimes, there is not enough room in the spinal canal
for the spinal nerves. Stenosis is much like a ring around a finger.
If the finger becomes injured or inflamed, the ring constricts and caused
pain. The pain in stenosis is usually centered around the lower back
which can shoot pain down into the legs and can flare up after walking
or exercising.
Relief from spinal stenosis can sometimes be found by leaning forward
or sitting. Pain typically increases when the back bends backward. Sometimes,
the pain can be treated nonsurgically with treatments such as injections
while at other times, surgery may be needed to create more space around
the nerves.
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Need
more information on back and neck pain?
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