Back Pain & Sciatica Relief

Post-Surgical

There are many surgical procedures for the low back including discectomies, laminectomies and even spinal fusion surgeries. The goal of most of these surgeries is to remove any broken bone, tissues or discs that may be pressing on exiting nerves from the spine. Furthermore, bringing stability to the spinal area is critical. It is important that you discuss with your physician conservative treatments first, such as physical therapy before surgery is absolutely necessary.

Compression Fracture

Compression fractures in the low back typically occur in older individuals and those suffering from osteoporosis. However, with severe trauma, such as in an accident, the force can cause a compression fracture in the bones of the spine (vertebrae). There are many minimally invasive surgical procedures today that can stabilize the broken area, such as kyphoplasty.

The goal with managing compression fractures is to stabilize pieces of bone from moving around and allow time for the bone to heal. Dealing with a compression fracture can be quite painful. Difficulty with getting up/down from bed, a chair and even difficulty walking are experienced.

Degenerative Diseases

Degenerative diseases of the spine fall under the categories of Degenerative Disc Disease (DDD) or Degenerative Joint Disease (DJD). In the spine, this is typically due to age and genetics. The wearing down of the joints or discs causes loss in normal height of the bony segments in the back. This can cause excessive joint pressures, bone on bone rubbing and increased inflammation. Typically with DDD or DJD comes stiffening of the spinal joints and weakening of key spinal muscles.

Spondylolisthesis

Spondylolisthesis is a condition by where one spinal bone (vertebrae) is not in alignment with the other. Typically, a slippage forward is found in the very low back at the 4th or 5th lumbar (low back) vertebrae. This is due to a stretching out of the ligaments that hold the bones together or possibly a fracture. With poor posture and weakened abdominals as well as spinal muscles, the increase in the angle of the spine becomes too much over time and misalignment of the bones occurs.

Symptoms can be mild such as general fatigue to the low back, achy pain or severe symptoms if there is compression on the nerves exciting the spine or spinal cord. There are varying degrees of severity. Most fall into a mild to moderate category that can be stabilized with improved posture and muscle strengthening. In severe cases, surgery may be necessary to fuse the area and bring stability back.

Herniated or Bulging Disc

A disc is a jelly like, fluid filled sac that acts as a cushion between the bones of your neck (vertebrae). Your discs change as you age, drying out and becoming more brittle. In addition, as the discs dry out with age, the change in height between the vertebrae decreases, causing changes in posture and function. In younger adults, the center of the disc (nucleus) is held in place by many rings of the disc (picture a cross section of a tree trunk). With minor or major injuries, poor posture and strain, these rings can rupture allowing a pressing outward of the disc nucleus. Finally, as the nucleus reaches the outer edges, the disc can begin to bulge, which in turn can rub and irritate nerve roots exiting your spine.

In more severe cases, the disc can become herniated, which further presses into the spaces where nerves are exiting. Symptoms can range from localized pain, to numbness / tingling to a specific part of the shoulder, arm or hands. In more severe cases complete lack of sensation, muscle weakness and paralysis of an area of the upper extremity can occur.

Changes in posture, strength and range of motion can all affect the positioning of the disc and how much bulging or herniation is occurring.

Spinal Arthritis

Spinal Arthritis is a very common area for osteoarthritis and rheumatoid arthritis. The low back takes a tremendous strain throughout our lifetime, supporting the body, moving, sitting and repetitively bending. In addition to these contributing factors, arthritis can also be affected by genetics, age, previous injuries, diet and exercise.

With abnormal forces on the back, the cartilage on the joints at each level of the spine can rub down causing even wear, build up of bone and eventually bone on bone rubbing. This can result in painful movement of the spinal joints and chronic, achy pain in the low back. Much like an arthritic knee, the spinal joints are helped through restoring natural movement, improving support from the spinal muscles and proper posture.

Spinal Stenosis

Spinal Stenosis is a condition that typically goes hand in hand with spinal arthritis. Spinal stenosis refers to a narrowing of the central spinal canal or the canals where the nerves exit the spine to the lower legs (called foramen). These canals are made up of overlapping spinal bones (vertebrae) over another. With degeneration of the spinal joints, collapsing of the disc height or abnormal bone growth, the canals can narrow. This leads to rubbing and even pressure on the nerves, which can cause a multitude of symptoms.

Sciatica

Sciatica is the term used to describe radiating pain into the buttock that can travel down the back of the thigh. Often this pain is achy and spread out along these areas. Sciatica is a result of irritation to the sciatic nerve, which travels deep in the buttock and down the back of the leg. In about 20% of people, the sciatic nerve pierces through the piriformis muscle deep in the buttock instead of under it. This can make the sciatic nerve more susceptible to irritation and pressure from the piriformis muscle. The piriformis muscle helps guide hip movement, but can become very tight with prolonged sitting. This increased tightness causes pressure and irritation to the sciatic nerve causing pain.