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If you have back pain you
are certainly not alone.
Estimate the 66% of adult
Americans have recurring
back pain. The question is;
do you have to live with it
or can you manage a way to
live without it? The fact is
that most types of back pain
are manageable or treatable
with some simple principles.
Like a computer program,
there are many menu options
that you can choose for
individual tastes and needs.
The question is, are you in
the right program? The first
step is a simple list of
questions to decide what the
underlying cause of back
pain is.
List of Questions
Do you have:
1. Back pain that stays
in your lower back?
2. Back pain that goes
to your buttocks or
posterior thighs?
3. Back pain that goes
to your leg and to your
foot?
4. Back pain that only
comes with activities,
bending, or lifting?
5. Back pain that comes
only when walking?
6. Leg or foot pain and
little or no back pain?
7. Cramping in the
buttocks or legs that
only comes with walking,
relieved by sitting or
bending forward and
helped by leaning
forward on a shopping
cart?
8. Leg cramps the come
with walking, only
relived by stopping for
a few minutes but
reoccurs at the same
distance of walking
especially repeatedly?
9. Back Pain with Leg
Pain and/or Leg Numbness
and/or Leg Weakness?
10. Leg Pain with or
without Back Pain,
Numbness, or Weakness?
This is an indication that a
nerve is being effected.
Usually the effected nerve
is in the lower part of your
back and goes to a special
part of your leg. Doctors
refer to this as
radiculopathy or sciatica.
Basically, the nerve is
pinched by a disc protruding
into the spine or the
ingrowth of bone from the
joints (bone spurs). For
either reason, the nerve is
pinched or squeezed and is
not getting enough blood
flow. If it is a disc that
is doing the squeezing, you
may be in luck, since discs
are 85% water. After they
protrude, they can shrink in
size and therefore stop
squeezing the nerve. You
know that people get shorter
as they get older; that's
because the discs are 85%
when you are eighteen years
old, but by the time we near
our sixties, the discs
should be down to 60% water.
This is good. When we are
eighteen years old we are
strong, energetic, and
flexible. But as we get
older we want a more
self-supporting spine so we
don't have to spend as much
energy to support our spine
and keep it stable. We
naturally become less
flexible as we get older,
but this has minimal effect
on our function since we
still have flexible hips and
knees to stay active. This
natural loss of water in our
discs has somewhat
inappropriately been called
Degenerative Disc Disease (DDD).
It is not a disease, but a
natural condition or process
of aging, and, as any doctor
will tell you, is not
necessarily associated with
back pain or leg pain. The
problem is your need to
listen to the messages your
body is sending to you. If
your back doesn't want to
bend but you keep bending it
or try to keep it flexible,
it will hurt. If you learn
to relieve the stress in
your back by having strong
abdominal and back muscles
and flexible hips, quads,
and hamstrings (lumbar
stabilization exercises),
you can get rid of the pain.
If pain is caused by a disc
pinching the nerve, the disc
can be:
How you perceive spine
problems
Low back pain can be divided
into two main types:
-
Mechanical Type pain
-
Compressive Type pain
Mechanical type back pain
results from inflammation
caused by irritation or
injury to the disk, the
facet joints, the ligaments,
or the muscles of the back.
A common cause of mechanical
pain is disk degeneration. A
typical muscle strain, or
lumbar strain, can also be
the cause of mechanical type
symptoms. Mechanical type
back pain usually starts
near the lower spine.
Mechanical type pain may
also spread to include the
buttock and thigh areas. It
rarely extends below the
knee.
Compressive or neurogenic
(meaning nerve related) type
pain occurs when the nerve
roots that leave the spine
are irritated or pinched. A
common cause of compressive
pain is a herniated disk.
The nerves that leave the
lower lumbar spine join to
form the sciatic nerve. This
nerve provides sensation and
controls the muscles of the
lower leg. Pressure or
irritation on the nerve
roots of the lumbar spine
that come together to form
the sciatic nerve can
interfere with the normal
function of the sciatic
nerve. One of the earliest
signs of pressure on a nerve
root is numbness in the area
supplied by the nerve. There
is commonly pain in the same
area, usually extending
below the knee to the foot.
In cases where there is
pressure o a nerve root as
it comes out of the spine,
it is not unusual for the
back itself to be painless.
This can be confusing at
times since there is no back
pain - but the problem is
located in the lumbar spine!
Finally, the muscles that
the nerve controls may
become weak and the reflexes
disappear. This is because
the pressure on the nerve
roots interferes with the
signals from the brain to
the muscles. There is no
signal going from the brain
to the muscle to tell it to
contract.
Spinal stenosis can also
cause compressive type pain.
In some people, degeneration
of the spine can result in a
narrowing of the spinal
canal - the bony tube where
the spinal nerves are
located. This causes all of
the nerves within the spinal
canal to become inflamed,
and fail to work properly.
One problem that occurs when
the tube is too small is
that the nerves cannot get
enough blood supply to work
properly. The nerves may be
OK when you are at rest, but
if you become active, the
nerves need more blood flow
to get more oxygen. Because
the tube is too tight, the
blood supply cannot
increase. One of the
symptoms this may cause is
numbness, which can involve
both of the legs. The
numbness may become worse
with activities, such as
walking. The pain can
involve both of the lower
extremities. The pain
becomes worse with
activities such as walking,
and gets better after short
periods of rest. Weakness of
the muscles of both legs may
also occur, and again, this
may get worse when activity
increases. |
