Lower Back Pain Conditions
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- Arthritis (Spinal Osteoarthritis)
- Compression Fractures
- Degenerative Disk Disease
- Pain After Surgery (Failed Back Surgery Syndrome)
- Sacroiliac Joint Pain
- Spinal Stenosis
- Herniated Disk
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The low back is a very important structure in your body because it bears the entire weight of your entire upper body, allowing us to be very stable. As we age, the vertebrae in our lower back start to degenerate. Low back pain is a very common condition, and it is one of the most common and most expensive reasons people miss work.
If you have low back pain, it can be due to multiple reasons. Low back pain can come from the small joints in your back called the facet joints that can become arthritic and overgrown. The disks can herniate or bulge out causing impingement on your nerves. The vertebral bodies, the bones that give us structure, can fracture and cause problems. And your muscles can spasm around the back as well.
If you continue to have problems after four to six weeks, despite conservative therapy, lifestyle changes, and exercise therapy, it may be time for you to come and see a physician at that time to get a proper workup and dive deeper into why you’re experiencing that back pain.
At SEVA Med Care we take several steps in evaluating low back pain. The first thing we do is get a detailed history of your low back pain. The next thing we do is a physical examination. Our goal is to correlate the two and create a story that makes sense for your clinical pathology. Where is the pain located? What is the intensity? What is the quality of that pain? When did it begin? Does it radiate anywhere? And then we do a focused physical examination to help narrow down the exact source of the pain.
Managing Low Back Pain
Persistent Low Back Pain
Arthritis (Spinal Osteoarthritis)
What is arthritis in the back?
In general, osteoarthritis is a condition in which the protective cartilage that cushions the tops of bones degenerates, or wears down. This causes swelling and pain. It may also cause the development of osteophytes, or bone spurs.
What causes arthritis in the back?
In general, osteoarthritis happens as people get older. As we age, the disks in the spine lose height and begin to bulge. They also lose water content and begin to dry out and weaken. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.
As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis, similar to what may occur in the hip or knee joint. The smooth, slippery articular cartilage that covers and protects the joints wears away.
What is a compression fracture?
Compression fractures can occur in vertebrae anywhere in the spine, but they tend to occur most commonly in the upper back (thoracic spine), particularly in the lower vertebrae of that section of the spine.
What causes compression fractures?
A compression fracture is the general term for the type of fracture in the spine caused by osteoporosis.
Degenerative Disk Disease
What is degenerative disk disease?
Degenerative disk disease is one of the most common causes of low back and neck pain, and also one of the most misunderstood.
Simply put, degenerative disk disease refers to symptoms of back or neck pain caused by wear-and-tear on a spinal disk. In some cases, degenerative disk disease also causes weakness, numbness, and hot, shooting pains in the arms or legs (radicular pain). Degenerative disk disease typically consists of a low-level chronic pain with intermittent episodes of more severe pain.
What causes degenerative disk disease?
One of the more unfortunate aspects of getting older is that your joints begin to wear out, oftentimes for no good reason. This wear and tear of the joints is not only common in the knees and the hips but also in the spine. The exact reason why the joints of the spine begin to wear out is not known and may be a combination of factors, such as doing a lot of lifting, having a family history of spine problems or having an injury to the spine. This wear and tear is a form of arthritis, which is where the cartilage in the spine joints begins to wear out.
Pain After Surgery (Failed Back Surgery Syndrome)
What is failed back surgery syndrome (FBSS)?
Sometimes patients, despite having had back surgery, still have persistent pain after surgery. FBSS is a very generalized term that is often used to describe the pain condition patients experience who have not had a successful result with back surgery or spine surgery and continued to have back pain. There are many reasons that back surgery may or may not work, and even with the best surgeon and for the best indications, spine surgery is no more than 95% predictive of a successful result. Some people experience persistent disabling back pain after cervical spine surgery.
What causes pain after surgery or FBSS?
The common factors that cause pain after surgery include pressure on a nerve persisting after operation, recurrent or residual disk herniation, spinal muscular reconditioning, altered joint mobility, and joint hypermobility with instability. Sometimes the daily tasks you may have to do after your operation put too much pressure on the recovering tissue and nerve, re-opening painful areas.
Sacroiliac Joint Pain
What is SI joint pain?
Inflammation of one or both SI joints is called sacroiliac joint dysfunction, or sacroiliitis. With this condition you may experience a sharp, stabbing pain that radiates from your hips and pelvis, up to the lower back, and down to the thighs. Sometimes it may feel numb or tingly, or as if your legs are about to buckle.
What causes SI joint pain?
Causes of SI joint pain include:
What is spinal stenosis?
Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck.
Some people with spinal stenosis may not have symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can worsen over time.
What causes spinal stenosis?
Causes of spinal stenosis may include:
- Overgrowth of bone. Wear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal. Paget's disease, a bone disease that usually affects adults, also can cause bone overgrowth in the spine.
- Herniated disks. The soft cushions that act as shock absorbers between your vertebrae tend to dry out with age. Cracks in a disk's exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
- Thickened ligaments. The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.
- Tumors. Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae. These are uncommon and identifiable on spine imaging with an MRI or CT.
- Spinal injuries. Car accidents and other trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of nearby tissue immediately after back surgery also can put pressure on the spinal cord or nerves.
What is a herniated disk?
Your spinal column is made up of a series of bones (vertebrae) stacked onto each other. These bones are cushioned by disks. The disks protect the bones by absorbing the shocks from daily activities like walking, lifting, and twisting.
Each disk has two parts: a soft, gelatinous inner portion and a tough outer ring. A herniated disk is a disk that ruptures. This allows the jelly-like center of the disk to leak, irritating the nearby nerves. This can cause sciatica or back pain.
What causes a herniated disk?
As you age, the disks in your spine weaken and become flatter (less cushiony). If a disk becomes too weak, the outer part may tear. The inside part of the disk then pushes through the tear and presses on the nerves beside it. You could be at higher risk of getting a herniated disk if you:
- Are middle-aged or older
- Lift heavy objects
- Are overweight
- Do repetitive actions involving bending or twisting
- Sit in the same position for a long time regularly
- Live an inactive lifestyle
SEVA Med Care treatments and procedures for lower back pain:
- Spinal Cord Stimulation (SCS): Stimwave/Bioness/Sprint/NALU
- TENS Unit (ENSO)
- Epidural Injections
- Facet Injections (Median Branch Block)
- Radiofrequency Ablation
- Sacroiliac Joint Injections
- Transforaminal Injections (Nerve Root Block)
- Trigger Point Injections
- Sacroiliac Joint Fusion
- Minimally Invasive Spine Surgery
- Interspinous Decompression
- Minimally Invasive Lumbar Decompression (MILD)
- Back Braces
- Physical Therapy