The lumbar spine refers to the low back, the five bones that sit atop the pelvis. These five bones are stacked vertically, and in between each pair of bones sits a disc. Each disc is soft, and made of a ring of cartilage with a core of softer tissue. These discs act as the shock absorbers of the spine, as they are relatively soft and compressible. They also act as the joints of the spine, allowing the bones above and below them to tilt slightly, for instance when one bends forward or backward.
What most people don't know is that the discs of the spine are designed to slowly break down over time. They slowly lose their ability to bear weight - imagine a tire slowly losing air over the years, which is a normal process. Like a car tire, a disc, over time, will bulge at the sides, as the weight of the body above it keeps pushing down, and the disc loses the ability to push back up. While this is a normal process, sometimes we notice it as it is occuring. At these times, we may experience low back pain.
Back pain from a degenerating disc will often improve on its own. But this can take time, and sometimes the pain we feel is too severe. Or sometimes the disc is actually injured more than simply degeneration - for instance, if there is an injury that leads to a large disc herniation. Another possibility with low back pain is that maybe something else is causing the back pain altogether. Because of these factors, it is advised to seek the evaluation of a physician, especially one who specialized in disorders of the spine. A specific diagnosis can be obtained, and treatment for the acute pain can be provided. And, in the case of degenerative disc disorder, a longer term exercise reginmen can be learned, to hopefully minimize progression of the degeneration, and reduce future episodes of pain.
The lumbar spine refers to the low back, the five bones that sit atop the pelvis. These five bones are stacked vertically, and in between each pair of bones sits a disc. Behind each disc sits a pair of joints: the facet joints. So, together with the disc in the front of the spine, the two facet joints form a tripod, on which each bone sits atop the bone beneath it. This tripod, located between each pair of bones in the spine, acts as one big joint: the bones above and below the disc and facets can tilt slightly, for instance when one bends forward or backward. Like any joint, the facet joints can get arthritis.
Pain from facet joint arthritis often manifests as low back pain that is worse with standing and walking. Often, the pain starts to kick in after standing for a certain amount of time, or walking for a certain distance. In these situations, it is advised to seek the evaluation of a physician, especially one who specializes in disorders of the spine. In this way, a correct diagnosis and treatment plan can be provided. This often includes physical therapy, but may include injections, or medications. Lumbar facet pain can be treated and eliminated, or managed to prevent progression, and maintain an active and rewarding lifestyle.
When arthritis in the spine is pronounced enough, the discs can bulge (as described above), and the facet joints can enlarge (see also above). Or, sometimes an injury can cause a disc to be herniated. When these things happen, the small holes and canals through with the nerves run can be narrowed. The medical term for this narrowing is stenosis. This stenosis gives the nerves that pass through the spine less room. When nerves have limited room, they can become inflamed, or compressed.
When a nerve in the body is inflamed or compressed, the human mind often perceives pain, not where the inflammation or compression is occurring, but in the places where the nerve travels further away. For instance, if the nerve that goes down the back of the leg and into the foot is inflamed or compressed in the spine, we may not feel pain in the spine at all. We may feel pain in the leg, the foot, or both, because that is where the nerve goes. Sometimes it’s not pain that’s felt in the leg or foot, but numbness, or tingling. And since nerves also tell muscles what to do, a problem with a nerve in the spine may affect muscles in the leg or foot as well, causing weakness. These are just some of the symptoms of nerve inflammation or compression in the spine being felt in the leg. The most common version of this problem is known as sciatica.
It is very possible that the arthritis in the spine that is causing the stenosis and is affecting the nerve is painful, so low back pain often accompanies sciatica. In any event, it is advised to seek the evaluation of a physician, especially one who specializes in disorders of the spine. In this way, the correct diagnosis can be obtained, and treatment can be obtained that can eliminate the pain, and reduce it’s chances of coming back.
The lumbar spine refers to the low back, the five bones that sit atop the pelvis. These five bones are stacked vertically, and in between each pair of bones sits a disc. Behind each disc sits a pair of joints: the facet joints. So, together with the disc in the front of the spine, the two facet joints form a tripod, on which each bone sits atop the bone beneath it. This tripod, located between each pair of bones in the spine, acts as one big joint: the bones above and below the disc and facets can tilt slightly, for instance when one bends forward, backward, or sideways.
Sometimes, as we grow up during childhood or adolescence, the spine grows in such a way that it has a curvature to it. Or, in later years, as our spine grows old with the rest of us, the spine can degenerate (which can be a natural process, please see above) in such a way that it becomes curved. Certain types of curvature in the spine are called scoliosis. In some people, this scoliosis can lead to uneven wear and tear of the joints and discs of the spine, which can lead to pain. In these cases, a spine specialist should be consulted, to assess and grade the scoliosis, and to provide a treatment plan to reduce pain, increase function, and reduce the likelihood of further pain down the road.
The lumbar spine refers to the low back, the five bones that sit atop the pelvis. These five bones are stacked vertically, and in between each pair of bones sits a disc. Behind each disc sits a pair of joints: the facet joints. So, together with the disc in the front of the spine, the two facet joints form a tripod, on which each bone sits atop the bone beneath it.
Sometimes, one bone of the spine slides forward or backwards on the bone beneath it. This is called spondylolisthesis. This may never be noticed or felt by the person in whom it has occurred, but sometimes, it can lead to low back pain. This pain may occur all at once, but more commonly it occurs over time, as the unusual alignment of the bones of the spine causes abnormal wear and tear of the joints and discs of the spine, and this leads to pain. As with scoliosis, a spine specialist should be consulted here, to assess the spondylolisthesis, to make sure it is not too severe, and to provide treatment for any pain that it may be causing.
The lumbar spine refers to the low back, the five bones that sit atop the pelvis. These five bones are stacked vertically, and in between each pair of bones sits a disc. Behind each disc sits a pair of joints: the facet joints. So, together with the disc in the front of the spine, the two facet joints form a tripod, on which each bone sits atop the bone beneath it. But one of the key parts of the spine is not technically in the spine at all: it is the cuff of muscles that surrounds the bones, discs, and joints of the spine. This cuff of muscles extends from the very bottom of the lumbar spine, in the small of the back, all the way up to the top of the cervical spine, meaning the top of the neck. These muscles stabilize the spine; they strengthen it and thicken it. These muscles, plus other muscles that extend further outward and away from the spine, provide crucial support in maintaining the spine’s correct curvature and alignment.
Sometimes, these muscles actually work too well. When someone feels back pain from a disc or facet joint (see above), the muscles around the spine contract and get tight – they are trying to protect the spine. Or sometimes this tightness is simply due to longstanding poor posture – the muscles become used to maintaining the body at an unusual angle, and they lose their ability to easily relax. In either case, the tightness in the muscles can take on a life of its own, and can actually be painful. This is called myofascial pain. In addition to myofascial pain, spine muscle tightness becomes a problem because now these tight muscles, which were trying to help, actually get in the way. Tight muscles make returning to a normal posture more difficult. And tight muscles can actually squeeze discs and joints in the spine, making these hurt more.
The good news is, doctors and therapists who specialize in spine care have many ways of treating myofascial pain and the other problems that tight muscles in the spine can cause. If you have back pain, or back tightness that you feel is limiting you in any way, It is recommended that you consult a spine specialist physician to assess for myofascial pain and any underlying causes.
Physical Therapy Website Design | Accessibility Policy
07631 Physical Therapy | 07024 Occupational Therapy | 07093 Sports Medicine