Low Back Pain
If you have lower back pain, you are not alone. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Back pain is the second most common neurological ailment in the world, second only to headaches.
Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is mechanical in nature - the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight. Occasionally, pain felt in one part of the body may “radiate” from a disorder or injury elsewhere in the body. Some acute pain syndromes can become more serious if left untreated.
Chronic back pain is measured by duration - pain that persists for more than 3 months is considered chronic. It is often progressive and the cause can be difficult to determine. Men and women are equally affected. It occurs most often between the ages of 30 and 50, due in part to the aging process but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age.
Sources of Back Pain:
Sprains and strains
(injury to muscle fibers, tendons and or ligaments) When the load exceeds the strength of soft tissue structures, they tear. When soft tissue is injured, inflammatory products are released, which leads to swelling, compression of nerves and pain.
Osteoarthritis of intervertebral joints / Facet Syndrome
Facet joint surfaces(joints between vertebrae) are imbedded with nerve endings underneath the cartilage. Those joints are the ones connecting vertebrae together. If this cartilage layer wears thin from degenerative joint disease or from trauma like whiplash, the nerve endings will be irritated, causing pain.
The disc has an outer layer called the annulus fibrosus, and an inner, jelly-like material called the nucleus pulposus. If the annulus fibers weaken, the nucleus can "escape", puncturing through the annulus. This usually occurs from a lifting incident, or may gradually occur over time without any specific trauma. If the nucleus protrudes and presses on a nerve root, this can cause radicular pain (pain radiating down the leg, usually the back and side of leg) or radiating down the neck shoulders and arms if the disc herniates in the neck. In severe cases, sensation and muscle strength in the leg or arms and hands are affected.
Annular Disc Tears
The annulus is made of concentric rings of collagen(type of fibrous material). Sometimes a fissure develops between two of these rings, and an inflammatory reaction develops. This type of pain is deep within the spine and hurts with movement, especially rotating (twisting) at the waist.
The space between the vertebral body and facet joints forms a canal, which contains the spinal cord. Arthritic changes to the vertebral body can cause bony projections, as well as ligamental calcifications and thickening, to narrow this canal. This can cause pinching of the spinal cord, and can lead to neurological deficits in the lower extremities (numbness, tingling, weakness, muscle wasting).
The vertebral body can fracture from trauma (a fall, a violent collision). Older people with osteoporosis can experience a spontaneous compression fracture. The affected vertebra loses its normal height and loses its ability to move properly in synergy with the adjacent vertebrae above and below. Recent compression fractures usually hurt with certain movements (extending the back, flexing the back, side bending) and are easy to visualize on x-ray.
This is an inflammatory condition that ultimately leads to fusion of spinal vertebrae and the sacroiliac joints of the pelvis. Persons with AS will demonstrate difficulty moving the neck, and a hunched posture.
There are two basic types: Osteoarthritis is advanced wear and tear of a joint and is found in weight-bearing joints like the spine, hips, and knees. Rheumatoid arthritis is an auto-immune disease that typically affects the finger joints and spine.
Various bone pathologies including Tumors can cause back pain. Renal disease, abdominal aorta aneurysm as well as prostate enlargement can refer pain to the lower back.
Chiropractic Manipulation combined with Class IV Deep Tissue Laser Therapy can help reduce back pain that is musculoskeletal (mechanical) in origin. Non-surgical Spinal Flexion / Distraction can be especially helpful for Disc Herniations, Facet Joints Syndrome and Spinal Stenosis.
The desired results of treatment:
- The intervertebral disc space is increased, that is, it is increased in height
- The pressure within the intervertebral disc is reduced.
- This reduces the pressure on the nerve it is compressing.
- This reduced pressure inside the disc stops the nerve irritation which relieves low back and leg pain.
- The size of the nerve opening within the spinal column, called the foramen, is increased by up to 28% in size.
- The joints of the spine are moved into their normal ranges of motion to regain normal mobility and freedom of motion without pain