Lower Back Pain

Articles of Dr. Stewart G. Eidelson, M.D. - SpineUniverse

Avoid Stressing Your Back. Here are some tips for avoiding stress on your spine while behind the desk at work.

Back Pain - A Universal Language. The causes of back pain are nearly as numerous as terms used to describe the symptoms. Learn more about these terms and causes of back pain.

Back Pain Treatment Options. If you are a back pain sufferer, talk to your doctor about which treatment options are best for you. The following is a brief discussion about the most commonly used treatments for back pain available today.

Bone Basics. Description of the function of bones in the body

Bone Scans. A Bone Density Scan is used to determine the compactness of bone. The computerized scanning equipment uses a low dose of radiation to measure the denseness of a hip or the spine.

Cervical Spine Anatomy (Neck). Basic description and picture of the parts of the spine

Consulting a Spine Specialist. Information on what to expect and what to bring on your first visit to a spine specialist.

Diagnostic Tests: X-Ray, CT Scan, MRI. X-ray, CT Scan and MRI are types of tests used to help diagnose certain spinal disorders. Learn about these and other diagnostic tests.

Dr. Spine: What is Spinal Stenosis?. An explanation of what spinal stenosis is by Dr. Stewart G. Eidelson.

Lumbar Spine. Explains which area of the spine is classified the lumbar spine and describes its role

Magnet Therapy. Magnet therapy is a type of alternative treatment some people have used to minimize back pain.

Minimally Invasive Spine Surgery TV Interview. A February 2003 interview with Stewart G. Eidelson, MD on minimally invasive spinal surgery

Smoking. Smoking is detrimental to the spine because it can decrease the oxygen supply and upset the nutritional composition of blood, which bones depend on for nourishment.

Spinal Column: An Integral Part of the Human Body. Chapter 2 from Save Your Aching Back and Neck, A Patient's Guide discusses spinal anatomy.

Spinal Cord - Ligaments - Muscles - Blood Supply. Learn about the spinal cord, nerve roots, cord membranes, ligaments and other spinal structures.

Spinal Cord Basics. Defines the role and the structure of the spinal cord (nerve root)

Spinal Ligaments and Tendons. Describes the structure and role of the ligaments and tendons of the spine

Spinal Muscles. The spinal muscles, along with the supporting system of ligaments, control the spine's ability to maintain balance and stability when a person stands or moves.

Spinal Nerve Disorders. Nerve compression can cause pain, tingling, numbness and weakness. Sciatica may be a symptom of compressive neuropathy when the lumbar spine is involved.

Spinal Stenosis: Treatment. A patient's guide spinal stenosis and the treatments available.

Spine Surgery: PreOperative Questions. Questions to ask your doctor before spine surgery; continued.

Spine Surgery: Questions to Ask Your Doctor. If you are scheduled to have spinal surgery, one way to relieve your anxiety about the procedure is to learn all you can about the procedure.

Spine Symposium Video March 11, 2003. The is a taping of a spine symposium presented March 11, 2003 at Bethesda Memorial Hospital by Stewart G. Eidelson, MD.

The Natural Curves of Your Spine. Basic description and picture of the form of the spine

Types of Spine Surgery. Learn about different types of spine surgery can be performed utilizing minimally invasive techniques.

Articles of Dr. Christopher P. Silveri, M.D.  SpineUniverse

Associate Clinical Professor, George Washington University Medical Center, Fairfax, VA, USA

Make Healthy Food Choices: Fiber - Carbohydrates - Salt - Sugar. Healthy carbohydrates are found in fresh foods from unprocessed grains, fruits and vegetables.

Questions & Answers. Questions and answers for kids on spinal health

Spine Health Benefits from Physical Activity. Physical conditioning reduces the change of injury and increases physical performance.

Surgery Recovery: From Hospital to Home. After any surgical procedure, the body needs times to restore damaged tissues and return to normal. The first part of recovery begins in the hospital.

Related Websites

Spine-Health.com

Spinal-Foundation.org

SpineUniverse.com

A World of Information on Pain - Pain.com

The campaign for better seating - BetterSeating.org

http://www.backpain.org

The Back Clinic

All about Bakc Pain - Back.com


Spine Inc.

Spine Health Links


Back Pain Message Boards

The Spine back pain and neck pain message board

Health Messag3e Board - BBC

Back Pain Message Board

Back1.com - Back Pain Discussion Board

SPINE DOCTOR - Bulletin Board

BackPain Support Group - Message Board

Pilonidal Discussion Board

Spine-health newsletter

Links to associations

Arthritis Care 
 
Arthritis Research Association

British Chiropractic Association 

British Acupuncture Council

British Medical Acupuncture Association

British Orthopaedic Association

British Osteopathic Association

Chartered Society of Physiotherapy

Complementary Medicine Association

General Chiropractic Council

General Osteopathic Council

McTimoney Chiropractic Association

National Ankylosing Spondylitis Society

National Osteoporosis Society

Society of Teachers of the Alexander Technique

Causes of back pain

By Fred Riddell

Most references to back pain focus on lower back pain in the lumbar spinal region. However, back pain causes in no particular order are:

A. Accidents or injuries leaving muscle pain

B. Osteoarthritis with deteriorating cartilage

C. Osteoporosis with bone loss / fracture

D. Fibromyalgia

E. Major conditions like cancer

Muscle, ligament and tendon problems are generally at the root of the pain problems along with some weakness in the lower back. Other body parts in the region can also be associated like bones and small joints. When no specific cause is apparent, the term NSLBP (nonspecific low back pain) is used. Any number of reasons for this pain can include degenerative disk disease, psychological issues, systemic disease, facet syndrome (similar to pinched nerves symptoms), herniated disk, spondylolisthesis or the forward displacement of one of the lower lumbar vertebrae over the vertebra below it or on the sacrum. Other factors could be spinal stenosis or constriction or spondyloarthropathy (disease affecting spinal joints). Lets take a look at each of these and what pain relief solutions are available.

DEGENERATIVE DISK DISEASE The degeneration of vertebral disks is a natural part of the aging process. What often happens though, is that when the narrowing of the disk space combines with the nociceptors, sensory receptors that respond to pain, in the outer annulus (in the disk space outside the nucleus) or dorsal root ganglion (spinal nerves) that become heightened, the result can be pain, although not always. Sometimes pain can be felt by some people, and other times not.

For example a minor accident like missing a step and landing a little harder than usual on your feet might cause back pain. And certain activities can aggravate degenerative disks, like yard work or house cleaning movements. But overall, pain associated with degenerative disk disease generally heals within a few days at most. Preventative measures like strengthening muscle groups to lessen future traumas are usually recommended along with an analgesic or medication that helps relieve pain. Only in some cases are epidurals or injections, blocks or surgery needed.

PSYCHOLOGICAL ISSUES - If acute back pain turns into chronic stages, factors of depression, fear and anxiety could increase discomfort and pain. And the longer the chronic pain persists, the more these factors tend to play a role, an increased role over time. So treatment strategies may need to include learning coping skills and alternative lifestyle enhancements to deal with the psychological factors present.

SYSTEMIC DISEASE This disease is the cause for up to 10% of back pain and largely among the elderly. Causes could be cancer-related or related to reduced bone mass or simply the aging process. Increasing or decreasing activities as well as switching positions all may have no affect on pain relief. Alternative therapies may be in need.

FACET SYNDROME - Similar to pinched nerves symptoms, this is believed to be associated with pain in the backs side joints and the main cause of up to 20 percent of back pain cases, with buttocks and upper leg pain increasing with long-term standing, and when switching sitting / standing / lying positions. An injection of local anesthetic into the facet joint helps determine the diagnosis. However, since the anesthetic relieves the pain at the same time and is used as a short-term solution, an x-ray doesnt help with imaging the pain results. Recommended treatment includes rigorous lumbar activities and body mechanics exercises to learn proper or more beneficial posture and movement techniques.

HERNIATED DISK Also known as a ruptured or protruding disk, a herniated disk extends beyond its own area into a surrounding region. Compression of the nerve root can cause pain. And pressure on the fibers in surrounding ligaments can cause pain. Although an accident involving lifting could be the cause of a herniated disk, its not necessarily so. For many, the cause is unknown; pain can occur suddenly or gradually over time. Relief for the pain can come from walking instead of sitting or standing, and surgery is rarely required right away, if at all in the event relief from pain happens within a limited amount of time. During this time (up to several weeks) any of the following might be effective to use, depending upon your healthcare provider: medication, physical therapy or non-frequently, steroid spinal injections.

SPONDYLOLISTHESIS or the forward displacement or slippage of one of the lower lumbar vertebrae (generally the fourth or fifth) over the vertebra below it or on the sacrum. This state of health is diagnosed by x-ray. Pain is believed to occur where the displacement is, at or below the displacement, or from spinal stenosis, discussed next. Depending upon the patient, strengthening exercises or a back support may be all thats required. In others, surgery may be an option.

SPINAL STENOSIS is the constriction or narrowing of the vertebral canal. Mainly due to aging, as the gradual lessening of disk space and changes in ligaments advance upon the nerve roots below the lumbar vertebra or L2, pain can result. Its often accompanied by numbness in the legs and is not aided any by walking. Different vertebra and varied physical activities can affect the pains location, intensity, recurring and duration. To help diagnose this condition, healthcare providers can use myelography, or an x-ray of the spinal cord after injection of air or a radiopaque substance into the subarachnoid space, with a post-CAT scan. And depending upon the patient, treatments can vary and be minor with medication if the pain gradually disappears, to epidural corticosteroid injections in the epidural, to blocks or surgery.

SPONDYLOARTHROPATHY - This term refers to a variety of diseases affecting spinal joints; arthritis variations- psoriatic arthritis and ankylosing spondylitis, the more common of the two and in males more often than women; and sacroiliitis, accompanies inflammatory bowels. Diagnosis consists of a physical exam, history and testing including x-rays, CAT or MRI, as the disease progresses slowly long-term fusing sacroiliac joints together and joints between vertebrae together. To relieve pain, there is treatment with exercises and physical therapy to promote better enhanced posture and mobility and some arthritic medications.

More free information about back health including treatments, exercises and prevention can be found at http://www.backachess.com

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