Cause of Lower Back Pain: Spinal Stenosis

Spinal Stenosis is a common cause of lower back pain and sciatica. It is most often found in older patients in their 60’s and older.

Stenosis means a restriction or blockage of a hole or opening. When doctors refer to “spinal stenosis” they are most often talking about stenosis or blockage of the central spinal canal. The central, canal is the large opening in the spinal bones that provides a bony “tube” that houses and protects the spinal cord.

The Cause of Spinal Stenosis
The central canal may become reduced in size due to:

• Disc bulge or herniation
• Bone spur of vertebral body
• Bone spur from facet arthritis

Symptoms of Spinal Stenosis
No matter what the cause, the symptoms of central spinal stenosis are the same. The textbook example is back and/or leg pain that is aggravated by walking and is relieved by short periods of sitting, after which time the person can walk for a period of time before the pain increases again. Sufferers of spinal stenosis must take frequent breaks on a walk.

As the condition worsens the amount of time the patient is able to walk gets shorter and shorter. Eventually spinal stenosis sufferers stop going for walks, shopping, etc.

Diagnosing Spinal Stenosis
The history of pain while walking relieved by rest is a big clue. A physical exam is necessary to determine the extent of neurologic function.

Two things must be documented and monitored for treatment:

1. How long the patient can walk before he or she must sit
2. How far down the pain travels; buttocks, back of thighs, calves, etc

An MRI is the most conclusive test to accurately diagnose stenosis and to determine the severity and cause, i.e. bone spur versus disc herniation.

Spinal Stenosis Treatment depends on:

• The cause; disc vs. bone spur
• The severity

For more information on spinal stenosis and a possible treatment go to: http://www.spinediscrehab.com/drx9000.htm

Is Your Disc Bulge ‘Focal’ or ‘Diffuse’? and Why it Matters…

The spine is made of 26 interlocking bones held together and made flexible by “discs” between each spinal bone.

Disc Function:
The disc is a flexible, yet very strong structure that bears the brunt of our weight by absorbing shock. Discs allow movement between the vertebrae or spinal bones. The discs also act as spacers to allow enough room for sensitive and important nerves to pass from the spinal cord to the rest of the body so that your brain can control and communicate with distant organs and tissues.

Disc Anatomy
A disc has 2 parts:
1. Annulus–outer fibrous tissue
2. Nucleus–inner gel substance

Disc Damage
When a disc is injured by acute trauma or by long-standing physical stresses, the outer fibers are weakened and allow the disc to bulge outward. The annulus may bulge or protrude in a small discreet area called a “focal” disc bulge or it may bulge across a wide portion of the disc, which would be called a “diffuse” bulge.

Focal bulges by their smaller and more localized nature cause more discreet neurologic symptoms like pain. Because the bulge is small or focused to only one area, the nerves involved are fewer.

Diffuse bulges however, take up more space and can cause more varied symptoms. You could one sided or both sided pain, you could have pain that appears to be coming from a different level altogether because of pressure on the spinal cord itself and not just a discreet nerve.

Obviously if you are going to pick and choose your bulge, you’d opt for a focal one. Unfortunately back pain sufferers have no choice. The “take away” point here though is if you know what type you have, it will help you to understand what your likely recovery is.

It’s also crucial for your doctor to take this into account to determine what treatment methods to use to cure your lower back pain and sciatica.

Learn what can be done to repair damaged discs and relieve the pain without surgery here:http://www.spinediscrehab.com/

Cause of Lower Back Pain: Bulging Disc Herniation

Intervertebral discs are “spacers” between the spinal bones. They provide room for the joints to move allowing flexbility of the spine. They also provide room for the nerves to exit from the spinal cord to the rest of the body.   

Discs are usually filled with water and are quite flexible, almost rubbery. Due to lifting injuries, repeated physical stress, automobile accidents, etc the outer disc fibers (annulus) become damaged allowing water to escape from the disc. In time, the disc become more and more dehydrated and beghins to weaken. Just like a car or bicycle tire that’s sidewall is weak, a bulge forms. The bulge may put pressure within the canal that nerves pass through causing not only back pian, but also butt, thigh, leg or foot pain (sciatica).

The disc bulge may worsen and the outer fibers may actually tear open and allow inner disc material (nucleus) to protrude outward (herniation) into the nerves or spinal cord. In most instances, a herniation like this will cause back pain and sciatica, but also serious physical signs such as loss of muscle strength in the legs, shrinking of leg muscles (atrophy) and/or loss of reflexes. See video tutorial of disc herniation here: http://www.CureForLowerBackPain.com

Diagnosis of disc bulge and herniation are by careful phsyical examination and confirmed conclusively on MRI scan. Plain x-rays will NOT show disc bulges or herniation. A seemingly normal x-ray may show up as a severe herniation on MRI.