Most people go through life with poor postural habits that over time create unnecessary stress on the discs, joints and muscles of the back. This unnecessary stress speeds up the degenerative process of the spine and creates compression in the lumbar spine. Occupations that include frequently carrying heavy loads, being required to work while bent over, or having to work in awkward positions puts you at higher risk for having a low back injury. To understand how these physical stresses contribute to back pain, it is important to understand the intervertebral disc in more detail.
Spinal discs function as shock absorbers, the intervertebral discs are designed to allow movement and withstand the compressive loads transmitted through the spine. If the spine is not mobile or stable then there will be compression and the disc space will be compromised. This compression is best to be removed by decompression therapy.
The center of the disc is a gel-like substance called nucleus pulposis. There are several rings of tough fibrous tissue surrounding the nucleus called the annulus fibrosis. Compressive loads to the spine are distributed by the nucleus pulposis to the fibrosis. The annulus is the principle load bearing structure of the disc. The annulus fibrosis will be able to withstand the compressive load as long as the forces are adequately distributed by the nucleus. Any impairment in the structure of the intervertebral disc will compromise its ability to withstand compressive loads and will ultimately cause the disc to fail.
The discs of the lumbar spine are subjected to greater compressive loads than the other discs of the spine; especially the discs between the fourth and fifth lumbar vertebrae and the sacrum. If the supporting structures that protect the spine become injured or weakened, the pressure in the nucleus may become great enough to rupture the annulus fibrosis. When this occurs, the nucleus pulposis may push on the wall of the annulus fibrosis (bulging disc), or may itself protrude (herniated disc) through the annulus fibrosis, toward the spinal cord and nerves. The pressure exerted on the spinal cord or nerves may cause considerable pain. For instance, when the roots of the sciatic nerve are irritated, the pain can radiate down the buttocks, the back of the thigh, through the calf, and occasionally into the foot. This is called sciatica.
The following lesser-known factors may also contribute or aggravate a person's back pain:
Obesity may contribute to back pain. A direct correlation does exist between obesity and back pain, in particular with chronic or recurrent low back pain. Even a few extra pounds may affect how a person walks, stands, or sits, placing additional strain on the spine.
Sports activities can contribute to back pain. Activities like skiing, jogging, golf, and rowing can be stressful on the back. Contact sports like football and rugby add additional risk factors of direct injury to other parts of the body. These injuries may indirectly contribute to additional stresses on the back.
Stress may also contribute to back pain. Anxiety, depression, and stressful situations may increase a person's risk for back pain. Psychological factors, more specifically stress and depression, may also be contributing factors in chronic low back pain.
These conditions may often be treated non-surgically:
A herniated disc (also referred to as a protruding or extruded disc) is a condition where a portion of the gel-like center of the disc has migrated through the layers of the annulus fibrosus. This can cause mechanical pressure on the neighboring structures and trigger chemical reactions resulting in pain and inflammation. These changes will often irritate the nerves, producing numbness or tingling in the legs or feet. Left untreated, this condition may result in life-changing pain and physical disability.
Degenerative disc disease is a state of dehydration and deterioration marked by the gradual erosion of the discs ability to distribute and resist mechanical loads. As discs deteriorate, they become more prone to injury from physical stress. Degenerative disc disease may also play a contributing role in conditions such as disc bulges, disc herniations, and stenosis.
Facet syndrome: facets are the posterior joints of the spine that aid in keeping the vertebrae aligned. Facet syndrome can result from injury or degeneration of the disc and is characterized by pain, stiffness, and inflammation. The pain generally increases with motion and is relieved by rest.
Sciatica is a condition often associated with a herniated or ruptured disc. When the injured disc compresses one of the spinal nerves leading to the sciatic nerve, it can produce a shock-like pain that travels through the buttocks and down one leg to below the knee. Tingling and numbness are common in this condition. Sciatica can occur suddenly, or develop gradually.
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