BACK PAIN

depositphotos_2629473-Highlighted-neck Low Back pain can be the result of numerous conditions, many of which will be described below.  The most important factor in treating low back pain is to secure a proper diagnosis.
A proper diagnosis does not simply mean obtaining an imaging study such as MRI or CT scan.  The first and most important part of a proper diagnosis comes from meeting with a skilled clinician who will obtain a history and perform a physical exam.  The history includes prior medical problems, the current events surrounding the current complaint, family history, social history, nutritional history and psychosocial history.  The exam includes the vital signs (heart rate, blood pressure, respiratory rate), a musculoskeletal assessment and a neurological exam.

¬†Here are a FEW Back Pain Causes……

Lumbar Strain

Lumbar strain results from a sudden or repeated overload of the low back muscles.¬† Sometimes, the individual is in a work environment in which the back muscles are constantly straining, and they cannot compensate for the demands placed upon them.¬† Other times, an individual engages in very stressful activity for which the low back muscles are not prepared‚Äďthe ‚Äúweekend warrior‚ÄĚ mentality.¬† Patients with lumbar strain have pain across the lower back, or on one side of the low back.¬† Pain usually does not radiate into the legs, and is usually relieved with lying down. Lumbar Strain is usually self-limiting, and can be managed with any combination of: medical therapy; physical therapy; spine manipulation; and a gradual return to activity.

Lumbar Disc Herniation

Lumbar disc herniation means that one of the lumbar discs between the vertebral bodies has torn, and the inner disc material has moved outside of the normal confines of the disc.  When this happens, the inner disc material can irritate pain sensitive structures in the back.  Depending on the pain structure that is irritated, the lumbar disc herniation can cause localized back pain or pain radiating into the leg.   Sciatica is the terminology that refers to radiating leg pain that results from irritation of part of the sciatic nerve.  The sciatic nerve is a large nerve that is formed from many nerves that originate in the lumbar spine.  These nerves join together to form the large sciatic nerve, which controls sensation in the back and side of the leg.

In addition to pain, lumbar disc herniation can lead to a decrease in stability and resiliency of the spine.  Once a lumbar disc herniates, the disc becomes drier over time.  Rather than acting as a shock-absorbing and stabilizing structure, the drier disc is more like a wet sponge out of water.  For proper function to continue, the individual must develop improved balance and strength in the lumbar spine support muscles.

Treatment of lumbar disc herniation depends on the size of the disc and the type of pain.  Initial treatment focuses on controlling pain, and this can include the use of medications, or performing therapeutic
injections such as epidural injections. Hands-on therapy is important, especially physical therapy that addresses both spinal balance and spinal strength.

spine

Lumbar Degenerative Disc Disease/Lumbar Spondylosis

Lumbar degenerative disc disease is not actually a disease, but is a process in which the lumbar discs lose their plumpness over time as a result of losing the inner water content.  This is usually a result of a genetic predetermination to the lumbar disc losing some important enzymes over time, which leads to a turnover of the inner water content.  Degenerative changes can also result from a lumbar disc herniation.  Once a disc herniation occurs, the outer protective layer of the disc is less effective, and the inner water content becomes expelled from the disc.

Individuals with lumbar disc herniation may develop intermittent attacks of low back pain, followed by weeks or months of little or no pain.  The attacks may result from a sudden change in the lumbar disc, which
may then result in part of the lumbar spine (such as the facet joint, described in another section) becoming jammed and irritated.  Other times, the disc may suddenly protrude and irritate a pain sensitive structure.

Treatment is directed at alleviating pain during attacks, and this can be achieved through medications or therapeutic injections (such as facet blocks). Pain relief should be coupled with hands-on therapy, and potentially decompression which helps to ensure proper spine balance and strength.  Our providers will discuss your options and individual needs.

 Facet Pain

Facet pain results from irritation of the facet joints.  Normally, the facet joints are smooth, gliding joints in the back of the lumbar spine.  When the lumbar disc degenerates, there is less plumpness of the disc and the vertebral bodies then move closer together.  When they do so, the facet joints also move close together and can assume a weight-bearing role rather than a smooth, directional gliding role.  Because the facet joints are pain sensitive, they may generate pain when they assume a weight-bearing role.

Facet pain usually occurs in individuals who also have lumbar disc problems, and the pain is maximal in a trunk extension position.  In this position, the facet joints can become more compressed.  Treatment is directed at alleviating pain, and this can be achieved through medications or therapeutic injections.  With therapeutic injections, the facet joint can be targeted specifically.  In some cases, individuals obtain good relief following a facet injection, but the pain then recurs.  This is why our clinic works hand in hand with our Physical Therapist as well as Chiropractors to stabilize the facet joint for LONGER pain relief.

 Sacroiliac Pain

Sacroiliac pain is pain that is referred to the sacroiliac joint, which is the narrow joint that lies between the sacrum and pelvis.  Sometimes this pain is the result of arthritic changes in this joint or an inflammation as a result of an auto-immune condition.  Sometimes the pain has nothing to do with the sacroiliac joint itself, but is rather the result of muscle imbalance around the joint. It is extremely important to arrive at a precise cause of pain when making a diagnosis of sacroiliac pain.  If the cause is from an auto-immune condition, then the underlying condition must be treated.  If the cause if from arthritis, then medications
and/or an injection into the joint, coupled with manual therapy, may be helpful.  If the cause is muscle imbalance, then the imbalance must be addressed with manual therapy and a proper exercise program.

 Myofascial Pain

Myofascial pain is physical pain that is caused by a change in the body’s normal physiology.  Although myofascial pain may be located in the low back, (or in another region of the body), the cause of the pain is not from a specific problem in the low back.  The cause is from dysfunction of the nervous system, and the underlying dysfunction is somewhat similar physiologically to a chronic migraine headache.  The nervous system generates pain signals, and the muscles in the region of pain can become secondarily overly contracted or tender. Treatment should be multi-disciplinary.  If treatment is simply directed at the region of pain, it is often unsuccessful.  Manual therapy may be helpful in combination with conventional physical therapy consisting of modalities and exercises.  The manual therapy should be focused on a combination of a relaxation response and re-balancing of the musculature.  Our medical staff will evaluate and treat as they conclude ALL necessary testing.

 Failed-Back Syndrome (Post-Laminectomy Syndrome)

Failed-back syndrome, with regard to the lumbar spine, means that an individual has undergone one or more lumbar spine surgical procedures, yet continues to suffer with back pain.¬† Often, the pain is worse than it had been prior to surgery despite the fact that the surgery may have been ‚Äėtechnically‚Äô successful.¬† Pain is often constant, and there are usually several muscle maladaptations in addition to chronic pain. Treatment must be multi-disciplinary if it is to be successful.¬† Further surgery will often worsen the pain, and surgery should only be considered if there is a clear-cut anatomical problem that has been identified and that correlates clinically with the individual‚Äôs pain.¬† Medication, manual therapy and¬†physical therapy are the norm for treatment.

Don’t Ignore the signs….

¬†Warning signs….. your low-back pain may¬†have a herniated disc would be specific symptoms of pain shooting down the leg. Leg pain, sometimes referred to as sciatica, can be a caused by herniated discs. A disc herniation does not always require surgery, but there are non-surgical treatment for back pain and bulging discs. It is vital that leg pain or sciatic pain is evaluated as soon as possible. Untreated bulging discs or disc herniations may require surgery. Patients wanting to avoid surgery should be evaluated as soon as they feel any pain down either or both of their legs.

Breakthrough Pain Relief Clinic is also a DME supplier, meaning we can supply our patients with a proper fitting Brace, therapy tools, or Tens units to take home. In most cases Insurance will cover the cost.

Remember, proper diagnosis of back pain is the first step for back pain relief. Advanced imaging along with the latest in diagnostic equipment help us to pinpoint the low back pain causes and outline treatment that is best for the patient.

Your wait is over, now you can visit one of our five locations, where we provide pain management and rehab services for patients all in one convenient location. Our board certified physicians treat back pain on a daily basis with great success. Contact the office nearest you for a free back pain consultation. We will get you a priority appointment and help you get immediate relief. Call now (877) 417-1277