08 July, 2011
Discs and Lower Back Problems
Millions of people live with chronic low back pain. There are many factors that cause back pain. It can be mechanical or result from poor posture or work habits, arthritis or other degenerative changes to the spine. It can also be a warning sign of a medical problem such as kidney disease. In some cases, low back pain can be caused by a problem with one or more of your discs. If your doctor has told you that a disc is responsible for your low back pain, learning all you can about your condition will help you to play an active role in your care.
Your spine is made up of bones, muscles, ligaments and tendons. The bones of the spine are called vertebrae. The vertebrae allow your back to have structure so that you can stand up straight. They provide a place for muscles, ligaments and tendons to attach and they have openings that nerves can travel through. In-between each vertebra are discs. Discs are circular structures with a tough outside layer that surrounds a jelly-like center says Ceders Sinai. They provide cushioning between your vertebrae and allow your spine to move in various ways. However, your spine and discs are susceptible to injury, disease and wear and tear. If there is a problem with one or more of your disks, you can develop acute or chronic symptoms. Disc problems are most common in the neck and lower back or lumbar area.
In the low back area of your spine, there are five vertebrae (L1, L2, L3, L4 and L5) and four discs. The discs are named for the vertebrae they are between. For example, the disc that is between the top two vertebrae is called L1-L2 disk. There is also a disc that separates the last vertebra from your sacrum or tail bone. This disk is called L5-S1. According to the University of Virginia Health System, the most common disc to be injured is L5-S1. With age and normal wear and tear, your discs can lose fluid and become dry. The discs may get smaller and you can lose some of the natural space that is supposed to be between each vertebrae. In some cases, as this occurs, the jelly-like center of the disc can start to push out and bulge. Because this happens to some degree as part of the normal aging process, many people have a disc bulge but never know it. Lower back disc problems do not always cause symptoms or require treatment.
Low back pain and other problems occur when the disc compresses nearby nerves, muscles, tendons or ligaments. If the disc has degenerated enough, the ends of the vertebra can rub against each other and cause the bones to deteriorate or develop bone spurs. In addition to age, poor postural habits, lifting or working incorrectly, medical conditions or accidents can also cause injury to the discs in the lower back. If due to illness or injury the jelly-like center pushes out of place without breaking the outer layer of the disc, it is called a disc bulge. If the jelly-like center pushes out enough so that the outer layer breaks, then you have a ruptured disc. Your doctor will need to do a physical exam, go over your history of symptoms and take X-rays, MRIs and other scans to properly diagnose the actual disc problem that is causing your symptoms. A ruptured disc may need immediate surgery, while a bulging disc may heal on its own if it is not too severe.
The symptoms you will experience with a low back disc problem will depend on the severity and location of the problem. The Mayo Clinic states that a disc problem can cause low back pain that is mild and localized or it can be severe and radiate down your legs. If the disc also presses on nearby nerves, along with lower back pain, you may develop numbness, tingling and burning sensations in your back, hips and in the legs. You may also find that you lose strength in your legs as well. Because the nerves that control your bladder and bowels also pass through the lower back, you may lose control over these functions. Once your doctor understands the extent of your injury, she can recommend treatment. Surgery is usually the last option and is reserved for times when your pain or loss of function is extreme. Many disc problems can be resolved with a multifaceted and conservative approach. This may include medication, physical therapy and the use of back braces.
The best thing you can do about low back problems caused by disc injury is to take steps to prevent it from happening in the first place. However, if you already have an injury, these same steps will help you to avoid re-injuring your back and in managing your symptoms. The American Academy of Orthopaedic Surgeons recommends always using good form when lifting, such as bending your knees, using your abdominal muscles and getting help for heavy objects. The National Institutes of Health state that in addition to using good postural and work habits, exercise at least two to three times per week. This includes exercises to strengthen the abdominal muscles and back muscles as well as stretches to keep the low back flexible. In addition, if you are overweight, you will need to do aerobic activities to shed the extra pounds, which can strain your low back.
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