Having a Back Pain Free Winter!!!

Dr. Samar Shehaiber, D.C. RRT

You are out shoveling snow from last night’s snowstorm, when all of a sudden your back gives out and you find yourself lying on the ground with immense pain!  You wonder to yourself what happened. The back and spine are designed to provide a great deal of strength, protection, and mobility. However, if not properly cared for and managed, can produce all sorts of ailments that were not anticipated. 

Back pain is often caused by a multitude of dysfunctions that alters the neurological as well as the muscular systems.  Younger adults (30-60) are more likely to experience back pain from disc space irritation such as a disc degeneration or Herniation, while older adults (over 60) experience pain related to joint degeneration as in osteoarthritis or spinal stenosis.  Acute lower back pain which is short term and lasts from a few days to a few weeks can become serious if left untreated.  Chronic back pain persists for more than three months and can be progressive or occasionally flare up.  The pain may be constant, intermittent, or only occur with certain positions or activities.  It can also remain in one spot or radiate to other areas.  Patients will often describe it as sharp, or a dull ache, piercing, or burning sensation.  Back pain can often accompany weakness, numbness, or tingling.

A back sprain or strain is usually localized to the low back, it often doesn’t radiate down the leg.  The pain starts after lifting something heavy, or twisting, or a sudden movement or fall.  Pain is described as a muscle spasm, tenderness, and worse with activity.  Note that a muscle is strained while a ligament or tendon is sprained.  This type of back pain often resolves within a day to three days on its own with heat and rest.

Sciatica is low back pain that radiates down the buttock region and down the leg or foot.  Patients often describe it as a numbness or tingling feeling.  This pain is often worsened with sitting or prolonged standing.  Sciatica can also be due to a Herniation or bulging of a lumbar disc in the low back. The inner core of the disc may lead out and irritate a nearby nerve root, causing sciatica.

If the low back pain is accompanied by leg pain, which is worse when standing for long periods of time or walking long distances, it is often due to a stress fracture in the back called isthmic spondylolisthesis. This stress fracture allows one vertebrae to slip forwards on another usually at the bottom of the spine mainly L4-L5.

Spinal stenosis or narrowing of the spinal canal and/or degenerative spondylolisthesis is pain that is felt down the legs when walking and standing upright and feels worse with more walking and gets better after sitting down.  Most commonly seen in older individuals. The spinal canal narrows due to degeneration, which ends up putting pressure on the nerve root and causes sciatica as well.

Pain that is exaggerated with certain movements and positions such as bending forward, running, tends to fluctuate with severity is often due to chronic degenerative disc disease.  A disc is the middle cushion layer of a spine that acts as your hydraulic system in the body.  This type of pain is often worse in the morning when you get up but relieved throughout the day with movement.  Another version of this pain is facet joint osteoarthritis, which also manifests the same symptomology along with stiffness in the morning and evening.  Often seen in older adults. As the disc degenerates it can allow small amounts of motion in that segment of the spine and irritate a nerve root and cause sciatica as well. With facet osteoarthritis, the degeneration occurs in small facet joints in the back of the spine that can cause back pain and decrease flexibility, which eventually leads to spinal stenosis and nerve pinching.

Many treatment options are available.  Consult your physician about which treatment is best for you.