Back Pain

Most of us experience lower back pain at some point in our lives. It is a common complaint of middle-age and older adults and those who work in jobs that require heavy lifting and bending. While most back pain is relieved by over-the-counter and prescription medication, rest, heat and physical therapy, sometimes the injury or disease requires surgery for the patient to get relief from the pain and associated weakness/numbness.

The lumbar spine is designed with five vertebrae that are protected with jellylike discs that keep the bones from rubbing against each other. Ligaments hold these discs in place and pairs of spinal nerves and roots connect the lower back in the lumbar and sacral regions.

Most patients have one of three lower back conditions:

  • Herniated Discs occur when the soft center and outer lining that surrounds the disc tears, resulting in some of the gel-like substance to leak through the opening. This is called herniated, slipped or ruptured disc.

  • Lumber Spinal Stenosis occurs when there is narrowing within the spinal canal. This results in pressure or compression on the nerves that run from the lower back through the legs. While some medical conditions can cause this to occur, it normally happens due to a degeneration of the discs in older adults. Patients may develop pain, numbness or weakness in the limbs on one or both sides of the body. More complex cases result in lost function in the legs, bladder and/or bowel function.

    Two medical conditions – degenerative spondylolisthesis and degenerative scoliosis can also cause spinal stenosis. In degenerative spondylolisthesis the vertebrae may slip due to the effects of breakdown caused by osteoarthritis. Degenerative scoliosis is more frequent in adults who are at least 65 years old. While the condition is normally treated conservatively, sometimes severe curvature may need to be surgically corrected for the patient to get relief from the pain.

  • Osteoarthritis is a breakdown of cartilage in the joints and often affects the lower back. Cartilage, a flexible and protective covering between bones and joints, helps reduce bone to bone contact. When there is breakdown, patients develop pain and sometimes bone spurs. In the spine, this type of arthritis is called spondylosis. Age is the primary cause of this degenerative disease that can result in disc degeneration, bone spurs, pinched nerves, and bone overgrowth that can narrow the spinal canal.

While most patients can control their pain with medication and therapy, some conditions may worsen to the point where surgery is required to repair the vertebrae, remove damaged discs or provide space in the spinal canal so that nerves are not pinched. When patients have pain that limits their daily activities, are unable to stand or walk normally, experience persistent weakness and numbness or lose of bowel and bladder function, surgery is the best option.

Learn about some common surgical procedures used to address these conditions.

 

 

 

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