Disc injury

This can be a disc herniation, rupture, bulge, or simple irritation.  All of these diagnoses cause inflammation in the low back that can put pressure on other structures that lead to pain.  The most common of these areas are the spinal nerve roots or even the spinal cord. Most people get nervous or upset when they learn that they have some kind of disc injury but as it turns out, most disc injuries are asymptomatic. This means that many people in Hamilton & Dundas are walking around with one of the above versions of a disc injury and they don’t have any symptoms (pain).

 
Did you know that most people that have a disc injury don’t have any pain at all? I have seen these quite a lot with the patients I have treated in Hamilton & Dundas region. A study published in the New England Journal of Medicine showed that 64% of people with diagnostic testing showing a disc injury had absolutely no low back pain.

People who have disc injuries….

• Are typically age 40 and under ? – There are of course always exceptions but most people with disc injuries tend to be on the younger side. This is because as you age, you start to lose the water content of the disc and it becomes less likely for you to have a disc injury like a bulge or a herniation.
• Have pain that gets worse with bending or sitting – Most people with a disc problem have an increase in pain in the low back or even down the back of the leg when they sit in a chair (and often even worse when sitting in their car) or when standing and bending forward, like when brushing your teeth at the sink or bending down to tie your shoe. When you do these activities, the pressure is put on the front of the disc and the material inside the disc pushes toward the back of that spinal segment which puts pressure on the nerves right behind the discs.

Typically have these signs and symptoms…

• Low back pain that can go down to the hip, knee or even all the way down to the ankle
• Have pain that is worse in the morning when they get-up
• Pain that gets worse at the end of the day
• Complain of numbness and or tingling in the low back or the leg
• Get relief of pain with standing or walking
• Feel nervous to move in certain directions (usually twisting motions of the spine) for fear of increasing the pain.

Spinal Stenosis

Stenosis in the spine is defined by a narrowing of the holes created by the vertebra (segments of the spine stacking on top of one another) that the nerves travel through.  These holes are called the vertebral foramen (the big hole that the spinal canal travels through) and the intervertebral foramen (the smaller holes that the spinal nerves travel through on each side of the spinal cord).  As these holes get smaller, there is less room for the nerve to move through. This is an issue because it can restrict the motion of the nerves or even put pressure on the nerves causing pain, numbness tingling and or burning anywhere from the low back down to the feet.  As we age, this is a natural process that most people know as being called arthritis.

People who have spinal stenosis….

• Are usually over the age of 40 – Acceptions can occur but most people with spinal stenosis are over the age of 40.  As the spine ages, the water content of the disc lessens and the space between each vertebrae gets smaller.  This is one of the reasons most people get a little shorter as they age. As the space gets smaller, there is less room for the nerves to travel through and thus there is an increase in the incidence of pain caused by this smaller space.
• Pain that gets worse with standing and walking and is relieved with sitting – If you are over the age of 65 and you have low back pain that gets worse as you stand and walk and gets better if you sit, there is a 95% chance you have spinal stenosis.  This is the telltale sign that your back pain is coming from a narrowing of the canals the nerves travel through.

Typically have these signs and symptoms…

• General pain/ soreness in the low back, usually stronger on one side
• Morning stiffness that feels better after you get up and moving
• A forward bending/ hunched over posture makes the pain better (like leaning forward on your grocery cart)
• Pain that extends down from the back into the hip, knee or even all the way down to the foot
• Numbness/tingling or even just pain and stiffness in the legs
• A feeling of general weakness or even a cramping sensation in the leg

Sacroiliac joint injury

A sacroiliac joint (or SI joint) issue is the most commonly missed problem during the examination of someone with low back pain. This problem can’t be seen on an x-ray or MRI and is difficult to diagnose.  It’s a shift in the position of the pelvis that typically causes very specific pain on one side of the tailbone. This pain is caused by the inflammation and irritation associated with the pelvis not being in alignment.  It can also cause the appearance that one leg is slightly longer than the other which causes a structural imbalance in the pelvis and spine. SI joint injuries usually come in combination with a disc injury or stenosis, but SI joint problems can happen on their own.

People who have an SI joint injury….

• Are Can be anywhere from age 9-90 – This is one of the factors that make a diagnosis so tricky. Although it is more common to have SI joint issue when you are young (birth to age 50) we see these issues in the aging population as well.   It is also much more common in female patients due to their chemical differences to males and is
• Pain that increases with a change of position – Getting in and out of the car, rolling in bed and changing positions from bending and squatting to moving upright, or vice versa, usually irritates SI joint injuries.

Typically have these signs and symptoms…

• Pain in a small area on one side of the low back/tailbone area that is easy to point to… “I have the pain right here!”
• Sharp stabbing pain with normal movement
• Feeling of being ‘uneven” like one leg is longer than the other
• Pain that can go down the back of the hip to the knee, but not past the knee
• Feeling of “being stuck” on one side of the pelvis

Are you looking for more information and someone to tell you what is going on with your low back pain!? All you need to do to get started is to call our Physio Hotline number (289) 803 – 8076 and pick your time and location (1. Upper Wentworth, 2. James St S, 3. Dundas, 4. Burlington). We look forward to meeting you and getting you back to normal!