Back Pain or "Lumbago"

The word lumbago refers to low back pain.  Low back pain sometimes occurs with sciatica.  Sciatica refers to the leg pain.  Back pain (lumbago) is usually due to degenerative disc disease whereas leg pain (sciatica) is most often caused by a pinched nerve.

Degenerative disc disease (DDD) is a term used by doctors to describe disc problems.  It is actually a misnomer.  It is not always degenerative and is not actually a disease.  The term "degenerative disc disease" is the label applied to almost any problem that affects the disks in the back. 

Disc disease is the leading cause of lower back pain in young adults. With age, the problem becomes more common.  We all have some degeneration, or “wear and tear,” in our vertebral discs.

At birth, a vertebral disc is about 80 percent water and functions as a shock absorber between the vertebral bones. As the disc ages, the water content decreases and the disc becomes stiffer and more fragile. Tears develop in the outer shell of the disc and the softer tissue inside can leak out.

Magnetic resonance imaging (MRI) is most commonly used to diagnose disc disease.

Twenty-five to thirty million Americans suffer from chronic low back pain, the number one cause of lost days from work in the U.S. Certain jobs, excess weight, alcohol use, and smoking all increase the chance of disc disease.

Q. What if the MRI Scan shows a herniated disc? What do I do then?

A. If you have a herniated disk, you should see a spine specialist.  The doctor will first diagnose the cause of the problem.  Unless there is severe pain or weakness, conservative care will usually be recommended.  Exercise and pain medications are used first.  Chiropractic or acupuncture may be helpful.  If these do not help, a steroid shot may be advised.  Surgery is usually the last resort.

Q.  What is a Drop Foot

A. Drop foot is not a disease but a symptom.  It is caused by weakness of the muscle that lifts the foot up at the ankle (the tibialis anterior muscle).   The drop foot may be temporary or permanent. Drop foot is most frequently caused by injury to the L₅ nerve root.  The L₅ nerve is usually injured by a bad L₄-L₅ disc.  Occasionally, a drop foot can be caused by an injury to the peroneal nerve.  The peroneal nerve is a branch of the sciatic nerve and can be injured during hip or knee surgery. It can be injured by a deep bruise or a bad  laceration.  Drop foot can also be caused by Amyotrophic Lateral Sclerosis (ALS) and Multiple Sclerosis (MS). The cause can be determined using MRI (magnetic resonance imaging), and EMG (electromyogram).   A drop foot can be an emergency condition, and you should see your spine doctor immediately if you develop this problem.

The type of treatment is dependent on the cause of the drop foot. An ankle foot orthosis (AFO) brace, can prevent falls. The damaged nerve should, however, be repaired as soon as possible.  If a disc is the problem, it should be corrected immediately.  If the nerve is damaged by a knife wound, repairing it is also urgent.

Q. How can I protect my back?

Strengthening Exercises	Stretching Exercises
Click on pictures to enlarge

A.  Strengthening exercises and stretching exercises are recommended as above.

B.  Follow several simple guidelines which have published by the North American Spine Society:

1. Standing - Keeping one foot forward of the other, with knees slightly bent, takes the pressure off your low back.
2. Sitting - Sitting with your knees slightly higher than your hips provides good low back support.
3. Reaching - Stand on a stool to reach things that are above your shoulder level.
4. Moving Heavy Items - Pushing is easier on your back than pulling. Use your arms and legs to start the push. If you must lift a heavy item, get someone to help you.
5. Lifting - Kneel down on one knee with the other foot flat on the floor, as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times.
6. Carrying - Two small objects (one in either hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body.
7. Sleeping - Sleeping on your back puts 55 pounds of pressure on your back. Putting a couple of pillows under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure.
8. Weight Control - Additional weight puts a strain on your back. Keep within 10 pounds of your ideal weight for a healthier back.
9. Quit Smoking - Smokers are more prone to back pain than nonsmokers because nicotine restricts the flow of blood to the discs that cushion your vertebrae.
10. Minor Back Pain - Treat minor back pain with anti-inflammatories and gentle stretching, followed by an ice pack.

For Information on fibromyalgia click here.

For Information on sacroiliitis click here..

For Information on the pyriformis syndrome click here.

Click here to see the page on neck pain.

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