Degenerative Disc Disease

The discs and the joints in the spine are partly made of cartilage, which deteriorate with age. Degenerative disc disease, one of the most common causes of back pain, is this gradual weakening of the discs between the vertebrae, losing their shock-absorbing abilities. The deterioration is usually accompanied by pain in the area and often causes degenerative arthritis.

Disk degeneration (spondylosis) makes the discs more susceptible to herniation (a slipped disc), where the disk tears and bulges out, sometimes pinching nerves.

Degeneration of the disc may affect the spine of the neck (cervical disc disease), the mid-back (thoracic disc disease) or the lower spine (lumbago), common in older people.

The pain from degenerative disc disease (sciatica) sometimes spreads from the back to the legs and feet, and causes weakness, numbness or pins and needles due to pinched nerves. Pain is usually treated with heat, rest, rehabilitative exercises, and pain killers or anti-inflammatory medications.

Treatment

Treatment options include anti-inflammatory drugs, physical therapy and rest. Surgery may be a last resort if these treatments are unsuccessful.

Spinal Stenosis

In spinal stenosis (Greek for “choking”), the spinal cord’s nerve roots are pinched or compressed, often causing pain, pins and needles, weakness or numbness that may spread to the legs, especially when walking or exercising.

The implication is that the spine is degenerating, limiting activity. About 75 per cent of spinal stenosis occurs in the lower back (foraminal stenosis), usually affecting the sciatic nerve that runs along the back of the leg.

Sciatica

Sciatica refers to back pain that spreads down the back of the leg along the sciatic nerve, the largest nerve in the body that connects the spinal cord to the leg and foot muscles, facilitating sensation, strength and reflexes. The pain may include numbness, burning or tingling, sometimes extending all the way down to the foot. Caused by a compressed or irritated spinal nerve, sciatica is one of the most common forms of back pain.

It is important to discover what is causing the compression, usually a herniated disc (a slipped disc) or degenerative disc disease. The discs are the cushions which separate the bones of the spine, acting as shock absorbers. When displaced, they may pinch the nerve, causing them to malfunction. Sciatica could also be the result of spinal stenosis, spine arthritis and in rare cases even tumours and infections.

Most sciatica cases will improve with time and care. However, if you experience worsening weakness, numbness or bowel or bladder problems, or if you are unable to control the pain with normal painkillers, seek urgent medical attention.

Treatment

• Sciatica usually improves on its own, within a few weeks.
• Try not to stop exercising or working. Don’t spend too much time in bed.
• Take pain killers or anti-inflammatory medication if necessary
• An epidural injection (one into the spine) could ease the pain
• In rare cases, if the sciatica does not improve surgery may be recommended

Other causes of back pain include muscle strain, trauma and spasms, arthritis, spondylolisthesis (when a vertebra slips forward, creating a gradual spine deformity), stomach aneurysms, bone fractures, kidney stones, shingles, cancer of the pancreas, viral infections, pregnancy and inflammatory disorders. These could include ankylosing spondylitis (lower spine rheumatism), arachnoiditis (spinal cord membrane inflammation) or discitis (low-grade disk infection). Osteoporosis could also be a factor, as a lower amount of bone tissue leads to vertebral fractures.

In rare cases, bone cancer or spinal tumours could be the cause of back pain. The main symptoms are pain which continues to increase despite treatment, and lumps or moles in the area.

It’s also possible for psychological problems like depression, nervousness or frustration to cause back pain, or to be the result of prolonged pain.

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