Pain is a general term that describes uncomfortable sensations in the body. It stems from activation of the nervous system.
A herniated disk is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is sometimes called a bulging, protruding, or ruptured disk. It is one of the most common causes of lower back pain, as well as leg pain or “sciatica.” Between 60% and 80% of people will experience low back pain at some point in their lives. Some of these people will have low back pain and leg pain caused by a herniated disk.
In most cases, low back pain is the first symptom of a herniated disk. This pain may last for a few days, then improve. Other symptoms may include:
- Sciatica. This is a sharp, often shooting pain that extends from the buttock down the back of one leg. It is caused by pressure on the spinal nerve.
- Numbness or a tingling sensation in the leg and/or foot
- Weakness in the leg and/or foot
Although a herniated disk can be very painful, most people feel much better with just a few weeks or months of non surgical treatment.
For the majority of patients, a herniated lumbar disk will slowly improve over a period of several days to weeks. Typically, most patients are free of symptoms by 3 to 4 months.
However, some patients do experience episodes of pain during their recovery. Initial treatment for a herniated disk is usually non surgical in nature. Treatment focuses on providing pain relief.
Non Surgical treatment may include:
- Nonsteroidal anti-inflammatory medications (NSAIDs). Medications such as ibuprofen or naproxen can help relieve pain.
- Epidural steroid injection. An injection of a cortisone-like drug into the space around the nerve may provide short-term pain relief by reducing inflammation.
Muscle strains (from overuse or poor posture)
A muscle strain (muscle pull or tear) is a common injury, particularly among people who participate in sports.
The thigh has three sets of strong muscles: the hamstring muscles in the back of the thigh, the quadriceps muscles in the front, and the adductor muscles on the inside. The quadriceps and hamstrings work together to straighten (extend) and bend (flex) the leg. The adductor muscles pull the legs together.
A person who experiences a muscle strain in the thigh will frequently describe a popping or snapping sensation as the muscle tears. Pain is sudden and may be severe. The area around the injury may be tender to the touch, with visible bruising if blood vessels are also broken. Swelling and areas of ecchymosis (“black and blue”) may often extend below the thigh into the calf and ankle. This may even occur one or two days after the injury.
- Poor conditioning. If your muscles are weak, they are less able to cope with the stress of exercise and are more likely to be injured.
- Muscle fatigue. Fatigue reduces the energy-absorbing capabilities of muscle, making them more susceptible to injury.
- Muscle tightness. Tight muscles are vulnerable to strain.
- Most muscle strains can be treated with the R.I.C.E. protocol. R.I.C.E. stands for Rest, Ice, Compression, and Elevation. Rest. Take a break from the activity that caused the strain.
- Ice. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly to the skin.
- Compression. To prevent additional swelling, lightly wrap the injured area in a soft bandage.
Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.
Cervical radiculopathy is often caused by "wear and tear" changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disk.
In most cases, the pain of cervical radiculopathy starts at the neck and travels down the arm in the area served by the damaged nerve. This pain is usually described as burning or sharp. Certain neck movements—like extending or straining the neck or turning the head—may increase the pain.
Treatment (Nonsurgical Treatment)
- Soft cervical collar. This is a padded ring that wraps around the neck and is held in place with Velcro. Your doctor may advise you to wear a soft cervical collar to allow the muscles in your neck to rest and to limit neck motion. A soft collar should only be worn for a short period of time since long-term wear may decrease the strength of the muscles in your neck.
- Medications. In some cases, medications can help improve your symptoms.
Narrowing of the spinal canal (spinal stenosis)
Spinal stenosis, a narrowing of the spaces in your spine, can compress your spinal cord and nerve roots exiting each vertebrae. Age-related changes in your spine is a common cause.
Lumbar canal stenosis is the narrowing of the spinal canal or the tunnels through which nerves and other structures communicate with that canal. Narrowing of the spinal canal usually occurs due to changes associated with aging that decrease the size of the canal, including the movement of one of the vertebrae out of alignment.
The narrowing of the spinal canal or the side canals that protect the nerves often results in a pinching of the nerve root of the spinal cord. The nerves become increasingly irritated as the diameter of the canal becomes narrower.
Symptoms include back or neck pain, and numbness, tingling and weakness in your arms and legs.
Can be prevented?
Since most causes of spinal stenosis are normal age-related “wear and tear” conditions, such as osteoarthritis and loss of bone and muscle mass, you can’t 100% prevent spinal stenosis. However, you can take certain measures to lower your risk or slow the progression:
- Maintain good posture.
- Exercise. Avoid exercises that cause pain but do stay active. Too much rest can be more harmful than helpful.
Osteoporosis is a disease of progressive bone loss associated with an increased risk of fractures. The term osteoporosis literally means porous bone. The disease often develops unnoticed over many years, with no symptoms or discomfort until a fracture occurs. Osteoporosis often causes a loss of height (a severely rounded upper back).
Because lost bone cannot be replaced, treatment for osteoporosis focuses on the prevention of further bone loss.
- Selective Estrogen Receptor Modulators. New anti-estrogens known as SERMs (selective estrogen receptor modulators) can increase bone mass.
- Bisphosphonates: including alendronate, markedly increase bone mass and prevent both spine and hip fractures.
The natural processes of aging
Many people age comfortably and remain active, alert, and vibrant throughout their lives. Knowing what to expect and taking steps to counterbalance the effects of aging can help you maintain a young spirit and an independent life. A healthy diet, regular exercise program, and positive attitude can help delay the onset and slow the progression of many age-related changes.
The Effects of Aging
As muscles age, they begin to shrink and lose mass. This is a natural process, but a sedentary lifestyle can accelerate it.
Throughout life, bones constantly change through a process of absorption and formation called "remodeling." As we age, the balance between bone absorption and bone formation changes, resulting in a loss of bone tissue.
The mineral content of bones decreases, so that bones become less dense and more fragile.
Joint motion becomes more restricted and flexibility decreases with age because of changes in tendons and ligaments. As the cushioning cartilage begins to break down from a lifetime of use, joints become inflamed and arthritic.
- Stretching is an excellent way to help maintain joint flexibility.
- Long-term regular exercises may slow the loss of muscle mass and prevent age-associated increases in body fat.
- Exercise also helps maintain the body's response time, as well as its ability to deliver and use oxygen efficiently. Just 30 minutes of moderate activity, incorporated into your daily routine, can provide health benefits.
An exercise program doesn't have to be strenuous to be effective. Walking, square dancing, swimming, and bicycling are all recommended activities for maintaining fitness as we age.