Herniated Discs

Currently we operate on less than 5% of all herniated nucleus pulposus or herniated discs in the United States. The herniated disc is probably one of the most troublesome diagnoses and causes of lower back pain.

In between each vertebrae is a disc composed of material which is formed in concentric rings quite similar to a tree trunk as seen from above. These concentric rings receive nutrients through osmosis as they have no arteries or veins directly. In the center of the disc is the nucleus called the nucleus pulposus. This fluid-filled jelly sack, similar to the inside part of a golf ball, can be pushed out by compressive forces down the spinal column. When the discs do not receive enough nutrition and fluid, the discs become dry, fragile and shrink. These degenerative discs are prime candidates where nucleus pulposus can then herniate through. As the nucleus pulposus pushes through the fragile concentric ring into the spinal cord, it pinches the spinal nerve with associated inflammation to the spinal cord. One experiences acute and then chronic back pain and leg pain.

Spinal Stenosis

Another common cause of back pain in the older population is spinal stenosis. Spinal stenosis occurs when the lumen of the spinal cord closes down and is like arthritis on the inside part of the spinal cord. The bone grows more and more on the inside thereby pinching the spinal cord.

Somatic Dysfunction

The most common condition for lower back pain is somatic dysfunction which is impaired or altered joint motion of the body's framework including its skeletal, arthrotial, myofascial and ligamentous vascular neural elements. This somatic dysfunction or ligamentous strain/soft tissue injury of the low back with accompanying muscle spasm are the principle diagnoses that most people come in with as their back is evaluated. Fortunately, most acute low back pain patients respond within 1-3 weeks with very conservative or no treatment. If acute back pain lasts longer than three days the back pain is probably not going to get better without medical intervention.

Treatment Options

One of the self-help treatment options you can do for acute low back pain, as long as you don't have numbness or tingling in your legs, is put ice on your lower back for a period of 15 minutes and rest lying down on your back. We have discovered that two days of bed rest is as good as two weeks. So if you are laying in bed for longer than two days, your bed rest is not going to help cure your backache-you need to see a physician.

Treatment for somatic dysfunction primarily involves osteopathic manipulative techniques: resetting the joint mechanical receptors and the nociceptal (pain) fibers in the ligaments, tendons and the joint capsules. Second is the use of physical therapy, ultrasound, interferential, electrical stimulation. Third is muscle relaxants, non-steroidal anti-inflammatories which are found to be helpful in taking the inflammation away from the tendons. Fourth, various types of Chinese Acupuncture and Japanese Scalp Acupuncture are quite effective in alleviating low back pain. Finally, as the pain subsides an exercise program is necessary to return your back to optimum health.