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On any given day in the United States, up to 20% of the population will be suffering with some sort of back or neck complaint. Most of the time, back or neck pain is a short-lived problem involving the muscles and tendons of the spine. Muscular strains and sprains will cause pain and spasms which can last up to 3 weeks. Although uncomfortable, the pain from strains or sprains usually can be ameliorated with the appropriate short-term lifestyle modifications, gentle rehabilitative exercise and the use of anti-inflammatory medication. If the back or neck pain persists more than 3 weeks or if the pain transitions to shooting down the leg or arm, then a consultation with a physician is necessary.

The most concerning pain is that which that radiates down the arm or leg. This is commonly called “sciatica” in the leg, but in medical jargon, the more appropriate term is “radiculopathy”, used to describe the pain that follows a particular nerve pattern in the arm or leg. This arm or leg pain generates from pressure on the nerves in the back or neck, which in turn, causes the extremity pain. Most patients don’t relate their arm or leg pain has having its possible origin in the spine, as a lot of these patients will not have any back pain. This can be explained layman’s terms as being similar to an electrical wire having a short circuit. In the lower back, the nerves that exit the spine transport the information of pain, temperature and touch from the legs to the brain, as well as transmit the information for muscular function from the brain to the legs. When there is pressure on a nerve in the lower back, the brain identifies the information as coming from the nerve that usually supplies information from the leg. The brain then interprets the information as leg pain rather than the real culprit, the disc problem in the back.

Pressure on the nerves in the back or neck can come from several causes. Nerves travel from the spine and into the arms or legs through small openings in the bones of the spine. These small holes have enough room for the nerve and a few blood vessels to pass, but not room for much else. When a piece of disc material protrudes from its normal position, it can fill the space reserved for the nerve root. We can call this a slipped disc, as a piece of disc material may “slip” out of its normal position. This extra material then puts pressure on the nerve root, and in turn, causes the nerve to become aggravated. Disc ruptures are very common in the neck and lower back, with a similar means of irritating nerves and causing pain due to the mechanical pressure.

A more dramatic way of putting pressure on the nerve root is by a slip in the bone. The technical term is “spondylolisthesis”. When bones slip on each other, this also will compress the opening where the nerve root exits. The bones need to be aligned properly in the spine for the nerve to have the proper room to function. With slipping of the bones, the nerve roots can be pulled or pushed by the bones that surround them. The bones then cause pressure and irritation of the nerves, which causes the leg or arm pain.

Relief of the nerve irritation is directed toward the cause of the irritation and can start with a series of medications, physical therapy exercises or potential surgery when the pain is not otherwise improved. The goal of each of these methods is to relieve the pain and return you back to your normal activities. The treatments should be directed by a spinal specialist to ensure that the optimal method for your condition is being provided. Fellowship-trained spinal surgeons have the knowledge and training of the full spectrum of spinal conditions which allow them to treat the spinal conditions from the simple nerve root irritation to the most complex of spinal conditions requiring extensive surgical reconstruction of the bone and nerves.

If you’re like many Americans, you suffer from back pain. It keeps you up at night, it distracts you from your work during the day, and it makes you downright miserable.

Most likely you’ve searched the Internet and come up with conflicting, if not depressing news… you need surgery. Surgery has become as normal as other medical maintenance techniques, like standard annual checkups or dental visits. Many medical institutions are only helping the notion along by giving surgical procedures undue weight or support.

I went on the Internet recently to see what my patients, and many others, were finding on the topic of “Back Pain” on the web. It was shocking, to say the least. On a respected medical website alone, I found that they were encouraging readers to seek immediate surgical help for:

· Herniated Discs: a potentially painful problem in which the hard outer coating of the discs, which are the circular pieces of connective tissue that cushion the bones of the spine, are damaged, allowing the discs’ jelly-like center to leak and irritate nearby nerves.

· Degenerative Discs: Most people’s discs degenerate over a lifetime, but in some, this aging process can become chronically painful, severely interfering with their quality of life.

I can tell you that although these persistent and painful challenges are serious and at times debilitating, in many cases, a doctor can take care of them with less intensive or invasive and much less-expensive procedures.

(Note: In emergency situations, surgery may be the only solution.)

Introducing Prolotherapy
Prolotherapy is based on the idea that our bodies actually know best and given the right stimulation, will respond accurately and beneficially.

Used effectively for over 50 years, Prolotherapy works by injecting a concentrated sugar solution into the injured tendons and ligaments. The injections naturally and gently irritate the tissues to cause inflammation, which rushes blood, nutrients, and cells called fibroblasts to the area. These fibroblasts then encourage the production of tissue which creates a matrix of new collagen, or in the case of joints, new cartilage. This new tissue allows for stronger ligaments that can better support the lower back. It basically returns you to a pre-injury, pre-pain state.

Luckily, lower back pain can be the easiest condition to treat, if you do it the right way.

Prolotherapy is safe and can make a day and night difference to the amount of pain you’re experiencing. Patient testimonials, as well as well-respected, peer-reviewed research, have shown that Prolotherapy is an incredibly effective treatment for chronic back pain.

A chiropractor helps in curing ailments without using actual medication. However, it is important to select the right doctor to get this treatment done for effective results.

Chiropractic care is a form of medical treatment that has been able to help a number of patients without the use of pain medication or other methods. Despite the fact that these types of physicians can provide an extremely valuable service to many people, it is important to remember that choosing a chiropractor is a task which should be approached much in the same way as one would choose any type of doctor. In this article, we will outline some tried and true tips to help aid in the selection process.

Where Should I Start?

To begin, it is important to consider the education and credential levels held by the practitioner. Most countries now have professional associations which evaluate physicians and provide memberships based on degrees and training accumulated by the chiropractor. Requirements are often also in place in regard to continued education directly related to the field.

Choosing a physician who holds active membership in one of these types of organizations is a fairly good sign that he or she is one who is well experienced in the practices of manipulative therapies while also having completed a fair amount of professional training.

Are There Specialties?

The main area of focus is also an important factor to consider. The idea here is to find a specialist whose prime area of expertise lies in only a few musculoskeletal issues. In this way, you will have a better chance of finding a physician who is skilled and knowledgeable, rather than one who is so-so in a broad number of treatments. Look for a chiropractor who focus’ on the core treatments and does not dabble in areas which fall outside their designated knowledge base.

Where Do I Look?

Another good place to gain information or recommendations is through your primary care physician. Deciding on care that is recommended through your doctor is a good idea for two reasons.

First, your doctor will most likely only suggest a practice that he or she feels is professional and effective. Secondly, the recommended physician will probably be more open to working with your general doctor in order to more effectively treat your condition. Where communication is involved, you will typically find better overall care.

You may also want to check local references. Ask around to family and friends to have been treated with similar issues and see what their experiences were. This way, you will be able to get an inside scoop on exactly how he or she interacts with their patients, as well as what to expect from your time there.

For a firsthand look, try scheduling a consultation. Go prepared with a list of questions and topics to discuss with the physician and see what they then recommend. Take lots of your own notes! At the end of the appointment you should have a pretty good idea of where you stand with your new practitioner.

Here Are Some Back Pain Solutions

In order to find back pain solutions, you need to understand what the possible causes are, and then try to eliminate them. Any number of reasons could be the cause to your suffering and you should try to find out at which point you started getting these pains. Do they normally feel more severe when you get up in the morning? If that is the case, perhaps the answer lies in your bed. A badly constructed bed or poor mattress can cause one’s back to suffer. This is because you will spend anywhere from 5 to 8 hours in the bed and you will be in a better posture during this time. If this is the reason, you should try to search for a new bed or mattress. There are many ergonomically designed mattresses that will maintain your spine’s correct posture while you sleep.

Smokers are more likely to run into problems with their backs than non-smokers. The simple reason for this is because smoking reduces the efficiency of the lungs. As a result, they are not able to take in as much oxygen as they should. This in turn means that oxygen is not getting to the rest of the body through the blood. Oxygen is extremely important as it helps our muscles and bones to repair themselves when they are damaged. In the case of disks in the spine, they are constantly being used and would have a lot of wear and tear. Due to the lack of oxygen, it will not be able to heal effectively. This inevitably will lead to back pains caused from dry or damaged discs. In this case, the best back pain solution will be to give up smoking and save your spine.

Exercises are extremely important and can be a great way to achieve back pain solutions. The muscles that surround the back need to be kept flexible and strong in order to help support your body’s weight. To keep these important groups of muscles in shape, we must perform regular exercises that are designed to achieve this. There are many stretching exercises that are very good for doing this and they can be done in the office or your home. All it takes is 15 to 20 minutes of your time to prevent any back problems from occurring, even if you already have problems, it can help relieve them. These are just a few examples of how you can find back pain solutions, once you know what the underlying cause is.

Exercises for sciatica doesn’t sound like such a great idea at first sight. You’re dealing with a lot of pain when suffering from an inflamed sciatic nerve and exercises for sciatica are normally what’s farthest from your mind. Well, you might actually want to rethink that position. Muscles and muscle strength play a key role in healing sciatica and preventing future flare ups.

Three different exercises for sciatica can go great lengths to relieve your sciatica. Some of us can’t even remember the last pain free day and what it meant to just move freely without having to think those moves through first. Sciatica is a royal pain in the behind, but help is on the way with these three exercises for sciatica.

Exercises For Sciatica: Relaxation Of The Hip Flexors

Start with the relaxation of your hip flexor muscles. When your hip flexors are too tight, they pull your lower back into an increased curve. Once that happens, pressure on your sciatic nerve grows and sooner or later the over-tightened hip flexors contribute to your sciatica.

To help your hip flexors to loosen up a bit you can do the following exercises for sciatica: Get down on one knee, the knee placed a bit further back than your buttocks. The other knee should be up in front of you and the foot flat on the ground. Place your hands on your hips for straight posture. Now gently bend the knee in front of you forward, until you can feel the pull in your hip of the leg with the knee on the ground. Repeat the movement slowly a couple of times, then switch legs and repeat. This type of exercises for sciatica helps loosen the hip flexors and thus relieves pressure on the sciatic nerve. It also increases blood flow in the muscles, which is always needed to reduce inflammation.

Exercises For Sciatica: Stretching Of The Piriformis Muscle

The Piriformis muscle is located on the very inside of your buttocks and has the sciatic nerve running right through it. Now if this muscle over-tightens you can imagine the pressure being put on the sciatic nerve; and we also know how well this nerve takes to being under pressure.

Simple stretching exercises for sciatica instantly relieve the pressure. Lie down flat on your back and pull up your legs in a 45 degree angle. Now place the right leg over the left as if crossing them. Fold your hands around both legs and gently pull them towards your chest until you feel the pull in your buttocks. Hold your position for a moment and release. Now switch the legs around and repeat the procedure. You will feel instant pain relief.

This isn’t a permanent sciatica cure, but will greatly relieve sciatica pain and tension in the Piriformis muscle right away. Once the Piriformis muscle loosens up it will stop aggravating the inflammation of your sciatic nerve. This is a great kind of exercises for sciatica when you feel that pain increasing and your muscles tensing up.

Exercises For Sciatica: Strengthening Your Abdominal and Core Muscles

Lower back and pelvis stability is provided largely by the abdominal muscles, along with other core muscles. When your abdominal and core muscles are weak, they fail to hold up your spine properly, thus pressure increases on the vertebrae and the disks, which in turn can put pressure on the sciatic nerve at its exit points from the lower spine.

So using exercises for sciatica to increase strength and flexibility in your core and abdominal muscles is an absolute must if you want to see long-term relief from your sciatica problems. Today’s life-styles are, for the most part, not very conductive to strong core and abdominal muscles. It is important to pay these muscles some attention and put them to work, so they can keep you spine healthy and protected.

So if you do these three exercises for sciatica, your condition should be easier to control and pain become manageable, so you can lay off the medication.

When people think about the causes of back pain, they often assume that it is one event that causes a back to give out. Lifting a heavy load, or being involved in a sudden movement that causes an immediate compression of the spine, or even having a physical accident such as a fall — all of these events can lead to a quick onset of lower back pain. However, this is only one of three main reasons why people may experience discomfort in the joints of the back or the muscle and other soft tissues.

The first cause of back pain is the type mentioned above. Obviously, if someone falls off of a ladder onto his or her back, there is a greater chance of experiencing pain than if the fall had not occurred. Trauma caused by a sudden impact is definitely a significant factor in causing lower back discomfort, but it is actually a bit more uncommon than the other main reasons why people get a sore back. If there is a sudden traumatic injury in a person’s history, though, this must be considered when evaluating back pain issues.

A more common cause of back pain is that of chronic overuse. There are actually two different types of overuse injury of the back, and each type can lead to a feeling of chronic pain.

The first type is when a person lifts a series of loads over time without resting. People who continually load boxes from the floor onto a truck, for instance, may experience back pain even if the weights they lift are actually not that heavy. Over time, however, even lighter loads can begin to break down the tolerance of the back’s muscles and joints and lead to soreness. If the back is not given enough time to rest, chronic pain can be the result.

The second type of overuse of the back is being in one position for a prolonged amount of time. Workers who have to stand and bend over to work on objects close to the ground can experience pain even if they are not lifting anything at all. This is also the type of soreness that office workers can develop if they sit at a desk all day with a rounded back. As time goes on, the tissues of the back reach their failure level and the result is pain.

Thus, not every instance of back pain is caused by a sudden injury. And even if it seems like such a sudden event did occur — lifting that last box or getting up too quickly after sitting for too long — it is more likely that the back’s pain threshold has been reached and the tissues have begun to get damaged. This is why everyone should become more aware of how they are using their backs and take precautionary measures like getting enough exercise to strengthen the back, as well as getting enough rest to make sure that chronic injuries do not happen.

The sciatic nerve is the largest nerve in the human body and is a common source of pain. The nerve arises from the nerve roots of the fourth and fifth lumbar spine and the first three sacral nerve roots. The nerve roots coalesce to form the nerve within the pelvic cavity and exits deep to the large muscles of the hip and buttocks. From there it travels deep within the muscular layers down the back of the thigh to the knee where it divides into the common peroneal and tibial nerve branches. This nerve controls the major muscles of the posterior thigh and lower leg.

There are a number of conditions that can cause or contribute to sciatica such as:

• Lumbar disc herniations
• Arthritic degeneration
• Sacroiliac joint dysfunction
• Piriformis Syndrome and muscular compression syndromes
• Trauma
• Pregnancy

Most of these conditions requires diagnosis by a trained professional and the true cause will dictate the best treatment of the pinched sciatic nerve.

Arthritic degeneration of the lumbar spine and lumbar disc herniations are fairly common and can be treated conservatively in many cases but may ultimately require surgery in severe cases. The nerve roots from L4 and L5 contribute to the nerve and compression or irritation of these nerve roots can result in sciatica nerve pain. There have been some great advances in non-surgical treatments such as decompression therapy and inversion therapy.

Sacroiliac joint dysfunction can irritate the nerve roots as they practically lay against the inside surface of the joint within the pelvic cavity. Stretching and chiropractic care are the best treatment for this type of condition.

Piriformis syndrome describes the condition where the sciatic nerve is compressed by the piriformis muscle as it exits the pelvic cavity. The nerve passes beneath the muscle in most cases so any irritation or spasm of the muscle can irritate and compress the nerve. In about 15% of the population the nerve actually pierces the piriformis muscle making it even more prone to compression.

Trauma can initiate sciatic pain since any hard impact, like a fall on a hard surface, can injure the muscles and tissues of the hip and buttock and result in compression or irritation of the sciatic nerve.

Pregnancy is another common cause of sciatica nerve pain since the growing uterus puts increasing pressure on the nerve roots and nerve within the pelvic cavity. There are techniques and conservative measures that can help alleviate sciatica during pregnancy and ultimately most cases resolve with childbirth.

Do you love horses but fear that you will never be able to ride with a bulging disc or herniated disc?

A back or herniated disc injury does not mean your passion for riding horses needs to end. Like any injury, a recovery time is required and it may be a lesson in patience, but there is no reason why you can’t eventually get back on a horse again.

After herniating my L4-L5 and L5-S1 discs causing severe sciatic pain, I was told surgery was my only hope and that there’d be many activities I wouldn’t be able to do again, horseback riding being one of them. I instead chose to heal myself naturally, and within 16 months was I not only living life pain free, but I was also back on a horse. I was actually doing a lot of other activities pain free a lot sooner. The key for me though with horseback riding was making sure I had fully healed first, and not to take unnecessary chances.

After a disc injury your body will never be completely the same as it was before, and you will have to make some adaptations. Your body has sustained damage, and your goal should be to be the best YOU can be. Both during and after recovery, building up strong core muscles is one of the most important things you can do in order to protect yourself from re-injury. For anyone with a herniated disc injury, and even for people without injury, strong core muscles and core stability will protect your spine while on a horse. Exercising your core muscles needs to be an ongoing part of your lifestyle, not something you stop doing once the pain is gone. Even after a disc injury, a person who learns and gains good core stability and proper spine alignment can actually further strengthen their back and core stability by horseback riding.

In fact, more dangerous than the act of riding itself are the throwing and twisting motions involved in the care of your horse (putting on a saddle, carting feed, lifting the tail ramp of your truck, etc). An equal or even greater amount of attention to your back and core needs to be given to these activities.

As the repetitive jolting of riding can aggravate underlying back problems, it is important to always stretch before getting on your horse. While riding you should be wearing some sort of a back brace or lumbar support belt. CoreShorts are highly recommended, not just when riding but when doing any physical activity. In terms of stirrups, the Herm Sprenger System 4 stirrups soften the impact on cartilage and ligaments, relieving tension in the hips, knees, ankles and calves, and thereby reducing referred pain and tension in the lower back. Choosing the right saddle can also make a big difference. If one saddle doesn’t feel right, try another. After the ride, a moist heating pad placed against your lower back may be helpful.

Remember to start off slow and ease back into your riding. Expecting to ride full gallop again immediately out of a disc injury is not only unrealistic but also foolish. Start off walking your horse for a few days. If no pain is present, work your way up to a light trot, and so on. Avoiding jumps would be recommended due to the sheer impact. Ease into posting, and only post if you are very comfortable doing do. Mis-timing a post can cause greater impact and compression of the spine.

Horseback riding can be a wonderful pastime, and the bond riders often share with their horses can be just as wonderful. This is not something that needs to end with the disc injury. In fact, as mentioned above, riding, when done properly and carefully, can actually be beneficial to your back. Be patient with yourself. Focus on your healing first, building up your core strength and stability. Then, get back out on the range. Hi-yo Silver!

If you are suffering from lower back pain, all you need is exercises to help strengthen your back muscles and make it much stronger. These exercises should not be rushed, because it will not do your back any good, therefore you should take your time while practicing the exercises. You should stop if you feel uncomfortable when doing any of the exercises and let your back relax for a bit. Before doing these exercises try to stretch your back.
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Exercise One – Lie on the floor and position your lower back pressed against the floor. Cross your arms and put them onto your chest. Now lift your head and tuck it into your chest, you should make sure that your back is still flat against the floor. Try tightening the muscles in your abdomen while your head and shoulders are lifted off the floor. You can hold this position for ten to fifteen seconds or until you feel uncomfortable. Now relax and repeat this exercise another four times. You can continue with the length of time you are holding the position or you can gradually increase the length of time you are holding the position for, and also gradually increase the number of repetitions.

Exercise Two – You start by lying on your back on your bed, then gently bend one knee and slowly start to move this towards your chest. Ensure that while you are doing this, you are pressing your lower back against the mattress. Try to hold this position until you start to feel it becoming uncomfortable. Now relax and lie down again, repeat this exercise with your other knee. As soon as you are through with one repetition, you should repeat the same thing on both knees another four times. Once you get more experienced you can increase the number of sets that you do.

Exercise Three – Lie down on your back and position your arms relaxed by lying down beside your sides. Try to keep your knees flat on the bed or floor and bend your knees. Your lower back should be pressed firmly against the floor and you will observe that your hips should start to rise. Make sure you hold this position for ten seconds and then relax. Repeat the exercise several times; gradually increase the length of time you hold the position for, so that eventually you are holding for one minute.

There are techniques to permanently cure your lower back pain. These techniques should be methods of physical and mental re-education to reduce habitual and unnecessary tension in all your activity through awareness of balance, posture and movement. It should also show you how to identify the cause of your pain.

Back pain is one of the commonest complaints – in fact nearly 1 in 4 people suffer from this condition. Most people have resigned themselves to either live with the pain or take medication to relieve the symptoms.

When you suffer from back pain, you get THAT look sometimes, don’t you? You know, the look that says you’re a malingerer that you’re putting on the agony, that you’re just after sympathy. Sometimes, you can even get it from professionals.
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Back pain conditions although common are not treated with the same “respect” as other illnesses because by their very nature they are not as visible as say a broken leg or arm. If you have a broken leg for example you are not only treated for the pain but corrective measurements are put in place e.g leg put in plaster. Usually the first statement is one of these “It will pass with time ” or “Its your age ” or “take these tablets – see how it goes.” Lets look at why this is the case

WHY DO TYPICAL BACK PAIN TREATMENTS NOT WORK?

Wrong Diagnosis – If you visit your GP or MD they very often do not hear much after the words ” I have this terrible back pain ” – after the first few questions it is likely they will come to a conclusion.

They do not get time to know you as a patient so they cannot possibly get to the root cause of your condition. Most medical practitioners will view back pain as a result of personal habits e.g working practices. Causes of back pain are varied and vast and without the correct diagnosis will never be solved. Make sure your MD or GP listens and understands why you are suffering, examine the causes not just the effects, as a mistake at this point can lead to years of pain

Treating The Symptoms – Most solutions treat the symptom not the cause of the pain. Common practice is to give pain killing drugs of varying strength, injections or suggest alternative medicines and treatments.

There is scant, if any research supporting any of the traditional treatments…yet they are still considered “best practice”. No wonder so many suffer from back pain!

Perhaps you are considering some of these treatments. To save you time and money let me tell you that there have been many exhaustive studies that conclusively show that the following therapies are not effective:

Chiropractor treatments (Ernt E. J R Soc Med. 2006 Apr;99(4):192-6.-3)

Physical Therapy (Van Tulder. Spine. 2007 Jul 15;32(16):1785-90)

Injections (Deyo R. J Am Board Fam Med. 2009 Jan-Feb;22(1):62-8)

Acupuncture (Furlan AD, Spine. 2005 Apr 15;30(8):944-63.)

Prescription Medications (Martell BA Ann Intern Med. 2007 Jan 16;146(2):116-27)

Scientific back pain research has one very obvious conclusion:

Traditional treatments are not getting the job done.

Generic “One Size Fits All” – As stated above at both the diagnosis and the treatment stage there is a tendency to go for the common best practice with the result you as the suffer do not get the root cause identified and resolved. As a consequence you continue to suffer the pain once the medication wears off. You are an individual and as such you need to be treated with that respect in gaining a solution to your “real cause” not just the effect.

WHAT HELP IS THERE?

Self Help – The problem with us as individuals is we focus on the pain, if we could just get relief. This is understandable, given the nature of back pain it impacts our lives in so many ways.

Take time to log what has led to the pain – when did it start, does something happen to trigger the back pain, when it happens, why it happens, what is the nature of the pain, when is it worse, what helps, how long does the medication help for? Log everything, no matter how small, little differences can sometimes have a big impact.

Completing this log will help you discuss your condition with your medical practitioner and help them arrive at a correct diagnosis and treatment plan for you.

Treatments – Be open minded but not gullible. Yes you want relief and you need to consider all your options, but look closely at the research backing the solution. Start in small steps and move forward and you will find you are much better equipped to make rational decisions. Look at natural remedies as well as the common “buy this pill for pain free lifestyle” drugs. Look for a treatment that suits you and has worked for others.

Generic – Just because it worked for Mr / Mrs X does not mean it is going to be the wonder cure for you. However if the cause is eliminated, you are going to feel better faster than you would do with just treating the symptoms.

Major research into back pain relief has been carried out by a leading nutrition specialist, who is also on the Medical Nutrition Committee at the American Society for Nutrition, (where he has advocated for nutrition as a treatment for back pain to become more widespread.)

His scientific background gave him a unique perspective when he set out to find the real cause of his own lower back pain. He knew how to do research and understood through experience the stunning effect that diet has on health.
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Also, he had a group of supportive colleagues at the following research societies that he is a professional member of including the International Association for the Study of Pain and the National Spinal Cord Injury Association.

He also served as a researcher at two major universities and practiced as a clinician at two large hospitals.

Evaluating low back pain in patients can be extremely difficult. Thankfully, 90% of acute back pain resolves within three months no matter what the treatment. However, if appropriate pain management treatment is instituted pain relief can potentially be achieved sooner rather than later.

Statistics show that over 30% of the time, medical providers cannot give an accurate low back pain diagnosis with regards to the pain generator. Even in this day and age of such modern technology as MRI and CT scans and EMG testing, low back pain still remains a conundrum in many cases.

The main categories of pain generation include fracture, infection, tumor, trauma, arthritis, soft tissue, or neuropathic.

Fracture or Trauma – Vertebral Compression Fractures are seen as a result of an axial load on the spinal column. The number one cause is osteoporosis, number two is a traumatic event like a car accident or fall from a height. These fractures are typically seen on plain x-rays, and also very easy to see on an MRI. Traumatic injuries also can result in soft tissue sprains/strains with damaged ligaments, tendons, or spinal musculature.

Infection – There are two areas of infection around the spine. One is the vertebra itself, which is called vertebral osteomyelitis. Another is infection in the intervertebral disc, which is called discitis. Infections occur post-surgical, post-procedure, and also in immunocompromised patients such as diabetics.

Tumor – There are various tumors that affect the spine and cause low back pain. Most commonly, the spine has a tumor from metastasis of a tumor elsewhere, such as the breast or lung. There are some tumors that occur primarily in the spine, such as multiple myeloma.

Arthritis – Just as degenerative arthritis occurs in the knee and hip, it also occurs in the spinal column. The joints of the spine are called facet joints, and they are about the size of a thumbnail. The facet joints are located on each side of each level of the spine. For instance the L3-L4 facet joint is the one located between the third lumbar and fourth lumbar vertebra. When arthritis occurs in facet joints, it is called facet syndrome or simply facet arthritis.

Soft tissue – The soft tissue areas of the spine include the following: Intervertebral disc, spinal ligaments, and also the para-spinal musculature with its tendons. Patients involved in a trauma can experience spinal ligament injury with resultant pain. Para-spinal musculature strain is extremely common. Often times the para-spinal mucles will react to other injuries such as fractures, ligament sprains, etc by going into spasm. This is called muscle guarding. Pain from the intervertebral disc itself is a result of disc injury. This can be chronic, called degenerative disc disease, or more acute. The outer part of the intervertebral disc contains pain fibers. This area of the disc is called the annulus and an annular tear can cause significant pain in the low back.

Neuropathic – This refers to pain emanating from an intervertebral disc herniation that is impinging on a nerve root. The pinched nerve sparks up inflammation and causes pain to radiate down the leg, called sciatica.

Evaluating a patient with low back pain takes determination and thoroughness with a specific algorhithm. If done correctly, it will give patients the best chance of success by leading to an appropriate treatment regimen.