Back pain is one of the most common types of medical problems. Affecting 80 percent of the population, this pain can be detrimental and debilitating to everyday tasks. Below are some common symptoms that can be aided by physical therapy.
These lower back pain symptoms include any combination of the following:
- Difficulty moving that can be severe enough to prevent walking or standing
- Pain that also moves around to the groin, buttock or upper thigh, but rarely travels below the knee
- Pain that tends to be achy and dull
- Muscle spasms, which can be severe
- Local soreness upon touch
Herniated, bulging, degenerating disc(s)
A herniated disc refers to a problem with one of the rubbery cushions (discs) between the individual bones (vertebrae) that stack up to make your spine.
A spinal disc is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of the softer "jelly" pushes out through a tear in the tougher exterior.
A herniated disc can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disc. Most people who have a herniated disc don't need surgery to correct the problem.
What's the difference between a bulging disc and a herniated disc?
Discs act as cushions between the vertebrae in your spine. They're composed of an outer layer of tough cartilage that surrounds softer cartilage in the center. It may help to think of them as miniature jelly doughnuts, exactly the right size to fit between your vertebrae.
Discs show signs of wear and tear with age. Over time, discs dehydrate and their cartilage stiffens. These changes can cause the outer layer of the disc to bulge out fairly evenly all the way around its circumference — so it looks a little like a hamburger that's too big for its bun.
A bulging disc doesn't always affect the entire perimeter of a disc, but at least a quarter if not half of the disc's circumference is usually affected. Only the outer layer of tough cartilage is involved.
A herniated disc, on the other hand, results when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disc. Herniated discs are also called ruptured discs or slipped discs, although the whole disc does not rupture or slip. Only the small area of the crack is affected.
Compared with a bulging disc, a herniated disc is more likely to cause pain because it generally protrudes farther and is more likely to irritate nerve roots. The irritation can be from compression of the nerve or, much more commonly, the herniation causes a painful inflammation of the nerve root
What is degenerative disc disease?
Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
The changes in the discs can result in back or neck pain and/or:
- Osteoarthritis, the breakdown of the tissue (cartilage) that protects and cushions joints.
- Herniated disc, an abnormal bulge or breaking open of a spinal disc.
- Spinal stenosis, the narrowing of the spinal canal , the open space in the spine that holds the spinal cord.
These conditions may put pressure on the spinal cord and nerves, leading to pain and possibly affecting nerve function.
Osteoarthritis is the most common form of arthritis, affecting millions of people around the world. Often called wear-and-tear arthritis, osteoarthritis occurs when the protective cartilage on the ends of your bones wears down over time. While osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, neck, lower back, knees and hips.
- Deep aching joint pain that is worse after exercise or any application of weight and is relieved by rest
- Grating of the joint with motion
- Joint pain in rainy weather
- Joint swelling
- Limited movement
- Morning stiffness
Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body. Sciatica most commonly occurs when a herniated disc, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.
Although the pain associated with sciatica can be severe, most cases resolve with nonoperative treatments in a few weeks. People who have severe sciatica that's associated with significant leg weakness or bowel or bladder changes might be candidates for surgery.
Myofascial Pain/Trigger Points
A “trigger point” is defined as a hyper-irritable focus within a taut band of muscle. It is a dysfunction where the nerve and muscle comes together. Muscles with trigger points are under twice as much tension as a regular muscle even at rest which can cause painful compression of nerves and blood vessels resulting in pain being referred to various patterns in the body known as referred pain patterns. In addition, muscles with trigger points have been shown to have high levels of pain producing chemicals.
Sacroiliac Joint Dysfunction
The sacroiliac joint (SIJ) is located at the lower end of the spine (sacrum) and joins the spine to the pelvis (the iliac bones) on either side.
There are differences between SIJ in men and women, specifically during their 20s-30s. In women, the joint plays an important role in childbirth and hormones influence its shape and mobility. In men, the SIJ has reduced mobility and has adapted to manage movements such as turning, twisting, pulling and pushing as well as lifting heavy objects.
During movement, the SIJ helps distribute the body's weight from the trunk to the pelvis and extremities while protecting the spine.
What goes wrong in the sacroiliac joint?
The sacroiliac joint is prone to wear and inflammation causing pain. SIJ pain is a common cause of low back pain and/or buttock pain on one side or both with 15-25% of patients with low back pain being affected.
What causes sacroiliac joint pain?
- Trauma such as a direct fall onto the buttocks, rear-end or broad-side type car accidents, a step into an unexpected hole or from miscalculated height.
- Idiopathic (when no specific cause can be found)
- Repeated stress injuries
- Ankylosing spondylitis - the sacroiliac joints become inflamed causing pain in the lower back and buttocks. The inflammation of the sacroiliac joints is called sacroiliitis.
- In pregnancy, women may experience SIJ dysfunction due to the hormonal effects of pregnancy on the joints ( hypermobility) as well as due to the childbirth mechanism.
- Lumbar fusion surgery