Compression
Fracture
Compression fractures can occur in any vertebra (spinal
bones) and is described as a collapse of the vertebra.
Symptoms - The first symptom of a compression fracture may be
sudden and severe back pain that remains in one local
area. Some persons may experience numbness/tingling,
or weakness in the arms or legs if the spinal cord or
nerves leading away from the fracture have been compressed.
If multiple fractures occur in an area of the back,
the person will develop a forward hump-like curvature
to the back.
Causes - There are many possible causes of compression fractures.
Car accidents, falls, and weakening of the bone due
to pathology (i.e. cancer), or Osteoporosis are common.
Diagnosis - The diagnosis is based on observation of the aforementioned
symptoms and x-rays of the spine. Additional tests (i.e.
bone scan, blood tests) may be needed to diagnose the
actual cause of the compression fracture.
back to top>>>
Cancer
If you have severe back pain, it is natural to wonder
whether or not the pain might be a sign of cancer. Tumors
in the spinal column may cause pain from expansion of
the bone or from weakening the bone, which in turn can
result in spinal fractures, compression (pinching) of
the nerves, or spinal instability.
back to top>>>
Discitis
Discitis, or disc space infection, is an inflammatory
lesion of the intervertebral disc that occurs in adults
but more commonly in children. Its cause has been the
subject of debate, although most authors believe it
to be infectious. The infection probably begins in one
of the continguous end plates, and the disc is infected
secondarily. Severe back pain that begins insidiously
is characteristic of the disease.
Discitis
in Children
Although most children will continue to walk in spite
of the pain, young children may refuse to ambulate.
The characteristic finding is extension of the spine
and the child's complete refusal to flex the spine.
Children with discitis usually are not systemically
ill. They rarely have an elevated temperature and their
white blood cell count is frequently normal. However
the erythrocyte sedimentation rate is usually increased.
Lateral radiographs of the spine usually will reveal
disc space narrowing with erosion of the vertebral end
plates of the contiguous vertebrae. bone scanning may
be helpful in localizing a lesion that is difficult
to diagnose clinically. Some bone scans are falsely
negative, so the diagnosis of disc space infection should
not be excluded simply because the bone scan is normal.
Magnetic resonance imaging (MRI) seems to be helpful
in identifying a disc space infection.
back
to top>>>
Kyphosis
Kyphosis
is the abnormal forward bending of the spine. In kyphosis,
the curve of the spine is abnormal, forming a hump.
What
is going on in the body?
The
normal spine rounds slightly in the chest area, with
arching in the lower back and neck regions. Excessive
kyphosis can occur mainly in the chest area of the spine,
causing the roundness of the back to appear exaggerated.
What
are the signs and symptoms of the condition?
Symptoms
are usually minimal, unless the deformity is severe.
In that case, the back may ache or, rarely, nerve problems
may arise. The hamstrings, or muscles at the back of
the thigh, may also be tight.
What
are the causes and risks of the condition?
Kyphosis
is generally caused by an abnormal posture. Other possible
causes include: · a significant fracture of the
vertebra, which can cause the back to angle forward
· spinal surgery · Scheuermann's disease,
which results in wedging of the vertebrae. This disease
is usually seen in teenage boys, and its cause is unknown.
Pott's disease, which refers to kyphosis due to collapse
of the vertebra when tuberculosis infects the spine
· osteoporosis in elderly women, which causes
a type of kyphosis known as dowager's hump ·
spinal tumors, or surgery to remove them · nerve
disorders
back to top>>>
Lordosis
Lordosis is a disorder defined by an excessive inward
curve of the spine. It differs from the spine's normal
curves at the cervical, thoracic, and lumbar regions,
which are, to a degree, either kyphotic or lordotic.
The spine's natural curves position the head over the
pelvis and work as shock absorbers to distribute mechanical
stress during movement.
Lordosis can be found in all age groups. It primarily
affects the lumbar spine, but does occur in the neck
(cervical). When found in the lumbar spine, the patient
may appear swayback, the buttocks more prominent, and
in general an exaggerated posture. A lumbar lordosis
can be painful sometimes affecting movement.
Certain
disease processes can adversely affect the structural
integrity of the spine and contribute to lordosis. Some
common causes include achondroplasia, discitis, kyphosis,
obesity, osteoporosis, and spondylolisthesis.
back to top>>>
Ligamentous
Hypertrophy
Ligaments run up and down the spinal column. Hypertrophy
of the ligaments in the vertebral canal (the posterior
longitudinal ligament -- runs up and down along the
back side of the vertebral bodies, and the ligamentum
flavum -- runs up and down under the posterior bone
ring made up of the lamina and spinous process) can
increase their mass enough that they narrow the canal
(stenosis) sometimes to the point that the spinal cord
and/or nerve roots running through the canal are compressed.
When the posterior longitudinal ligament in front and
ligamentum flavum behind the spinal cord hypertrophy
the cord is almost "circumferentially" surrounded
and compressed).
Hypertrophy
of the ligamentum flavum laterally near the facet joint
can also contribute to foraminal narrowing (stenosis)
with potential nerve compression (pinching).
back to top>>>
Obesity
According to the American Obesity Association (AOA) 64.5 percent of adult Americans (about 127 million)
are categorized as being overweight or obese (1). The
unfortunate truth is that obesity is becoming a global
epidemic affecting adults and children.
Connection
to Back Pain
Most people know that obesity contributes to the development
of coronary heart disease, diabetes, high blood pressure,
and colon cancer. However, did you know that obesity
is a contributing factor to back pain? It is true. Being
overweight or obese can significantly contribute to
symptoms associated with osteoporosis, osteoarthritis
(OA), rheumatoid arthritis (RA), degenerative disc disease
(DDD), spinal stenosis, and spondylolisthesis.
The
spine is designed to carry the body's weight and distribute
the loads encountered during rest and activity. When
excess weight is carried, the spine is forced to assimilate
the burden, which may lead to structural compromise
and damage (e.g. injury, sciatica).
One
region of the spine that is most vulnerable to the effects
of obesity is the low back; the lumbar spine. Lack of
exercise and bodily conditioning leads to poor flexibility
and weak muscles in the back, pelvis, and thighs. This
can increase the curve of the lower back causing the
pelvis to tilt too far forward. Further, this is detrimental
to proper posture and as posture weakens, other regions
of the spine (neck) may become painful.
You
may try to dismiss the cause of some of these spinal
disorders to the process of normal aging. It is true
that with age body tissues can cause changes to spinal
anatomy (2). However, if you are overweight or obese,
chances are you have, or will have, back pain.
back to top>>>
Trauma
Trauma to the spine refers to injury that has occurred
to bony elements, soft tissues and/or neurological structures.
The two things that surgeons are most concerned about,
in the case of spinal trauma, are instability of the
vertebral column and actual or potential neurological
injury.
Stability to the spinal column can be compromised when
bony elements are injured or there is disruption to
soft tissues such as ligaments. Instability causes the
back to become unable to successfully carry normal loads,
which can lead to permanent deformity, severe pain and
in some cases catastrophic neurological injuries. Most
often the instability comes from a fracture in one of
the bony parts of the vertebra, specifically the vertebral
body, the lamina or the pedicles.
In
the case of trauma, dislocations and fractures happen
simultaneously and can result in a very unstable spinal
column. They can occur in any region of the spine and
are associated with a degree of neurological injury.
A surgeon needs to restore the mechanical stability
of the spine to try and prevent more neurologic injury,
progressive deformity or prolonged incapacitation pain.
back to top>>>
Back
pain in pregnancy
Introduction to back pain during pregnancy
For pregnant women, back pain during pregnancy is not
a trivial matter. If not addressed, it can have a negative
impact on your daily lifestyle, cause missed time from
work, and make your delivery more difficult. Back pain
in the course of your pregnancy can also create problems
that will continue for an extended period after delivery.
Addressing
back pain during pregnancy
While it is fairly common, back pain during pregnancy
should definitely not be accepted as just part of the
process. To help make your pregnancy as pleasant as
possible and facilitate an easier delivery, back pain
should be always be addressed as quickly as possible
and managed throughout your pregnancy.
Low
back pain of long duration (several weeks or months)
during pregnancy is a predictor for post partum back
pain (pain after birth). For this reason, pregnant women
are encouraged to seek appropriate treatment for back
pain during pregnancy.
Likewise,
any post partum pain that lasts longer than six to eight
weeks should be treated in order to avoid chronic or
recurring back problems.
back
to top>>>
Radiculopathy
lumbar radiculopathy, which refers to pain in the lower
extremities in a dermatomal pattern. A dermatome is
a specific area in the lower extremity innervated by
a specific lumbar nerve. This pain is caused by compression
of the roots of the spinal nerves in the lumbar region
of the spine. Diagnosing leg and back pain begins with
a detailed patient history and examination.
back to top>>>
Scoliosis
Scoliosis is defined as a side-to-side deviation from
the normal frontal axis of the body. Although traditional,
this definition is limited since the deformity occurs
in varying degrees in all three planes: back-front;
side-to-side; top-to-bottom. Scoliosis is a descriptive
term and not a diagnosis. As such, a search is made
for the cause. In more than 80% of the cases, a specific
cause is not found and such cases are termed idiopathic,
i.e., of undetermined cause. This is particularly so
among the type of scoliosis seen in adolescent girls.
Conditions known to cause spinal deformity are congenital
spinal column abnormalities, neurological disorders,
genetic conditions and a multitude of other causes.
Scoliosis does not come from carrying heavy things,
athletic involvement, sleeping/standing postures, or
minor lower limb length inequality.
In managing AIS, the judgment of the surgeon and the
participation of informed patients and families are
as important in determining treatment outcome as surgical
techniques. Decision-making in the management of AIS
remains complex despite the availability of data on
natural history, prognosis of different curve patterns,
brace treatment factors, and surgical innovations.
The management of AIS includes several steps and
treatment options:
· screening and early detection of deformity,
· observation of changes in deformity over time
with informed judgment regarding prognosis, orthotic
and non-operative interventions,
· surgical planning and operating.
back to top>>>
Sciatica
This is a condition which causes pain down the back
of one or both thighs. Inflammation of the sciatic nerve
(which is the largest nerve in the body-about the diameter
of your little finger) can be either constant or intermittent.
Success in solving this problem is directly correlated
to the diagnosis. Sciatica can be caused by a pinched
nerve as it exits the low back spine or it can be caused
by prostatic cancer. Odds are usually that the cause
is some structural imbalance, but there are so many
potential causes, some serious and some benign, it is
better to at least know that there may be a grave cause
to the symptoms.
This doesn't mean that you shouldn't immediately incorporate
a strategy to eliminate any structural imbalances. In
most cases, this will resolve the problem. If the problem
doesn't respond to these basic efforts, then professional
assistance may be needed. The first effort in relieving
sciatic symptoms should be to review Hip Pain.
Trigger points can accumulate in the piriformis muscle
forcing a contraction and strangulation of the sciatic
nerve. The tennis ball exercise should be incorporated
to help to relax the piriformis muscle. Stretching may
be beneficial, but that is more of a "try an see"
exercise.
If there are no improvements with this approach, refer
to Low Back Pain to better understand the relationship
between the sciatic nerve and the low back spine. Seeking
help from a chiropractor or orthopedist may be indicated
if the solution can't be found at home.
back to top>>>
