Saturday, August 8, 2009

Newsletter: Back pain, part 2

Diagnosis. All right, what happened? Was it a sharp wincing type of pain that came from one side of the back, or was it a headache type of pain (more dull than sharp, but still debilitating) that seemed to emanate from inside your spine? It's very important to think about this, because if you do see a doctor, you'll need to describe in detail what happened, what you felt, and what you did about it. More often than not, the sharp pain from either side of the spine means muscle strain (slight tearing of the muscle), followed by a cramping of that muscle - it's a protective mechanism built into your body that you have little control over. Believe it or not, this is the lesser of the two evils of back pain. This problem is much easier to treat. Muscle -or soft tissue - injury will require less recovery time, in general.
Structural injury is a more serious problem. You're probably dealing with a bulging -or herniated- disc. What's the difference? A bulging disc is just that -bulging out from the space it occupies between the two vertebrae above and below it. It means it's compressed, and the soft nucleus pulposus center has pushed out either through a tear in the connective tissue surrounding the disc, or pushing the connective tissue itself out. The bulge can either directly impinge on a spinal nerve, or cause a narrowing of the space where the spinal nerve comes out (foramen)between the two vertebrae, and the bones of the vertebrae (facets) are pinching the nerve.
Secondly, a question to ask yourself is this: "did I experience any discomfort or pain down either of my legs prior to the pain hitting me?" If so, you may have sciatica, which is a pinching of the sciatic nerve that runs down the back of both legs, and is fed by the spinal nerves in the lower lumbar area as well as the sacral area. Pinching of this nerve, and the resulting pain down the legs, lets you know that you have a bulging disc, and that the problem is a structural one. Muscle cramping around the sciatic nerve will most often ensue, so attacking the soft tissue problem first will help alleviate some of the discomfort of sciatica until you can treat the structural one.
Decompression is the first order of business for the structural problem. Rest and Ice is the first order of business for the soft tissue problem. (Actually, Rest and Ice will help with the structural problem as well, but only initially. You will still have the structural problem after the rest and ice, and that needs to be addressed.)
Next: treatment options

No comments:

Post a Comment