Most people take a pain pill for their back pain and try to continue their activities while thinking of getting professional help later at a more convenient time. They are unaware that, in many cases, they could get pain relief or decreased pain from just a few chiropractic adjustments. In some cases, a significant decrease of pain on the first visit to a chiropractor occurs. I know this because I’ve had new patients say, “wow!” after experiencing their first chiropractic adjustment for their back pain.
It is not surprising that many are unaware of this. Statistically, most people go to their family doctor (often specializing in general practice or internal medicine). For back pain syndromes, family doctors typically do not delve deeply into diagnosing the underlying origin of musculoskeletal pain. A prescription for a pain reliever or a muscle relaxant is typical. This only covers up the problem temporarily. Often, the back pain cause is not identified. When the problem is not resolved, it could lead to complications, and in some cases, disability.
Two of the most common back pain causes are facet joint pain and disc pain.
1. Common Back Pain Cause: Facet Joint Pain
What is Facet Joint Pain?
Facet joint pain results from lack of free motion from the gliding joints at the back of the spinal bones (vertebrae). There are facet joints in all three regions of the spinal column: the cervical region (neck), the thoracic (mid-back) and lumber region (lower back). The facets key function is to guide motion. Smooth, unrestricted motion is necessary to keep the facet joints healthy. Restricted motion for any reason will cause facet joint degeneration and pain. The facet joints are small joints, when compared with the larger joints like the knee, hip and shoulder, but they are similar to these larger joints in that they are lined with cartilage and coated with a lining of joint fluid, called synovial fluid. These joints are supplied by nerves, thus, when the joint is damaged or inflamed, it can produce pain.
Causes of Facet Joint Pain
The facet joints often become injured from trauma, such as falls, auto accidents, sports injuries and even “catching” yourself from slipping. The cartilage in the joints becomes damaged, and if not allowed to heal properly, chronic pain and joint degeneration can occur. Healing involves restoring proper motion, providing key nutrients, and strengthening the surrounding muscles.
Facet Pain Characteristics and Location
Facet pain is often a deep, dull ache. Facet joint pain can be localized or referred to other areas. Lumbar facets can refer pain into the buttocks, groin, hips, and thighs. Lumbar facets don’t often refer pain into the lower legs like lumbar disc pain can, but it can happen.
Diagnosis of Facet Joint Pain
In office orthopedic tests performed by a properly trained and experienced clinician can help differentiate facet pain from other origins of pain, including disc pain. Diagnostic imaging using X-rays, CT-scans or MRI can help diagnose facet joint pain origin.
2. Common Back Pain Cause: Disc Pain
What is Disc Pain?
The discs lie between the round-shaped weight-bearing parts of the lower back vertebrae. They are called intervertebral discs. Disc pain results from small tears in the ligaments surrounding the gelatinous center of the intervertebral disc. The gelatinous center is called the nucleus pulposus. The nucleus pulposus leaks out of the small tears and compresses the spinal nerves in the lower back. This is what occurs when people refer to a herniated disc, disc protrusion, “slipped disc” or bulging disc, though not all these terms are technically correct. There are intervertebral discs in all three regions of the spinal column. The discs key function is for weight-bearing cushioning. The lower back or lumbar spine discs have the most weight bearing, therefore the lumbar discs are the most commonly injured. Proper body mechanics, balanced strong muscles and adequate water intake is necessary to keep the intervertebral discs healthy. The spinal nerves coming off the spinal cord exit off to each side and behind the discs. Therefore, when there is a disc injury, the spinal nerves are often irritated.
Causes of Disc Pain
The discs often become injured from trauma, such from auto accidents, sports injuries, incorrectly bending lifting and twisting while trying to pick up something, sitting for long periods with a sudden twisting upon standing, and even just sneezing vigorously. The ligaments surrounding the gelatinous center tear; the gelatinous fluid of the nucleus pulposus leaks out through these tears, and this irritates the spinal nerves.
Disc Pain/Injury Characteristics and Location
Intervertebral disc pain is often a sharp, shooting pain, and can cause numbness and tingling. Disc injury can also cause muscle weakness and muscle atrophy. It can be localized and is often referred to other areas. The more the nucleus pulposus protrudes out, the more it compresses and irritates the nerves. In the less frequent, most severe cases, a disc protrusion can compress the spinal cord causing various unusual symptoms such as inability to urinate or constipation. The more the nerve is irritated, the farther away from the local disc protrusion the pain will be referred to. Referred pain from lower back disc protrusions, which are the most common, can refer pain into the buttocks, groin, hips, front, back and side of the thighs, and even into the calves and feet. Lower back disc protrusions are often the most debilitating of the three spinal regions.
Diagnosis of Intervertebral Disc Pain
In office orthopedic tests performed by a properly trained and experienced clinician can help differentiate lower back intervertebral disc pain from other origins of pain, including facet joint pain. Diagnostic imaging with X-rays, CT-scans or MRI can help diagnose disc origin pain.
If you have any questions regarding resolving your back pain, don’t hesitate to contact us.