It's a bad ache

THERE are a few spinal problems besides herniated (intravertebral) disks (as a result of degeneration or damage to the disk) that will cause backache. The following are a few to note:

Degenerative disc disease

Degenerative disc disease (DDD) is part of a natural ageing process that involves the gradual loss of fluid within the disk, making it brittle and prone to tears. DDD could also cause herniated disks.

Who gets it?
Degenerative disc disease is as certain as death and taxes, and to a certain degree this process happens to everyone.

Symptoms
Not all people who have DDD experience pain as a result of the disease. When DDD becomes symptomatic, patients can experience pain in the back, numbness and reflex loss in the limbs, and weakness.

Some will experience stiffness in the body, especially towards the end of the day.

Treatment
Treatment options available are medications to help relieve pain and inflammation, exercises to improve flexibility, manipulative treatment to help increase spinal flexibility and physiotherapy to help relieve pain.

For those who are unable to function due to the pain, surgery is an option.

While it is true that the disc degeneration is likely to progress over time, the lower back pain from degenerative disc disease usually does not get worse. In fact it usually gets better over time.

Spondylolysis

Spondylolysis and spondylolisthesis

Spondylolysis and spondylolisthesis are separate, yet related conditions. Spondylolysis is a condition where one experiences a stress fracture in one of the bones (vertebra) in the spinal column (usually in the lower back). Spondolylisthesis occurs when one vertebra slips forward in relation to an adjacent vertebra. Spondylolisthesis is often caused by spondylolysis.

Who gets it?
Those who were born with thin vertebral bone can have a tendency to develop this condition while athletes involved in sports which put a great deal of stress on the spinal column are also at risk.

Symptoms
The symptoms that accompany spondylolisthesis include pain in the lower back or legs, muscle spasms and weakness. Often, the symptom of spondylolisthesis is tightness of the hamstring muscles in the legs. Some people are symptom free and remain oblivious of the condition, until it shows up on an x-ray.

Treatment
If the spondylolisthesis is non-progressive, no treatment except observation is required. Conservative treatment includes two or three days of rest followed by some muscle strengthening exercises. A spine care specialist may prescribe the wearing of a back brace for a short period of time to decrease muscle spasm and pain as well as help immobilise the spine to aid the healing process.

Osteoarthritis

Osteoarthritis

Osteoarthritis, also called degenerative arthritis, can cause breakdown of cartilage between some joints of the spine. When the joints move, the lack of cartilage causes pain as well as loss of motion and stiffness.

Who gets it?
Osteoarthritis occurs more frequently as we age. Before age 45, osteoarthritis occurs more frequently in males. After age 55 years, it occurs more frequently in females.

Symptoms
Most people who suffer from this problem typically complain that the pain is most pronounced in the morning, decreases throughout the day and becomes worse again later in the day. The pain may also become worse with twisting or extension motions of the spine.

Treatment
Conservative treatment is the most effective for relieving symptoms and it concentrates on maintaining motion in the spine. Manipulative treatment helps to relieve the pain and to increase spinal mobility. Exercises can help strengthen back and abdominal muscles and restore spinal mobility. Medications and physiotherapy helps to relieve pain.

Ankylosing spondylitis

Ankylosing spondylitis

Ankylosing spondylitis is a progressive form of arthritis affecting the spine joints. While the cause of ankylosing spondylitis is not clearly known, the condition appears to have a strong genetic component.

Who gets it?
It usually develops before age 40 and is twice as likely to occur in men as in women.

Symptoms
Ankylosing spondylitis usually begins with pain and stiffness in the lower back. In its early stages, it may be mistaken for other spine-related problems.

Treatment
For most patients suffering from ankylosing spondylitis, conservative treatment is the first and usually successful step. Options such as medications, exercises, manipulative treatment and physiotherapy aims to strengthen muscles, restore spinal flexibility and ease the pain.

References:

1. Common causes, Global Spine Network,
www.globalspine.net/disc_degenerative_disease.html

2. Osteoarthritis (Degenerative arthritis), William C. Shiel Jr.,
MedicineNet.com, www.medicinenet.com/osteoarthritis/article.htm

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