Acting as the scaffolding for the muscles that move our limbs and maintain our balance, the spine is a complex network of bony vertebrae and cartilage discs surrounding the spinal cord and spinal nerves. In its center, the spine contains a channel formed of bone, cartilage and ligament that offers protection to the spinal cord—the organ that connects our brain to nearly every other part of our body. The two most mobile sections of the spine are the neck, also known as the cervical region, and the lower back, or lumbar
region. With up to 80 percent of the U.S. population experiencing significant lower back pain at some point in their lives, the lumbar spine is an important section of the spine. Fortunately, less than 1 percent of those with lower back pain require surgery. While back pain is common, not all back pain arises from the same cause. Young, athletic people with a sudden onset of one-sided back and leg pain may suffer from a herniated disc, while an elderly person with the same symptoms may have a synovial cyst.
While there are many conditions related to the spine, I’m going to focus on the symptoms and treatments of a herniated disc. Serving as cushions between the bones, the vertebral discs are thick, leathery pieces of cartilage filled with a jelly-like substance called the nucleus pulposus. When a disc is
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torn, a small amount of this substance can be pushed against nearby nerves. This may be called a bulge, herniation or rupture. Inflammation of the compressed nerves can cause weakness, tingling or pain in one leg. This condition usually heals gradually over time and can be managed with short periods of bed rest and anti-inflammatory medication. If this doesn’t provide relief, a short, one-week course of steroids will often reduce the leg pain. Sessions with a physical therapist may also help patients learn how to return to their daily routines without putting strain on their backs. Additional therapies such as hot packs, cold packs, electrical stimulation or chiropractic manipulations can also help reduce discomfort. If all these treatments are unsuccessful—leg weakness and numbness persist or pain is intolerable and severely limits daily activities—surgery may be considered. The most common surgical procedure is a microdisectomy to remove the portion of the herniated disc pressing on the nerves. In rare cases, a severely herniated disc can paralyze the foot, or cause bladder or bowel dysfunction. If these symptoms develop, contact your physician immediately as emergency surgery may be required to correct the problem.
There are a number of ways to care for your back to prevent back injury during day-to-day activities at work or home. The following recommendations are from the North American Spine Society: Standing: Keeping one foot forward of the other, with knees slightly bent, takes the pressure off your low back. Sitting: Sitting with your hips slightly higher than your knees provides good low back support. Reaching: Stand on a stool to reach objects above your shoulder level. Moving Heavy Items: Pushing is easier on your back than pulling. Use
your arms and legs to start the push. If you must lift a heavy item, get someone to help you. Lifting: Kneel down on one knee with the other foot flat on the floor as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times. Carrying: Two small objects (one in each hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body. Sleeping: Sleeping on your back puts 55 pounds of pressure on your back. Putting a couple of pillows under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure. Weight Control: Additional weight puts a strain on your back. Keep within 10 pounds of your ideal weight for a healthier back. Quit Smoking: Smokers are more prone to back pain than nonsmokers because nicotine restricts the flow of blood to the discs that cushion your vertebrae. With proper care and good ergonomics, you can reduce the risk of spine injury—as well as the possibility of several weeks of pain and discomfort. If you happen to develop bothersome back or leg pain, talk with your physician. While most of us will experience back pain at some point in our lives, very few of us will actually ever need the services of a spine surgeon.
