lowbackThe gradual wearing out of spinal discs is a natural part of aging that can often lead to a herniated disc. But only a few people who have herniated discs have severe or troublesome symptoms.

Due to age, injury, or both, a disc’s outer layer, the capsule or annulus, may dry out and develop tiny cracks. This causes the disc to bulge, break open (rupture), or break apart. Often herniated discs bulge but do not rupture or break apart.

  • Herniated Disc. Some of the jellylike material (nucleus) that fills the disc may leak into the cracks in the capsule. The disc may begin to bulge out from between the bones of the spine (vertebrae). It often bulges away from the spinal cord and nerve roots and therefore doesn’t cause symptoms.

  • Ruptured disc. The nucleus material inside the disc breaks through the capsule.

  • Free fragment. Fragments of a ruptured disc may break completely free of the disc and lodge in the spinal canal , the opening in the vertebrae through which the spinal cord runs.

Any of these stages can cause pressure on a nerve root and symptoms of pain and numbness.

The cracks in the disc capsule do not repair themselves, but the pain usually fades over time. About 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, most recover.

Often material from a herniated disc is broken down and absorbed by the body, a process called resorption. In about 2 out of 3 people, the disc herniation is at least partly gone after 6 months.

Long-term herniated disc problems can develop.

  • Pain may come and go. Periods of time when pain goes away (remission) occur less frequently.

  • Long-lasting (chronic) and recurring pain can develop because of continued tissue irritation caused by the disc pressing on a nerve.

  • Chronic pain syndrome can result from having ongoing pain, causing depression, anxiety, and difficulty coping with daily life.

  • Symptoms caused by long-term nerve root compression include loss of agility, strength, or sensation in one or both legs and feet.

Compression of the bundle of nerve roots in the lower back (lower lumbar region) can lead to weakness in both legs, and the loss of bowel, bladder, and sexual function. This rare condition, called cauda equina syndrome, requires immediate medical attention.

Source: Web MD

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Causes of Back Pain

The causes of back pain can be very complex, and there are many structures in the back that can cause pain. The following test procedures are used to test and evaluate the cause of pain: 

X-rays can be very effective in diagnosing traumatic bone and joint injuries such fractures and dislocations.   An X-Ray provides images that can be used to evaluate bones, joints and degenerative lesions in the spine.

A myelogram uses X-rays and a special dye called contrast material to make pictures of the bones and the fluid-filled space between the bones in your spine. A myelogram may be done to find problems with the spine such as a herniated disc, or narrowing of the spinal canal caused by arthritis.

An MRI is a common test to evaluate the lumbar spine.  MRI’s can be used to evaluate vertebral bones, discs, joints, nerves, and soft tissue

CT scans may be requested when problems are suspected in the bones or when a patient is unable to obtain an MRI

A discography is a medical procedure that involves injecting a dye into the jellylike center of a spinal disc to help diagnose back problems. During discography, a doctor looks at the amount of pressure needed to inject the dye into the disc, whether it causes pain that is the same as your regular pain, how much dye is used, and how the dye appears on X-ray once it is inside the disc.

An electromyogram (EMG) measures how well and how fast the nerves can send electrical signals. If you have leg pain or numbness, you may have these tests to find out how much your nerves are being affected. These tests check how well your spinal cord, nerve roots, and nerves and muscles that control your legs are working.

Bone mineral density (BMD) testing generally correlates with bone strength and is used to diagnose osteoporosis

A bone scan is a test to help find the cause of your back pain. It can be done to find damage to the bones. A bone scan can often find a problem days to months earlier than a regular X-ray test.