The back is a remarkable combination of strength, flexibility and sensitivity comprised of bones, ligaments, tendons, muscles and nerves. However, some motion in the spine, even micro-motion at a specific spinal segment, can cause pain. The portions of the spine that are able to move are called motion segments and it is important to understand that motion segments can cause pain in the lower back. You should also understand how the spine can be treated to reduce or remove that pain.
There are many different types of motion that can indicate the problem in your spine causing the pain:
- Movement causes pain to radiate down the lower back and legs
- Any movement causes pain in the lower back and hip area, worst in the morning or late evening
- Pain or numbness in the legs when walking
- Pain gets worse when sitting or bending
The most common reason motion will cause back or neck pain has nothing to do with the spinal structure at all. The muscles or ligaments surrounding the spine in the back or neck can become over-stretched or even torn. This causes inflammation and pain while the body tries to limit motion while it heals.
Spinal Anatomy and Herniated Disc
Of the four major regions of the spine, the lumbar spine (lower back) has a lot of motion and carries all the weight of the torso, making it the most frequently injured area of the spine. While the vast majority of episodes of lower back pain are caused by muscle strain, other structures in the lower back can also cause pain.
Cartilage Breakdown Creates Frictional Pain in Lumbar Spine Osteoarthritis
Spinal arthritis is relatively common and is most likely to occur in people over age fifty. Spinal osteoarthritis is the mechanical breakdown of the cartilage between the aligning facet joints in the back portion (posterior) of the spine. The facet joints (also called vertebral joints or zygophyseal joints) become inflamed and progressive joint degeneration creates more frictional pain. Back motion and flexibility decrease in proportion to the progression of back pain induced while standing, sitting and even walking.
Additional Pain Can Result From Bone Spurs or Synovial Cysts
With osteoarthritis, bone spurs (small irregular growths on the bone, also called osteophytes) typically form on the facet joints and are a response to joint instability (from the degeneration). Bone spurs can be a normal part of aging and do not directly cause pain, but may become large enough to cause irritation or entrapment of nerves passing through spinal structures, and may result in diminished room for the nerves to pass (stenosis). Most cases will produce pain (and perhaps numbness and tingling) into the legs with walking, and the pain will be relieved with sitting.
A Painful Disc Causes Low Back Pain in Lumbar Degenerative Disc Disease
Degenerative disc disease refers to a syndrome in which a painful disc causes chronic low back pain, typically in people 30 to 40 years of age. With symptomatic degenerative disc disease, the condition creates excessive micro-motion at a vertebral level and leads to pain.
Most Motion-Painful Segment Conditions Respond Well to Conservative Care
There are a number of non-surgical treatments available to help successfully manage the low back pain and occasional episodes of more severe pain associated with painful motion segments. Treatment plans typically include exercise and physical therapy, healthier lifestyle choices (e.g. weight loss, posture, ergonomic improvements), medications for pain and/or inflammation (including injections) and spinal manipulation.
Source: www.spine-health.com; Stephanie Burke; October 27, 2010.