Degenerative Disc Disease (DDD), Herniated Discs & Sciatica Causing Lumbar Back Pain
What is degenerative disc disease and what are the symptoms?
Spinal disc degeneration and disc herniations are two of the most common causes of back pain, affecting in particular the lumbar spine (low back). Spinal discs are soft, compressible structures that separate the vertebrae of the spine. The discs act as shock absorbers, allowing the spine to flex, bend, and twist.
Sciatica is the name for the horrible leg pain that is caused when a bulging lumbar disc irritates a lumbar nerve root. The discomfort can be a combination of burning pain and numbness that responds poorly to pain medication.
There is a normal amount of expected wear and tear of our spinal discs as we age. On the other hand, arthritis, injury, and extreme wear and tear of sports can accelerate the degeneration. On a cellular level, there is continual loss of healthy cells inside the disc that is responsible for the discs structure. Over time, normal cells are damaged and hydration is lost, leading to tears in the internal structure of the discs.
When discs degenerate, mobility is affected and function is limited, resulting in symptoms that include stiffness, weakness, and ultimately, unrelenting pain.
What is spinal facet disease and what are the symptoms?
Spinal facet disease is one of the most common causes of neck and back pain and can cause pain at any level of the spine. The spinal facets joints are located on both sides of the back of each spinal segment. They connect each spinal level and are responsible for stabilizing the vertebral bodies and counterbalancing the intervertebral discs. The facets can be injured during acute trauma often seen in flexion extension injuries such as a whiplash event or sports accident. The surfaces of the facet joints are covered by articular cartilage and are also prone to chronic degenerative arthritis much like the larger joints such as knees and hips.
Pain that is caused by facet dysfunction is typically isolated to the back of the lumbar spine, thoracic region and neck. The discomfort can be isolated to one side or may affect both sides of the spine at once. The pain may radiate into the muscles but does not extend into the extremities like sciatic pain that is caused from a disc herniation. Typically the pain is worsened with extension and or rotation of the neck or back. Diagnosis of facet pain begins with a physical exam and imaging studies, but often requires diagnostic injection with local anesthetic and or steroid to confirm the diagnosis.
When the facet joints are injured mobility is affected and function is limited, resulting in symptoms that can mimic disc disease such as stiffness, weakness, and ultimately, unrelenting pain.
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