Back Injury

HERNIATED DISK

Everyday activities can be very difficult to complete when you have back pain that shoots down your leg.  One cause of this shooting pain may be a herniated disk, which is also referred to as a ruptured disk or a slipped disk.  Your spine consists of vertebrae that are cushioned by pads of a small and oval shape made of cartilage that have an outer layer called annulus and a soft inner layer called nucleus.  When a disk is herniated, a small part of the nucleus pushes out through a tear in the annulus and into the spinal canal.  This may result in an irritated nerve and the end result is pain, weakness, and numbness in your back as well as possibly even in your leg or arm. 

Symptoms of a Herniated Disk

You can actually have a herniated disk and not even know it.  Some, however, can be very painful.  The  most common symptoms of a herniated disk includes sciatica, which is a pain that aches and radiates in your buttock and down the back or side of one leg.  Another symptoms is pain, weakness, and numbness in your lower back and one leg, or in the shoulder, chest, arm, or your neck.  Finally, another symptom is pain in your lower back or pain that gets worse when you cough, sit, or sneeze.  If you are feeling back pain that is disabling for over a week, you need to make an appointment with your physician to have your back evaluated.  Back pain can interfere with your daily activities.  Prompt medical attention is necessary if you lose control of your bowels or bladder, your pain increases over time, or you develop weakness or numbness in one or both legs. 

Causes of a Herniated Disk

A herniated disk occurs when the portion of the nucleus of the disk pushes out of a tear in the annulus and into the spinal canal.  This can cause the spinal nerves to become irritated.  The herniation of disks is often the result of aging-related and gradual wear and tear known as disk degeneration.  When you age, your spinal disks will lose some of their water content.  This makes them less flexible and more prone to rupturing or tearing, even in the case of a minor twist or strain.  Most people are unsure of the exact reason why their herniated disk occurred.  Sometimes it may be using back muscles to pick up heavy objects rather than thigh and leg muscles.  Twisting and turning when lifting can also be a cause.  It is rare that a traumatic event like a blow to the back or fall will cause a herniated disk.

There are several risk factors that will make you more susceptible to a herniated disk.  First, herniated disks are more common in middle age because of aging related degeneration of disks, so it is most common in adults aged 35 - 45.  Smoking increases your risk of disk herniation due to decreased levels of oxygen in your blood which keep your body tissues from getting vital nutrients.  Being overweight is also a risk factor because it causes you to put extra stress on the disks located in your lower back. Being tall also will increase your risk of disk herniation, as women who are taller than five foot seven inches and men taller than five feet eleven inches have a higher occurrence of disk herniation.  Finally, occupations which strain your spine also put you at increased risk, such as jobs that require repetitive pulling, lifting, pushing, bending, and twisting will increase your risk of disk herniation.  

Treatment of a Herniated Disk

Most people who have a herniated disk can be treated with conservative treatment, such as following a pain medication regimen and a planned exercise treatment.  In fact, in just a month or two, most people with this condition will get better.  Imaging studies that have been conducted show that the displaced or protruding disks shrink over time.  One of the treatments prescribed by your doctor may be modified activity, which is when you have to take it easy and try to stay away from activities that make your symptoms worse, like improper reaching, bending, lifting, and prolonged sitting.  Physical therapy and exercises that will help increase your strength and flexibility will likely be prescribed.  Physical therapy may also assist with your pain relief, as heat, ice, ultrasound, traction, and electrical stimulation can be applied.  Physical therapists can also demonstrate exercises and positions that are designed in order to minimize the pain you feel.  Heat or cold are often used initially to relieve pain and inflammation.  After just a few days, gentle heat may be used in order to provide comfort and relief.  If you have back or limb spasms, muscle relaxants may be prescribed.  Without any improvement, narcotics may be prescribed for a short period of time.  Bed rest may also be recommended for severe back pain.  It generally takes about four to six weeks for the symptoms of a herniated disk to improve.

Surgery may be necessary for only about ten percent of people who are suffering from a herniated disk.  If the conservative treatment fails, your symptoms may improve after just six weeks.  The most common surgery is microdiskectomy, which is a spinal surgery that involves cutting away some of the spinal bones to access the disks that are herniated and the compressed nerve roots.  Surgeons will use a surgical microscope or a magnifying lens in order to allow smaller incisions in the muscles, skin, and bone over the herniated disk.  During this surgery, you will be placed under general anesthesia, so you will not be conscious during the surgery.  You may be able to go home on the same day or you may need to stay in the hospital overnight.  Typically patients of this surgery are able to return to work within about two to six weeks. 

Prevention of a Herniated Disk

There are actions you can take to help prevent a herniated disk from occurring.  First, you should get regular exercise which will slow the age related degeneration of your disks as well as stabilize and support the spine through exercise.  Good posture is also important as it reduces the pressure that you put on the disks and the spine.  It is important to keep your back straight and aligned, especially when you are sitting for long periods of time.  When you lift, you should be sure to put most of the pressure on your legs rather than your back.  You also need to maintain a reasonable and healthy weight, as being overweight puts more pressure on your disks and your spine.  Smoking increases your risk of back problems, so you should not smoke. 

BACK STRAINS, SPRAINS, AND SPASMS

The most common cause of back pain is when there has been an injury to a muscle resulting in a strain, or a ligament, resulting in a sprain.  Sprains and strains can occur for a number of reasons, including being overweight, lifting improperly, or poor posture.  They can also develop from sleeping at an awkward angle, or hauling around a heavy bag.  The lower back is particularly at risk for developing muscle strains.  At times a muscle strain or sprain can cause back pain that occurs immediately.  In other situations, the stiffness and soreness may occur later.  Additionally, an injured muscle may knot up.  This spasm in the muscle is the body's way of making the muscle immobile in order to protect it. 

Symptoms of Back Strains, Sprains, and Spasms

Back Sprains may result in feelings of pain, swelling, bruising, stiffness, and even a popping noise.  Strains may include symptoms such as muscle spasms, swelling, pain, and a limited ability to move the muscle that has been affected.  If you are unable to walk without significant pain, cannot move the affected joint, have a numbness, or see red streaks from the area of injury, you need to see a doctor right away.

Risk factors for any of these back injuries include poor conditioning that leaves your muscles weaker and unable to sustain injury, fatigue, as tired muscles are unable to support your joints well, and improper warm up, which leave your muscles tighter and more susceptible to tears and trauma.  

Treatment for Back Injuries

Treatment may include medications such as an over the counter pain reliever, therapy, or surgery.  Home remedies include protection of the injured area, such as wearing a brace, resting the affected area, icing the area immediately and for fifteen to twenty minutes every two or three hours for the first few days following the injury, and compression using an elastic bandage.