Back Clinic Lower Back Pain Chiropractic Team. More than 80% of the population suffers from back pain at some point in their lives. Most cases can be linked to the most common causes: muscle strain, injury, or overuse. But it can also be attributed to a specific condition of the spine: Herniated Disc, Degenerative Disc Disease, Spondylolisthesis, Spinal Stenosis, and Osteoarthritis. Less common conditions are sacroiliac joint dysfunction, spinal tumors, fibromyalgia, and piriformis syndrome.
Pain is caused by damage or injury to the muscles and ligaments of the back. Dr. Alex Jimenez compiled articles outline the importance of understanding the causes and effects of this uncomfortable symptom. Chiropractic focuses on restoring a person’s strength and flexibility to help improve symptoms of lower back pain.
Chiropractor Dr. Alexander Jimenez of Injury Medical and Chiropractic Clinic focuses on long-haul truck driversand non-invasive spinal treatments. Truck drivers are at a much higher risk of developing degenerative spinal disorders from the stress that constant driving and repetitive lifting can place on the spinal muscles of the lower back.
Driving a huge truck for eight to ten hours every day/night means the person sits in a stationary position for a long time. The muscles, joints, and ligaments tend to become stiff, and proper blood circulation is affected over time. Ailments can last for weeks, even up to several years if drivers don’t take time to focus on their health and find the right treatment.
Teams are in a truck that never stops. Even sleeping in the bunk, these drivers are subject to constant vibration and bouncing as the truck moves. Roads that are poorly maintained can cause impact trauma to both the driver and the person in the bunk. Various factors can cause musculoskeletal pain like:
Having limited mobility can lead to structural problems like pain in the back, hip, knee, shoulder, arms, and legs. This is compounded by the fact that prescription medications are the norm for these issues and can be dangerous.
Long Haul
These individuals are taught proper lifting techniques but with time forget to follow them during the rush to make the delivery/s on time. Driving for extended periods regularly places added strain on the back. This is due in part because these individuals can’t use their feet to support the lower part of their bodies while working the pedals of the truck.
The continuous instability, vibrations, and positional changes that come with long-haul driving can cause tension in the spine and surrounding muscles in the area. Research has shown that vibration of the body while driving increases the load on the lower back and driving on roads that are not maintained can exacerbate the condition.
The continuous bouncing can lead to spinal disc compression, which in turn causes degeneration of pain in the spine and nerves. This continuous strenuous routine can lead to herniated/bulging discs, which can cause pain and lead to the development of other spinal conditions like sciatica. Improper alignment of the spine can lead to dysfunction and pain in one or several areas of the body. Other conditions that could develop include:
Facet joint syndrome – the cartilage wears away making the spinal joints stiff and swollen. This syndrome can lead to reduced mobility.
Spinal compression from sitting in a single position for a long time places pressure on the spinal column. As the spinal column compresses, it causes tightness in the lower and upper back muscles.
Sciatica is a combination of symptoms and pain that travel from the lower back to the knee and even into the foot. Usually, caused by a herniated disc that compresses the sciatic nerve, it can cause shooting electrical pain down the leg. Drivers with sciatica can also have tight gluteal muscles that place pressure on the nerve.
Neck pain from tight and tender muscles can affect the middle back and cervical/neck area of the spine causing soreness.
Tension headaches begin with the muscles at the base of the skull. When these muscles are tight, they can pinch the nerves, beginning a headache.
Shoulder pain can be caused by overuse when loading, along with rotator cuff injuries and bicep tendonitis. An inflamed bicep can cause inflammation and pain in the shoulder.
Preventable and Treatable
Prevention and proper treatment are key. Here are a few simple ways to improve the drive:
Better seating to reduce vibration
Correct sitting posture
Chiropractic/physical therapy
Exercise
Proper diet
Ice therapy
Proper sleep support
Proper Seat
The seats that are standard in a truck do not offer proper support for a driver’s back, shoulders, neck, and legs. A seat pad for extra comfort or a memory foam seat with a massage base can relax the muscles. For quick lumbar supportroll up a pillow, towel, or t-shirt and place it behind the lower back.
An ergonomic truck seat helps fight the discomfort and awkward positions, that result in positive posture. A proper seat will force the back into its healthy arch. Driving with less strain helps:
Boost circulation
Distribute the body weight evenly
Helps drivers operate longer
Reduces the vibrations running through the body
These long-haul drivers can choose to bypass invasive procedures that can take months to heal. This is because the inability to drive means they don’t earn a check. And being taken out of a driving job for any period can cause financial difficulties.
Chiropractic provides long-haul truck drivers with a non-invasive, drug-free way to treat injuries, manage conditions, and relieve pain. Regular chiropractic can help correct postural habits that expose the body to injury or move the body and the spine out of alignment. It can identify emerging issues before they become a severe condition.
Larger truck stops offer drivers access to medical and chiropractic services allowing them to get treatment when they need it. Long haul drivers can be out for weeks and may not be able to get their regular adjustments. But it is still a good idea to have a regular chiropractor at home so you can stay healthy and on the road.
An overview of chiropractic treatment for lower lumbar back pain, how it works, how safe it is, and how often treatment is necessary. Along with the principles of chiropractic for the relief of lower/lumbar back pain, whether acute or chronic. Seeing a doctor ofchiropractic/DC, a chiropractor�or a chiropractic physician can be highly beneficial towards effectively treating low back pain. �
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Practice
Chiropractic medicine utilizes a variety of treatments/therapies that are designed to manipulate/adjust the:
Spine
Joints
Tissues
These treatments focus on the entire body to relieve pain and improve functional ability. This is referred to as spinal manipulative therapy or SMT, but there are many other treatment methods and techniques.
Every chiropractor has a personal treatment approach based on the patient’s condition/s, medical history, and personalized treatment plan. A chiropractor will begin traditionally starting off with soft, natural, less-invasive treatments. If these do not generate positive results they will move on to more aggressive techniques.
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Consent Form
At every stage of the chiropractic process, there is a strict emphasis maintained on proactively discussingwith the patient exactly what is taking place and what is going to happen. A chiropractor makes sure that the patient understands everything that occurs during:
Diagnosis
Examination
Procedure/s
This is all done in order to educate the patient and receive direct permission to start the treatment. The emphasis on informed consent is essential. This is because some chiropractic techniques could carry material risk. This means that a certain technique or particular procedure could possibly cause injury.
A chiropractor also informs the patient of the possible risks of not being treated. It is not meant to scare a patient. It is to eliminate any misunderstandings and make sure that the patient has full control over their body, so they can make an informed decision, as to which way they want to go. �
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Examination
A chiropractor will thoroughly examine a patient before making any sort of diagnosis or treatment plan. The assessment can include:
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Medical history
The characteristics of the pain, any red flag symptoms that require further diagnostic testing will be conducted to remove any potentially serious medical issues that can be associated with neck or lower lumbar back pain-like:
Neurological disorders
Fractures
Infections
Tumors
There can be many reasons as to why low lumbar back pain happens. A chiropractor will investigate and develop a personally customized treatment plan. Next, a physical exam will be performed. This includes an orthopedic and neurological exam. These will test the:
Reflexes
Sensory nerves
Joints
Muscles
Other areas of the body
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Advanced Diagnostic Testing
Imaging and laboratory tests are not always used for non-specificlower lumbar back pain, but they could be necessary if there are signs/symptoms of an underlying condition.
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Severity/Duration of Condition
Chiropractic medicine looks at the symptoms and conditions of an injury or ailment and classifies them on how severe they are, and how long they last. Symptoms can be divided into degrees of severity: They are:
Mild
Moderate
Severe
For the duration period, pain and other symptoms are referred to as:
Acute pain – lasts for less than 6 weeks
Subacute – lasts between 6 and 12 weeks
Chronic – lasts for at least 12 weeks
Flare-ups – the same symptoms happen irregularly or from an exacerbation of the original injury
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Treatment Trial
If an individual is dealing with acute or subacute lower lumbar back pain, then a chiropractic trial could be an option. This could be two to three weekly sessions over the course of two to four weeks adding up to twelve total sessions. This can be a sufficient treatment to completely alleviate the pain. However, when the pain does not go away then additional treatments could be necessary, especially if an individual has other issues/conditions.
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Measured Outcomes
Outcome measurements are a valuable tool because they help determine whether or not the treatment is producing significant results. Some outcome measurements of treatments include:
Numeric Pain Scale for patients to rate the pain
Pain diagram so patients can describe the location and character of the pain
Increases and decreases in normal daily practices, like work, exercise, and sleep
Testing functions
Lifting ability
Strength
Flexibility
Endurance
For some low lumbar back pain could last and go over the 12-week mark making it a chronic pain condition. A chiropractor will look for signs/symptoms to see if there is a risk of developing chronic pain. �
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Chiropractic How Often
When the pain is acute lower lumbar back pain, a standard treatment plan can be six to ten sessions over the course of two to four weeks. These treatments emphasize the passive non-exercise approach of manual therapy for relieving pain and improving function.
If the non-exercise method doesn’t deliver positive results then a more active exercise-based treatment can be utilized to increase function and return an individual back to normal life.
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Back Pain That Doesn’t Go Away
Often acute symptoms are resolved within the first 4-weeks. But it is possible that the pain can become chronic, meaning that it lasts longer than 12 weeks. Some individuals can hit a plateau during the recovery process.
This is referred to as MTB or that the patient has met the therapeutic benefits. A chiropractor will want to see if pausing/stopping chiropractic treatment will have a residual effect, exacerbate the pain, or reduce function and activity.
Example: If mild to severe chronic lower lumbar back pain has worsened, a patient could need one to six more visits with each pain episode. And this would be two to three weekly treatments for two to four weeks. However, patients rarely need continuing or ongoing care of one to four visits per month.
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Re-Evaluation
Chiropractors will not continue treatment/s if they are not helping the patient. Therefore, every 2 to 4 weeks there is a re-evaluation of the patient to see if the treatment is still having a positive and beneficial effect. Here are some of the criteria for continuing treatment:
Individual still responds positively to the treatment
The individual has met the therapeutic benefits and worsens when they are not treated
Proof shows that self-care alone will not be sufficient to maintain the therapeutic benefits
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Continuing Treatment
Living with chronic lower lumbar back pain can be a challenge, but chiropractors want to emphasize to individuals that self-care is an essential component for pain management. This includes physical rehabilitation combined with range-of-motion exercises. A chiropractic physician may encourage a variety of treatment options, like:
Chiropractic treatment and the benefits are different for everybody. This is why it is important to communicate with your chiropractor every step of the way and to be open-minded about the different treatment options they offer.
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Lower Back Pain Chiropractic Treatment
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas*& New Mexico*�
Those who like to jog or run say there is nothing like the feeling of jogging and running. The breeze all around, the sound of feet hitting the pavement, and the accomplishment felt after. Jogging and running can generate empowerment that makes individuals feel like they’re on top of the world. Until back pain rears its ugly head.
Many individuals with back pain see no alternative and so give up trying to jog or run and just forget the whole thing. However, it is possible to be a successful runner and hold down a jogging/running regiment, even with back pain. �
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Jogging and Running
Running can be highly beneficial for those with back pain. Aerobic exercise is considered a form of effective treatment for low back pain. Other studies have found that runners have stronger spines. An article published in Scientific Reports looked at the intervertebral�discs in joggers/runners, as well as, non-joggers/runners. The joggers/runners had healthier intervertebral�discs.
Running can be quite helpful to those having trouble with mechanical back pain. Mechanical means an individual has a structurally sound spine but has a job/ that creates force/s that can damage tissues, which results in back pain. Often, those with back problems have a weak:
Core
Front
Back
� Jogging and running can help strengthen the core along with weight loss and improved fitness will definitely benefit the spine/back. Jogging and running increases endorphins. This is great for the brain and mood and decreases overall general pain.
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Individuals that should not be jogging or running
It does not mean these individuals cannot jog or run. But because of underlying conditions, they need to talk to their doctor first and may have to take extra precautions.
Back pain can be mechanical or structural. If the spine has a structural problem, then jogging or running might not be the best option for a therapeutic exercise regiment/program. This can be dangerous as any added stress placed on an abnormal spine could worsen symptoms, instead of helping to reduce back pain. It could even worsen the condition. This is where the proper spine treatment is directed by a doctor, spine specialist, chiropractor, or physical therapist.
� If the back pain is mechanical, there are ways to work in a running program while keeping the back safe. Usually, this means stretching out, getting physical therapy, and applying heat, and ice. These can all help while being able to jog and run.
Lace-up, make sure there is plenty of water and hit the neighborhood, trail, pathway, etc. However, running with back pain is not the most optimal way to jog or run. Here are some ways to get the full benefits from the experience.
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Stretching Out
Stretching is highly beneficial not only to runners, but everyone, especially those with back pain, which is why stretching before and after jogging and running is extremely important.
The hamstrings, quadriceps, groin, and calf muscles definitely need to be stretched out. These are the legs muscles and need to be loose and ready to move. The thigh muscles are all directly connected to the pelvis and hip. If they are not properly stretched it can affect pelvic tilt and generate low back tightness.
The calf muscles are not directly connected, but the body is a kinetic chain, which means that the body works as a whole unit. For example, let’s say an individual has a tight calf or Achilles tendon. This can change stride length, which can then affect the hamstrings, hips, and back. Icing the back after a jog or run will reduce back pain and inflammation. �
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Ease Into The Routine
Experienced runners know all too well that literally hitting the ground and taking off results inpain and injuries. First-time joggers/runners, as well as those coming back to jogging or running need to take it low and slow. This means to gradually ease into a jogging/running routine rather than trying for ten miles right away.
Go for reasonable goals that can be accomplished. This will increase the likelihood to stay with it and continue. This goes for new runners or joggers/runners making a return. Gradually increasing distance and speed is the safest approach. Gradual increases in the jog or run allow for positive and progressive gains.
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Mix In Other Workouts
Cross-fit training can help the body take a break when carrying out a running program. Cross-fit training involves:
Swimming
Biking
Weights
A comprehensive exercise program should include resistance training and cardiovascular exercises. Only want to stick to only running and nothing else then change distances and speeds on a regular basis. Changing running workouts frequently will help to avoid overuse injuries.
Overuse injuries can stop an exercise routine cold. Therefore, making sure that the body gets the proper amount rest between jogs, runs, and workouts is crucial for the therapy to work, to eventually alleviate back pain. �
Proper Equipment
Throwing on a pair of old sneakers and jogging out the door is not the way to go. Improper shoes could exacerbate the back pain/condition and even create new injury/s. Therefore choosing the proper jogging and running equipment will prevent injuries and back pain.
Shoes, braces, and orthotics do make a difference. Just like using the right tool for a job makes a difference. Especially, when using a cheap knock-off that breaks or falls apart. It is the same with exercise equipment/gear. For the low back, a neoprene belt can help the low back remain loose by providing heat and spine support.
Shoes and orthotics are important, but be sure to know foot size and type. Otherwise, they could worsen back pain or cause another injury. Effectively utilizing them, a runner should get a custom foot orthotic/s sizing. Because every person is unique, functional custom foot orthotics can help balance a person�s unique body structure. Dr. Jimenez can help provide functional custom foot orthotics to patients who want to improve back pain. For example, some things to consider:
Some choices depend on the constant surface the runner is on, like cement, pavement, trail, or dirt road. Specialty running shoe stores can provide a foot strike analysis to find the shoes that are best matched for your physical needs. �
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Feel That, Your Body’s Telling You Something
Experienced athletes, especially runners know how to listen to their bodies. If an injury is acting up they take the necessary time off to heal properly before re-starting the regiment. For those with back pain, this is especially important during the program.
If back pain presents mid-run, it is recommended to slow down. If that doesn�t bring relief then stop and stretch. And if that does not help then stop the workout altogether. It could be nothing and all that is needed is more rest before starting up again. But if it persists then check with your doctor, chiropractor, or physical therapist to re-evaluate the program, as there could be some changes/adjustments that need addressing.
It does not matter, whether it is back pain, shin splints, or plantar fasciitis, the point is to listen to your body. Pain that lingers on or wakes you out of sleep should be checked out.
Chiropractors On Metabolic Syndrome & Inflammation
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Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900. The provider(s) Licensed in Texas& New Mexico
Staying at home means it can be tough to see a doctor, chiropractor, spine specialist, or neurosurgeon to handle back pain, especially when it tends to flare up at the most inconvenient times. There are still options, here�s what to do. What options are available when you want to see a doctor about back pain, but getting to the clinic can be a challenge.
Fortunately, there are a variety of tools to handle back pain that can provide some relief.
Over-the-counter pain medications like Motrin are one of the best medicines for non-traumatic back pain inflammation.
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Heat Packs/Heat Therapy
Heat therapy promotes vasodilation and draws nutrient-rich blood into the targeted tissues. Increased blood flow delivers oxygen and nutrients and cell waste is removed. The warmth decreases muscle spasms, relaxes tense muscles, relieves pain, and increases range of motion.
Superficial heat is available in different forms, which include:
Hot and moist compresses
Dry or moist heating pads
Hydrotherapy
Commercial chemical/gel packs
Remember heat packs in any form should be wrapped in a towel to prevent burns, as a punctured heat pack should be discarded, as the chemical agent/gel can burn skin. �
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Cold Packs/Cold Therapy
Cold therapy produces vasoconstriction. This slows blood circulation, which reduces inflammation, muscle spasms, and pain. Superficial cold is also available in different forms, which include:
Commercial cold packs
Ice cubes
Iced towels/compresses
Hydrotherapy.
The application of cold therapy is usually less than 15 minutes, as the effects of cold are known to last longer than heat. Cold packs or ice should never be applied directly to the skin.
A towel, should be placed between the cold object and the skin surface to prevent any skin and nerve damage. A punctured cold pack should be discarded, as the chemical agent/gel will also burn the skin.
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Telemedicine
It might be hard to believe that a virtual video visit can work to handle back pain. On a video call, a chiropractor is unable to physically palpate the sore areas and measure the range of motion and strength. However, this should not discourage you from scheduling a virtual appointment.
Telemedicine, without a physical examination, can be highly beneficial. A chiropractor can start the process of ordering tests, like MRI, X-ray, etc. Even if the pain is tolerable, meaning the kind that doesn�t need medicine or imaging tests, this should not be an excuse to skip an orthopedic visit.
With telemedicine, a chiropractor can still give advice, show back stretches, exercises, order back pain supplements, and talk about the risks and benefits of treatments available to try on your own. �
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Physical Therapy
With chronic low back pain, chances are your chiropractor suggested physical therapy or PT. Now is the time to bring back those PT exercises, especially with a back-pain flare-up.
Low-back pain or any back pain for that matter with no neurological issues, could mean that a stretching and exercise program is all that is needed. Find out if your chiropractor or a physical therapist offers other options:
Patient portal communication or e-visits.
Uploads of illustrated handouts describing how to do various stretches and exercises.
Remote evaluation. The individual submits pictures or a video of their movements for personalized feedback, which the chiropractor or physical therapist evaluates and provides.
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Get Active
Evidence shows that being active is better than resting. Moving increases the blood flow to the muscles, which helps with muscle spasms, trigger points, tense muscles/ligaments, and other issues.
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Pilates
Pilates focuses on controlled movement, breathing, and stretching. A review found Pilates can be a highly effective and beneficial approach to handle back pain and related discomfort. Check out beginner Pilates videos. Be sure to avoid any move/s that cause pain, worsens the existing pain, or generate new pain.
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Yoga
A review found that yoga can help improve mobility and decrease pain. If this is a new practice, start with gentle yoga or restorative yoga.
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Walking
Going for a walk is easy, accessible, and is beneficial for the spine. Walking can be as effective as non-drug interventions in decreasing pain and discomfort in chronic low-back pain. Simple movements along with rollers and massagers can handle back pain as well. These include:
Self-massage with a tennis ball
Foam rolling
Hand-held massager
Stretching
McKenzie Method, comprised of gentle stretching exercises
These strategies and approaches can become the methods and techniques for the relief of existing back-pain in the absence of a doctor, chiropractor, or physical therapist.
Recognizing and understanding common and not so common neck and lower back spinal Stenosis symptoms can help in getting an early diagnosis and beginning a preventative treatment plan. Symptoms develop when the spinal canal begins to narrow. The nerve roots become compressed/pinched causing:
Neural irritation
Inflammation
Pain
The low back and neck are commonly affected by this age-related and progressivedisorder. Symptoms can inhibit the ability to move without discomfort, pain, and neurological issues like tingling sensations and numbness that spreads out or radiates into other parts of the body.
Low Back Spinal Stenosis Symptoms
The most common symptom of spinal Stenosis is pain in the:
Low back
Buttock area
Back of the thigh that gets worse when standing and walking
These symptoms are called neurogenic claudication. Some individuals with low back spinal stenosis experience symptoms only when standing or moving/walking around. Discomfort usually eases up when bent forward and goes away when the individual sits down. Example: Grocery shopping feels a lot better when leaning forward on the handle of the cart, with pain reduced. This is common for people with spinal stenosis in the low back. Pain that goes away and reduces when bending forward, sitting down, or lying down is common of low back spinal Stenosis.
Understanding that claudication is not neurogenic or pseudo claudication is important. The symptoms of claudication are similar to pseudo claudication, however, the cause is different. Claudication is caused by the blood not circulating properly in the leg muscles. Other symptoms are low back pain and low back spreading pain or radiculopathy.
Better known as sciatica, lumbar radiculopathy involves:
Pain
Numbness
Weakness
Tingling/numbing sensations that travel down from the low back into the buttock/s and leg/s.
Some individuals experience pain in both legs, with one leg having worse pain than the other.
Bowel/Bladder emergency:
There can be severe cases of lumbar spinal Stenosis where the nerves that control the bladder or bowel can get compressed, leading to partial or complete incontinence. If there are problems controlling the bladder or bowel seek immediate medical attention.
Neck Spinal Stenosis Symptoms
Spinal Stenosis symptomsin the neck can cause cervical radiculopathy. This can include pain along with:
Tingling sensations
Numbness
Weakness
These symptoms may radiate downward from your neck into one or both shoulders, arms, and/or hands. The pain caused by cervical spinal Stenosis has been described as:
Acute
Episodic
Occasional
Chronic
The intensity can go from mild to severe along with other symptoms that include:
Headache/s
Balance issues with a higher risk of falling
Fine Motor skills like writing, buttoning up a shirt/blouse, computer keyboarding skills can become affected
With severe cervical spinal stenosis, symptoms can be associated with cervical myelopathy. Cervical myelopathy happens when the spinal canal narrows so much that it compresses the spinal cord in the neck. Pinched nerves in the neck can affect the shoulders, arms, and hands. Myelopathy can affect both the arms and legs.
Symptoms of cervical myelopathy can include:
Neck pain
Stiffness
Tingling sensations
Numbness
Weakness
Clumsiness
Balance issues
Difficulty walking
Bowel and Bladder problems
Sexual dysfunction
Symptoms Don’t Always Present
Imaging studies like MRI and CT scans can detect a spinal disorder from an individual that has no symptoms. This is why imaging tests are performed to confirm a diagnosis. This is supported by results from the physical/ neurological exams, medical history, and symptoms.
Those who have undergone an x-ray or other imaging test for a non-spinal related issue could have discovered they have spondylosis, osteophytes, and a herniated disc. However, they never knew it because they showed no symptoms. Spinal Stenosis of the spine is usually an age-related and gradual process of physical change. It can take time for symptoms to show themselves. If you have neck or low back pain symptoms that are becoming worse, speak with your doctor.
Bertolotti syndrome is something has not been heard of when it comes to lower back pain, but diagnostic work has uncovered a common congenital condition. Back pain is experienced at some point by all of us. Around two-thirds of the population will develop low back pain in their life, and more than half will develop chronic low back pain or pain that has lasted more than six months. Low back pain can be challenging in finding the root cause. Diagnostic work is required through� X-rays and MRIs. These tests can identify a lesser-known cause of mechanical low back pain called Bertolotti syndrome.
Bertolotti Syndrome
This congenital condition’s name comes from Italian physician Mario Bertolotti. It is in 10 to 20 percent of the population, �with or with no lower back pain. Bertolotti syndrome happens when the last lumbar vertebra, known as the lumbosacral transitional vertebra/LSTV. This vertebra and the sacrum become fused together or create a false joint due to an enlarged transverse process.
This can be bony bumps on the vertebrae where muscles and ligaments attach to the lumbosacral transitional vertebra. When the LSTV and sacrum fuse together, known as sacralization or pseudo-joint, it does not generate pain. It�s just the way that an individual’s anatomy has been since birth. Only when it causes lower back pain that it is called Bertolotti syndrome.
Causes
Low back pain that leads to inflammation and reactive muscle spasms brought on from Bertolotti syndrome can be caused by:
Asymmetrical structures of the lumbar vertebrae. If the LSTV is fused to the sacrum and iliac bone, these are the wings of the pelvis, which can place unwanted stress on the sacroiliac joint, which can cause pain that is felt above the buttocks.
A�pseudo-joint does not have the cushion or lubrication between the bones like real joints to absorb shock. This causes bone-on-bone grinding, which can be quite painful and can lead to osteoarthritis. This can also generate added stress on the discs of the pseudo-joint.
Sacralization fusion can decrease the spine�s mobility. This can speed up the wear and tear of the vertebrae and shock-absorbers of the intravertebral discs.
Added non-equal force/s on the muscle tissues that surround the lower back. This can be caused by the spine not being properly�aligned causing muscle imbalance/s and fatigue. Both sides of the back can be affected, but when tightness and muscle spasms in the low back and pelvis present, it’s usually only on one side.
Symptoms
Most individuals usually never know they have a sacralization or pseudo-joint. These are often found accidentally from an X-ray for something unrelated. But when symptoms present they can vary from person to person and usually appear in adulthood�in the 20s or 30s.
These include:
Low back pain that is localized and does not spread/radiate down the legs
Pain or discomfort in or around the sacroiliac joint
Stiffness that comes out of nowhere or difficulty moving a certain way with pain present
Symptoms improve once the individual sits or lays down
Diagnosis
Bertolotti syndrome can be diagnosed based on medical history, physical exam, and X-rays. A physical exam can include a recreation of the movement/s that triggered the pain/discomfort. An X-ray of the low back and pelvis will reveal any bony abnormalities.
Treatment
Bertolotti syndrome can be effectively managed with non-invasive treatments. These� include:
Improperly and overdoing repetitive rotation/s and extension/s through work or just movements that have become second nature are injuries just waiting to happen. Lifestyle changes and re-learning how to move properly will ease the strain on the affected area.
Over the counter pain medication/s like�Advil, Aleve, or Tylenol.
Chiropractic/Physical therapy can help build low back areas and increase mobility.
Local anesthetic and spaced out intervals of corticosteroid injections to the affected nerve/s to reduce inflammation.
Platelet-rich plasma (PRP) uses the body�s platelets to reduce pain, inflammation, and healing the damaged joints through an injection.
Prolotherapy treatment uses concentrated local anesthetic and dextrose injected into the low back area to enhance the body�s natural healing.
Radiofrequency ablation uses heat to numb the affected nerves around a pseudo-joint so that pain reduces.
Surgery is the last resort and is usually done to eliminate a pseudo-joint. It can also consist of reducing or removing an elongated transverse process�and can be performed as a same-day or outpatient procedure.
If you or someone you know is dealing with some form of idiopathic low back pain and doctors can’t seem to pinpoint the cause. Bertolotti syndrome could be a suspect, therefore it’s best to seek a spine specialist near you that can help.
A February 2020 study explored the relationship between low back pain and menopause. Hormones and vitamin D play a role. Vitamin D deficiency is related to increased lower back pain and degenerative disc disease in postmenopausal women. Decreasing estrogen levels can also drop levels of vitamin D, which can be downright painful if left unaddressed.
Menopause:
Hot flashes
Mood swings
Sleep issues
Libido changes
A drop in�estrogen levels can cause these symptoms.
Degenerative Disc Disease
In between the vertebra are fibrous discs that are the shock absorbers for the spine. These discs also support and stabilize the spine, which allows you to move freely pain-free. The health of the spine is a vital part of well-being and provides the ability to bend, lift, twist, and perform normal activities without pain.
With the passage of time, the discs start to dry out and lose their flexibility and elasticity. When the discs dry out, known as desiccation is a natural process that happens as we age and does not always cause pain symptoms. The discs become thinner and less able to absorb shock that can lead to pain and stiff movement. The loss of elasticity and height in the discs is known as degenerative disc disease.
Stenosis/Compression
With degenerative disc disease, sometimes the body tries to compensate for the loss of stability by producing more bone to stabilize the spine.
This causes bone growth/s, called bone spurs or osteophytes. These can crowd the spinal canal, which is a condition called stenosis.
Stenosis places pressure on the nerve roots that branch off the spinal cord.
The symptoms of this compression can present with:
Pins and needles sensations
Muscle spasms
Decreased sensation to touch
Weakness and pain in the back or that radiate down the arms or legs.
Treatments for degenerative disc disease include physical therapies and surgery. Most cases are treatable without surgery by utilizing physical therapy, occupational therapy, strength/flexibility exercises, injections, and supplements. Surgery could be considered to make more room in the spinal canal, relieve nerve compression, and reduce pain.
Vitamin D and Bone Health
Vitamin D has multiple functions in the body. It’s produced by the body when exposed to sunlight and is also found in certain foods and supplements. One function of vitamin D involves bone health support. The body needs vitamin D to absorb calcium and phosphorus, which are essential for bone production. Calcium is stored inside the bones.
When there is a deficiency in calcium, the body breaks down the bone/s and takes/pulls the calcium back into the blood. Inadequate vitamin D means the body is not able to absorb enough calcium and cannot prevent the bones from being broken down. Vitamin D deficiency at an early age can cause low bone density along with diseases like rickets, osteopenia, and osteoporosis. Osteoporosis is a condition where the bone gradually weakens and breaks easily.
It can cause vertebral compression fractures, where the vertebrae crack because the bone tissue is not strong enough to support the body�s weight and resist gravity.
Two causes of osteoporosis are nutritional deficiencies and hormonal imbalances, like low estrogen production after menopause. Proper vitamin D/calcium intake is essential for preventing and reducing bone loss that can lead to these conditions and increased lower back pain.
Estrogen and Bone/Spine Health
Estrogen plays a role in male and female bone health. Cells called osteoblasts help in the production of bone are highly active. Estrogen helps slow the breakdown of bones and promotes bone growth. A drop in estrogen over time compromises the health of bones. Individuals with chronic hormone imbalances and postmenopausal women are frequently affected by bone disease/s and the loss of bone density over time.�Studies reveal the risk of developing osteoporosis is higher in postmenopausal women.
Estrogen helps maintain tissues that contain collagen, which is found in intervertebral discs. Lower estrogen levels following menopause have shown to lead to more severe lumbar disc degeneration and increased lower back pain in women when compared to men. This demonstrates the importance of monitoring changes in lower back pain for women after menopause.
Vitamin D and the Spinal Discs
The relationship between increased low back pain in postmenopausal women and vitamin D deficiency is real. Supplements can help correct these deficiencies, can help reduce low back pain and promote bone health.
Postmenopausal women are especially at risk for vitamin D deficiency. Vitamin D and calcium supplements can be used in combination.The bone/s breakdown is stopped, while the bone tissue is strengthened thus reducing back pain. Low back pain brought on by degenerative disc disease is pretty much present in patients over age 65.
These health concerns can be helped through:
Vitamin supplementation
Exercise
Healthy diet
Slowing down bone loss can be achieved with strategies that range from diet change to prescription medication.
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