Have you heard of the terms ‘slipped disc or pinched nerve?’ When you hear these terms, it often describes a spinal disc physically compressing and irritating a nerve root. Although disc herniations can happen along the entire length of the spine, most commonly, a disc herniation occurs in your lower back.
Osteoporosis is a condition that is characterized by a loss of bone density. If you lose bone density, the bones become weak and are at increased risk of having a fracture. This can happen in the bones of the spine called vertebrae bodies. In fact, one of the most common complications of osteoporosis is vertebral compression fractures where the vertebral body collapses under the weight of the structures above it. Some people have minimal pain with compression fractures and others can unfortunately have intense, debilitating pain. Whether painful or not, however, vertebral compression fractures have the ability to lead to additional fractures in other parts of the spine and this can cause spinal deformity and loss of normal everyday ability to function. In severe cases, it can cause breathing difficulties as well. In addition to pain, other signs and symptoms of a compression fracture include:
- Loss of your overall height (a reason why you may shrink as you age)
- Kyphosis (‘humpback’ appearance of your spine)
- Difficulty Maintaining Balance
- Neurological symptoms such as numbness, tingling, or weakness
It is important to treat vertebral compression fractures. A recent study by the Journal of Bone and Mineral Research looked at the death rates of nearly 900,000 patients with vertebral compression fractures. This study ultimately showed that those patients who had their compression fractures treated with procedures called kyphoplasty or vertebroplasty were 37% less likely to die over a four-year period.
Degenerative Disc Disease
Degenerative Disc Disease is a common condition in adults as we age. We have discs that are between each vertebrae in our spine that are made up of protein, cartilage and water and serve as “shock absorbers.” As we continue to age, these discs gradually become dehydrated and lose their height and ability to maintain structure. If severe enough, DDD can become symptomatic causing back pain and potential weakness. The most helpful investigation to screen for this condition in an MRI (magnetic resonance imaging) study. Common findings seen on an MRI that are characteristic of DDD are:
- Disc bulging
- Dehydration (loss of water from center of disc)
- Decreased disc height (flattening of disc)
- Endplate changes – bony changes to the ends of the vertebral body above and below the disc
Facet Joint Inflammation
Facet joints are small stabilizing joints in the spine that function to guide rotation and movement of the spine. These joints are located between two vertebrae and, like any other joint in our body, facet joints go through wear and tear as we age. This wear and tear can eventually lead to arthritis, a sometimes painful condition characterized by joint inflammation
Sacroiliac Joint Dysfunction
The sacroiliac joint connects the base of the spine to our hip. Dysfunction of this joint may cause low back and/or leg pain. This pain can also mimic the pain caused by a number of other spinal structures including lumbar discs, nerve roots, facet joints, or hips. Typically the pain is felt on one side of the low back or buttocks and in severe cases, it can radiate down to the leg.
The word ‘stenosis’ means narrowing or tightening of an opening in the spine. In this case, spinal stenosis, the tightening typically occurs at the neural foramen (where nerve roots exit the spine) or at the central canal of the spinal column. Spinal stenosis places abnormal pressure on the spinal nerves (foraminal stenosis) and/or spinal cord (central stenosis). While some patients are born with congenital narrowing of the spine, most cases of spinal stenosis occur in patients over the age of 50. Many patients with spinal stenosis do not have symptoms until other conditions further compress the spinal canal. Some of these other conditions that can cause spinal compression include:
- Calcification (hardening of the soft tissue around the spine due to calcium deposits)
- Osteophytes (hard bony growths on bones and joints)
- Herniated or bulging discs
- Spondylolisthesis (slipping of one vertebra over another)
- Trauma (such as from a fall, accident or injury)
The symptoms of spinal stenosis include:
- Low back pain that is partially or completely relieved when sitting or bending forward.
- Neck pain (if the stenosis resides in the cervical spine)
- Pain, weakness, or numbness in the upper (cervical stenosis) or lower (lumbar stenosis) extremities.
- Burning, stinging and tingling sensations in the affected extremity.
- Balance issues and clumsiness
- In SEVERE cases, there could be a loss of bladder and bowel control and even paraplegia