The spine is a very, very strong part of your body. It is made up of solid pieces of bone known as vertebra, joined together by softer pads or discs which act as shock absorbers and maintain flexibility.
The spine is then reinforced by strong ligaments and also surrounded by powerful muscles for support.
By far the most common type of back pain is ‘mechanical’ back pain. This means that the pain is coming from the spinal muscles, joints and ligaments.
Although it can be extremely painful and make even small movements difficult, ‘mechanic’ back pain is not related to any serious underlying condition and there are no trapped or compressed nerves.
Simply put, the pain is from stiff or restricted spinal joints and tight spinal musculature. And it is usually quite a simple condition to treat.
Less frequently, the nerves of the back can become irritated, trapped or compressed by a prolapsed disc or a herniated disc also referred to as a ‘slipped disc’.
The intervertebral disc sits in the space between the bones which make up the spine. The disc normally acts as a shock absorber. It is made of two parts. The center, called the nucleus pulposus, which is spongy and provides most of the shock absorption and the outer strong ligament rings surrounding it, called the annulus fibrosus.
A disc herniation happens when there is a weakness or injury to the outer fibers allowing some of the spongy material to ‘run out’ causing pressure/irritation to the nerve root as it leaves the spine.
In the lower back the most commonly injured discs are the one between the 4th and the 5th lumbar vertebra, the L4/5 disc or the one between the 5th lumbar vertebra and the sacrum, the L5/S1disc. This tends to put pressure on the L5 nerve root or the S1 nerve root ( trapped nerve) and sends severe pain down the leg. This is often referred to as sciatica.
It may also be associated with numbness, pins and needles, tingling and even weakness in some of the leg muscles.
A thorough examination is usually enough to diagnose a lumbar disc herniation but at times we may refer you out for a MRI scan.