Slip Disc / Spondylolisthesis
Most common causes for low back pain are :
PIVD/ Herniated Disc
HERNIATED DISK / PROLAPSED INTERVERTEBRAL DISC (PIVD) :
A herniated (slipped) disk occurs when all or part of a disk in the spine is forced through a weakened part of the disk. This places pressure on nearby nerves.
The bones (vertebrae) of the spinal column protect nerves that come out of the brain and travel down your back to form the spinal cord. Nerve roots are large nerves that branch out from the spinal cord and leave your spinal column between each vertebrae.
The spinal bones are separated by disks. These disks cushion the spinal column and put space between your vertebrae. The disks allow movement between the vertebrae, which lets you bend and reach.
These disks may move out of place (herniate) or break open (rupture) from injury or strain. When this happens, there may be pressure on the spinal nerves. This can lead to pain, numbness, or weakness.
The lower back (lumbar area) of the spine is the most common area for a slipped disk. The neck (cervical) disks are affected a small percentage of the time. The upper-to-mid-back (thoracic) disks are rarely involved.
Radiculopathy is any disease that affects the spinal nerve roots. A herniated disk is one cause of radiculopathy.
Slipped disks occur more often in middle-aged and older men, usually after strenuous activity. Other risk factors include conditions present at birth (congenital) that affect the size of the lumbar spinal canal.
Low back or neck pain can feel very different. It may feel like a mild tingling, dull ache, or a burning or pulsating pain. In some cases, the pain is severe enough that you are unable to move. You may also have numbness.
The pain most often occurs on one side of the body.
With a slipped disk in your lower back, you may have sharp pain in one part of the leg, hip, or buttocks and numbness in other parts. You may also feel pain or numbness on the back of the calf or sole of the foot. The same leg may also feel weak.
With a slipped disk in your neck, you may have pain when moving your neck, deep pain near or over the shoulder blade, or pain that moves to the upper arm, forearm, or (rarely) fingers. You can also have numbness along your shoulder, elbow, forearm, and fingers.
The pain often starts slowly. It may get worse:
- After standing or sitting
- At night
- When sneezing, coughing, or laughing
- When bending backwards or walking more than a few yards
PIRIFORMIS SYNDROME :
Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve and causes pain in the rear and may cause pain along the back of the leg and into the foot. Piriformis syndrome is most common among women, and is thought to be common among active individuals (such as runners and walkers).
Piriformis syndrome can develop when the piriformis muscle becomes tight or spasms and places pressure on the sciatic nerve that runs beneath it. The pressure on the sciatic nerve can cause low back pain and/or pain that radiates to the rear and down the leg (similar to sciatica pain)
- Tenderness in the area of the muscle.
- Pain in the buttocks.
Pain which radiates down the back of the leg, usually into the hamstrings and sometimes even the calf muscles.
- Pain when walking up stairs or inclines
- Increased pain after prolonged sitting
Spondylolisthesis is a condition of the spine whereby one of the vertebra slips forward or backward compared to the next vertebra. Forward slippage of one vertebra on another is referred to as anterolisthesis, while backward slippage is referred to as retrolisthesis. Spondylolisthesis can lead to a deformity of the spine as well as a narrowing of the spinal canal (central spinal stenosis) or compression of the exiting nerve roots (foraminal stenosis).
Spondylolisthesis may be caused by any of a number of problems with the small joints in your back. You could have:
- A defective joint that you’ve had since birth (congenital).
- A joint damaged by an accident or other trauma.
- A vertebra with a stress fracture caused from overuse of the joint.
- A joint damaged by an infection or arthritis.
Spondylolisthesis affects children and teens involved in sports. Some sports, such as gymnastics or weight lifting, can overuse back bones to the point of causing stress fractures in vertebrae, which can result in spondylolisthesis.
Older adults can develop spondylolisthesis, because wear and tear on the back leads to stress fractures. It can also occur without stress fractures when the disc and joints are worn down and slip out of place.
The condition can produce increased lordosis (also called swayback), but in later stages may result in kyphosis (roundback) as the upper spine falls off the lower spine.
Symptoms may include:
- Lower back pain
- Muscle tightness (tight hamstring muscle)
- Pain in the thighs and buttocks
- Tenderness in the area of the slipped disc
Nerve damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down the legs.
GOALS OF PHYSIOTHERAPY :
- Improves pain through advanced modalities
- Reduces inflammation
- Reduces spasm
- Reduces tightness
- Increases strength resisted band exercises
- Alignment correction through manual therapy
- Taping technique
- Laser therapy for instant pain relief