Back and neck pain is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population. It is a common ailment that can affect individuals of all ages and backgrounds, impacting not only physical well-being but also quality of life.
It is one of the most common reasons people seek medical help or miss work. As the population ages and our lives become more sedentary, this situation is unlikely to change.
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Back and neck pain refers to discomfort or aching sensation in the spine that can result from many different injuries or conditions, most often an injury to the intervertebral disc, muscles, tendons or ligaments in the spine. The source of back or neck pain can be from a wide variety of structures, including muscles and ligaments, intervertebral discs, joints, or nerves. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
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SCIATICA
Sciatica is the sensation of pain, tingling, or numbness in the buttocks and/or legs caused by sciatic nerve inflammation. The sciatic nerve is formed by several nerve roots that originate from each side of the spinal cord in the sacral area (just above your tailbone). The sciatic nerve only runs a short distance down the buttock before splitting into several nerves. These smaller nerve branches continue down the leg, eventually reaching the ankle and foot.
Sciatica is caused by herniated, bulging, or degenerative discs, which impose pressure on the spinal nerve roots. Other causes include bony growths on the spine (bone spurs) or nerve compression due to injury.
BULGING AND HERNIATED DISC
Bulging/ Herniated disc is a spinal condition characterised by the displacement of the soft, gel-like centre (nucleus pulposus) of an intervertebral disc through a tear or weakening in the tough, outer layer (annulus fibrosus) enabling a portion of the gel-like centre to emerge. The escaping nucleus pulposus may then press severely on nerve roots, causing pain, numbness, tingling, and/or muscle weakness.
Discs are positioned between each vertebra and provide the spine with flexibility and shock absorption. The annulus fibrosus is a fribrous outer disc wall that surrounds a jelly-like interior termed the nucleus pulposus.
FACET SYNDROME
Facet syndrome is a condition caused by compression or inflammation of the facet joints in the spine. An indicative symptom is a deep ache in the lower back that may extend to the buttocks, hip and even below the knee. Facet syndrome is often associated with degenerative disc disease and soft tissue damage in the lumbar spine.
Facets are the bony, wing-like protrusions extending from the back of the vertebrae that align with facets on the vertebrae above and below and give the spine a more diverse range of motion. Facets function as guides for the spine and are not designed for bearing weight like vertebrae and discs. Joining adjacent facets are small ligaments called facet joints. It is one of the lesser-known surprisingly common causes of back pain.
When a person is standing upright, the facet joints bear about 16% of the normal compressive forces of the spine. With disc height loss of 1-3 mm, the compressive load can be five times the normal amount on the facet joints. Bearing the brunt of all that weight can lead to tearing or degeneration of the ligaments, as well as inflammation of surrounding tissues. Adhesions over the joint surface can form over time, leading to loss of mobility and break down of facet cartilage.
SPONDYLOSIS
Spondylosis is a form of arthritis that affects the spine and joints. It occurs when the discs and vertebrae in the spine undergo wear and tear over time. As a result, the discs may lose some of their fluid content, causing them to flatten and reduce their shock-absorbing capabilities. Additionally, the edges of the vertebrae may develop bone spurs, which can narrow the spaces through which spinal nerves pass.
While spondylosis is a natural part of the ageing process, it can lead to symptoms such as back pain, stiffness, and reduced flexibility in the spine. In some cases, it may also compress spinal nerves, causing radiating pain or numbness in the limbs.
PINCHED NERVE
A pinched nerve, also known as nerve compression or nerve impingement, is a painful and often debilitating condition that occurs when a nerve becomes compressed or irritated. This compression can happen anywhere along the length of the spine, and it typically results from surrounding tissues, such as discs, bones, muscles, tendons, or ligaments, exerting pressure on the nerve.
When a nerve is pinched, it can disrupt the normal flow of signals between the brain and the affected body part, leading to a variety of symptoms. Common signs of a pinched nerve include pain, tingling, numbness, and weakness in the area served by the affected nerve. The intensity and location of these symptoms depend on which nerve is compressed and where it innervates in the body.
Pinched nerves can occur in various areas, including the neck (cervical radiculopathy) and lower back (lumbar radiculopathy or sciatica), among others. Causes of nerve compression can range from herniated discs and spinal stenosis to repetitive motion injuries and poor posture.
CERVICAL RADICULOPATHY
Nerve damage caused by severe pressure to the cervical nerve roots is known as Cervical Radiculopathy.
One of the hallmark features of cervical radiculopathy is radiating pain, tingling, numbness, or weakness that travels down into the arm, shoulder, or even the hand on one side of the body. These symptoms occur because the compressed or irritated nerve roots serve specific regions of the upper body, and any disruption to their normal function can result in discomfort and sensory or motor abnormalities.
Common causes include disc bulging or herniation, degenerative disc disease, spinal stenosis, osteoarthritis and facet syndrome. Symptoms are pain, numbness, tingling and/or muscle weakness in regions of the shoulders, arms, hands or fingers.
