Definitions of Common Diagnosis for Back Problems

Sciatica / Cyatica: Back pain that radiates below the knee. This may be related to a herniated disc or to inflammation of the sciatic nerve causing sciatica or cyatica. The nerve root can be compress and this can cause pain, numbess, tingling and/or weakness in one or both legs.

Herniated disc/
Ruptured disc: The shock absorber between the vertebrae are called intervertebral discs. They have a relatively liquid center. When you have a ruptured disc or herniated disc, the liquid center squirts out of the restraining membrane called the annulus into the spinal canal and can put pressure on the spine and nerves. The annulus can develop a fissure or crack and fluid can leak out or the annulus can tear and a large piece of the nucleus pulposus can be squeezed out into the spinal canal and compress the nerve root.

Degenerative Disc Disease: The degeneration of the discs is a term that was first coined by radiologists to describe what they were looking at on x-ray and MRI. Discs have a lot of water in them. As we age, through use, this water is squeezed out of the disc and disc dessication occurs and the disc gradually gets squashed or becomes a narrowed disc space. It is part of the natural aging process and is related to decreased circulation (as we age) and repeated trauma. Young, world class athletes often have "degenerative discs" because of the repeated trauma of practice and competition.

Facet Joint
Arthritis: This is the build-up of calcium around the joints of the back. It is also part of the natural aging process and directly related to decreased activity as we age. It may also be related to constant, uneven stress on joints. Many of us, over 40, have some arthritis, somewhere in the body. The joints become worn and lose the thickness of the articular cartilage and osteophyte formation or bone spurs will form.

Radiculopathy: Pain that travels down specific nerve pathways. Sciatica is a type of radiculopathy or a radiating pain.

 

Neuropathy/
Paresthesia: Loss of feeling or a feeling of tingling in a specific area of the body that corresponds to specific nerve distribution(s). A feeling of cold, numbness in the nerve distribution.

Spondylolisthesis: Vertebrae sit alligned on top of each other like blocks. They are connected together and stabilized by ligaments and tendons. Sometimes, some of these ligaments will stretch and the vertebra will shift forward on each other if the facet joint wears out. Sometimes the bone will crack due to mechanical forces and the bone will shift forward on each other. This can cause back pain and sciatic pain into the legs.

Failed Back Syndrome: Back pain that persists after surgery and other traditional medical therapies.

Selective Arthroscopic Discectomy: Removal of only the abnormal disc material as identified by staining the degenerated disc material with indigo at the time of the discogram.

Curvatures of the spine: Scoliosis (S-shaped lateral curvature of the spine) due either to idiopathic(unknown reasons) or degenerative scoliosis. Kyphosis (bending forward of the spine in the upper back area) and Lordosis (excessive backward bending of the mid-low back) all can cause back pain.

Spinal Stenosis:
The spinal canal can become narrowed with age due to a combination of thickening of the soft tissue within the spinal canal called the ligamentum flavum and build up of calcification within the canal and around the facet joints. This will cause pressure on the spinal nerves and result in leg pain, cramps and numbness.

Foraminol Stenosis: The opening between the vertebra are called a foramen. When the foraminol opening gets smaller due to a combination of the disc space collapsing, build up of calcium and disc bulging or disc herniation there is pressure on the exiting nerve root causing pain, numbness, cramping, tingling or weakness in the legs.

Lower Back Pain: Lower back pain is usually due to a disc herniation, facet joint that is arthritic or muscles that are in spasm. Most lower back pain will resolve with rest and conservative treatment. Only 5% of patients will need invasive treatment.

Epidural Steroid Injections: The spinal nerves are bathed in spinal fluid which is contained by the dural sac. The small space in the spinal canal between the dural sac and bone is called the epidural space. A cortisone injection into the epidural space is frequently given to help provide relief of leg pain from sciatica and some back pain from a disc injury. The relief may be temporary and partial or complete and permanent but the epidural cortisone does not heal or reduce the size of the disc herniation.