How can I tell the difference between muscular back pain and a problem with my spine?

Kenneth J. H. Lee, MD
Modern Spine, PLLC

How can I tell the difference between muscular back pain and a problem with my spine?
Low back pain (lumbago) is a common musculoskeletal disorder, affecting 80% of people at some point in their lives.  It is the second most common cause of missed days of work, behind the common cold!  The causes of lower back pain are varied.   A low back muscle strain occurs when the muscle fibers are abnormally stretched or torn.  A lumbar sprain occurs when the ligaments (tough bands of tissue that hold bone together) are torn from their attachments. When the lumbar spine is strained or sprained, inflammation of the soft tissue results, which can cause pain and muscle spasms.  People are often surprised at how painful and debilitating a lumbar strain or sprain can be, as these are not small injuries. That said, over 90% of patients are able to completely recover within a month.  If not, the problem is more likely related to a spine condition and should be evaluated by a physician.  In addition, if you experience progressive weakness, loss of bladder or bowel function, and are in severe, constant pain, you should be evaluated by a physician.

How is osteoporosis treated?

The goal of osteoporosis treatment is to prevent the occurrence of fractures.  Treatment typically will include education on diet and nutrition, exercise, and medications.  A necessary first step in treating osteoporosis is having a thorough knowledge of the appropriate calcium and vitamin D intake levels as well as overall nutrition.  In addition, the appropriate exercise and fitness routines are another step towards maintaining bone density and reducing the risk of falls.  Finally, the proper medications can help reduce the risk of fractures.  These classes of medications work by helping to strengthen the bones and prevent further bone loss.

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What is degenerative disc disease?
Degenerative disk disease (DDD) is not really a disease, but a term used to describe the normal changes that may occur in the disk during the aging process.   While disk degeneration is a normal part of aging and for most people is not a problem, for certain individuals, a degenerated disk can cause severe constant chronic pain.  While DDD can take place throughout the spine, it most often occurs in the disks of the neck (cervical region) and lower back (lumbar region).
The disks in the spine function as shock absorbers between the bones (vertebrae).  The disks allow for the spine to flex, bend, and twist.  As we age, the disks can break down, or degenerate, which may result in DDD.  Age-related changes include loss of fluid in the disks and/or annular tears.  Loss of fluid results in the disk being less flexible and reduces its ability to act as a shock absorber.  Annular tears (tiny tears or cracks in the outer layer of the disk) also compromise disk function.  These changes occur more frequently in people who smoke cigarettes, those who do heavy physical work, and people who are overweight.
Symptoms depend on the location of the affected disk.  A degenerated disk in the neck may result in neck and/or arm pain, while a degenerated disk in the lower back may result in pain in the back, buttocks, and/or legs.  The pain is often worse with movements such as bending over, reaching up, or twisting.  Treatment options are best discussed with your physician, as the plan is tailored to the patient’s individual problem.

What is “incomplete sacralization?”  After a car accident, this was found in my x-ray report. Will it be a problem in the future?

The lower spine (lumbar region) usually consists of 5 distinct bones (vertebrae).  Sometimes, it appears on x-rays that the bottom lumbar vertebra (#5) is trying to fuse with the sacrum.  The fifth lumbar vertebrae is not completely separate, but it’s not completely fused, like the other bones in the sacrum.  This condition is not one that develops or progresses.  It is a congenital condition, meaning that people are born that way.  However, this transitional vertebrae changes the biomechanics of the lower spine in terms of how it handles strain and shear forces.  This may place additional stress on the lower part of the spine and contribute to degeneration of the lumbar spine.   Incomplete sacralization, itself, does not need to be treated.  However, it may contribute to degeneration of the lumbar spine, which may eventually require medical attention and treatment.

In what ways are a woman’s reproductive organs connected to conditions of the spine?
There is no direct connection between a women’s reproductive system and low back pain.  However, there are many disease processes of the female reproductive system that can refer or masquerade as low back pain.  Some of the conditions include endometriosis, pelvic inflammatory disease, urinary tract infections, fibroids, ovarian tumor, and salpingitis.

Kenneth J. H. Lee, MD
Modern Spine, PLLC
With offices in:
Sugar Land and
The Woodlands

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