What causes back pain / leg pain
Sprains and strains account for most acute back pain. Sprains are caused by overstretching or tearing ligaments, and strains are tears in tendon or muscle. Both can occur from twisting or lifting something improperly, lifting something too heavy, or overstretching. Such movements may also trigger spasms in back muscles, which can also be painful
Intervertebral disc degeneration is one of the most common mechanical causes of low back pain, and it occurs when the usually rubbery discs ( between the vertebrae) lose integrity as a normal process of aging. As the discs deteriorate, they lose their cushioning ability. Any bone degeneration, usually with age is called generally, osteoarthritis. While age is the most important factor, certain repetitive/ persistent postures can aggravate it
Initial degeneration of the intervertebral disc (a) subsequently leads to the facet joint osteoartritis (b; facet joints joins the vertebrae to the vertebrae below and above it). (c–d) : a and b intern cause stresses to spread to the discs above.
Kushchayev, S.V., Glushko, T., Jarraya, M. et al. ABCs of the degenerative spine.Insights Imaging 9, 253–274 (2018) doi:10.1007/s13244-017-0584-z
Herniated or ruptured discs can occur when the intervertebral discs become compressed and bulge outward (herniation) or rupture
![URBINA, Mizraim Castillo et al. EFFICACY AND SAFETY OF LUMBAR ARTHROPLASTY IN DEGENERATIVE DISC DISEASE. Coluna/Columna [online]. 2018, vol.17, n.2 [cited 2020-01-22], pp.103-109. Available from: <http://www.scielo.br/scielo.…](https://images.squarespace-cdn.com/content/v1/5e18bc2a7fcc9522d36a7373/1579699954729-4S0X92FEV6QYF2FBBK6C/disc+degeneration.jpg)
URBINA, Mizraim Castillo et al. EFFICACY AND SAFETY OF LUMBAR ARTHROPLASTY IN DEGENERATIVE DISC DISEASE. Coluna/Columna [online]. 2018, vol.17, n.2 [cited 2020-01-22], pp.103-109. Available from: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000200103&lng=en&nrm=iso>. ISSN 1808-1851. http://dx.doi.org/10.1590/s1808-185120181702190992.
The light blue outer part of the disk is called annulus fibrosus and it can be ruptured when the inner disc herniates through it.
Kushchayev, S.V., Glushko, T., Jarraya, M. et al. ABCs of the degenerative spine.Insights Imaging 9, 253–274 (2018) doi:10.1007/s13244-017-0584-z
Spondylolisthesis : when a vertebra slips forward, or backward out of place (b in below). It can be caused by, or causes additional facet joint degeneration ( red inflamed joint)
Fracture of the vertebra (a in below): This may not cause symptoms or be obvious in older people and may be found on routine X-ray.
Traumatic injury, such as from playing sports, car accidents, or a fall can injure tendons, ligaments or muscle resulting in low back pain. Traumatic injury may also cause the spine to become overly compressed, which in turn can cause disc herniations, which can then result in nerve compressions
Kushchayev, S.V., Glushko, T., Jarraya, M. et al. ABCs of the degenerative spine.Insights Imaging 9, 253–274 (2018) doi:10.1007/s13244-017-0584-z
Skeletal irregularities : these include scoliosis, a curvature of the spine that does not usually cause pain until middle age; lordosis, an abnormally accentuated arch in the lower back; and other congenital problems
Source: Pennsylvania hershey health ADAM
NON -SPINE CAUSES OF BACK PAIN.
These mostly cause buttock pain. Exercises are the initial treatment. If they dont work, Injections are given. If they don’t work, surgeries may be needed.
Superior Cluneal Nerve entrapment :
Gluteus medius muscle pain
Pyriformis syndrome/ Sciatic nerve entrapment by pyriformis: 5-17% of cases, sometimes develops after back surgeries. treatment is exercises. If not relieved, then injections or even surgery may be needed
Sacroiliac joint degenerative disease
eg superior cluneal nerve or sciatic nerve entrapment by pyriformis muscle
Peripheral Nerve problems in leg. These mostly cause lateral / side of leg pain. Exercises are the initial treatment. If they dont work, Injections are given. If they don’t work, surgeries may be needed.
lateral femoral Cutaeous Nerve entrapment
Common peronealnerve
Superficial peroneal nerve
Posterior tibial nerve / Tarsal tunnel syndrome)
Click on Each of the following pictures for details:
Kyongsong Kim, Toyohiko Isu. Common diseases mimicking lumbar disc herniation and their treatment. Mini-invasive Surg 2017;1:43-51. https://misjournal.net/article/view/2036
OTHER CAUSES:
Fibromyalgia: widespread pain with fatigue, sleep, memory and mood issues. Painful sensations are greatly increased by affecting the way your brain processes pain signals. Medications, therapy, stress reduction can help.
CRPS: Complex regional pain syndrome (CRPS or Reflex Sympathetic Dystrophy -RSD) is a chronic burning (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot)developing after injury, surgery, stroke, or heart attack. caused by damage to, or malfunction of, the peripheral and central nervous systems. Treatment usually consists of medications, heat or cold therapy, physical therapy, and biofeedback.
Click on Each of the following pictures for details:
What else can we add or work on? Please let us know in the comments. No need to log in.