Lower Back Pain
Low back pain is not due to the pressure on a nerve root, as lower extremity pain is. Most low back pain is muscular or mechanical in nature, caused by overexertion, overuse, or strain or sprain of the ligaments and tendons of the low back. It may also be attributed to degeneration of the disc and facet joints, which hold the spine together.
Additionally, low back pain may be caused by arthritis, stenosis, or referred symptoms from organ involvement (bladder, gall bladder, kidney, prostate). One must also rule out organic causes such as cancer, especially prostrate CA.
Radicular Pain - Lower Extremity (Leg) Pain
Lower extremity (leg) pain is often seen to radiate, termed "radicular pain." This refers to pain which shoots down the leg, from the low back or buttock. It usually results from pressure on a nerve, which produces a ”pinching” of the nerve, which appears to radiate down the leg in the distribution of the nerve pattern.
When the "pinching" of the nerve is mild, one may experience numbness or tingling. As it progresses and becomes more severe, pain may develop.
Further progression may present actual damage to the nerve and weakness may also result.
The discs of the spine receives nourishment through blood vessels until approximately the age of 20. At this point, the disc is filled with a lifetime supply of nourishment. However, the disc has to make that supply of nourishment last a lifetime.
Through aging and with normal wear and tear, the nourishment is used and a slow degeneration of the discs is experienced. This is normal aging.
The more “stress” you put on the disc, the more you use up the nourishment, weakening and deteriorating the disc, creating a problem. One of the amazing benefits of decompression is that it can heighten the disc space, returning it to a more normal size and function.
In the middle of the disc is a jelly-like substance called the Nucleus Pulposus. This jelly-like substance is prone to injury and the most common situation causing problems is one that puts pressure on the disc.
The pressure causes the jelly material inside the disc to “bulge” or “slip” out of place. As this occurs, the bulge itself puts pressure on other structures near the disc, like the nerves. This is how bulging discs cause pressure to build up on the nerve.
Herniated discs are also often referred to as ruptured discs. A disc can bulge without herniating. When the jelly-like nucleus pulposus is under pressure, it can bulge. But, when the pressure is excessive, it can herniate (rupture) through the outer bands called the annulus fibrosis.
As the "herniated" disc material spills out, a portion can press on a nerve, causing pain and accompanying radiation and weakness of the muscles involved. The nerve can get "pinched" resulting in the condition of sciatica, radiating pain to the buttocks and/or lower extremity (leg and calf).
Over 90% of herniated discs occur in the lowest two levels of the lumbar spine, between L4/L5 and L5/S1.