As a disc becomes damaged or degenerates, the soft inner gel like material in the disc can leak through the outer fibrous layers, back into the spinal canal. This is known as disc herniation, or herniated disc. Once inside the spinal canal, the herniated disc material puts pressure on the nerve, causing pain to radiate down the nerve leading to sciatica or leg pain (from a lumbar herniated disc) or arm pain (from a cervical herniated disc).
When a patient has a symptomatic herniated disc, the material that is leaking out of the inside of the disc may pinch or irritate a nearby nerve. This type of pathology produces pain called radicular pain (e.g., nerve root pain) leading to pain that may radiate to other parts of the body, such as from the low back down the leg or from the neck down the arm. Leg pain from a pinched nerve is usually described as sciatica.
When a patient has a symptomatic degenerated disc or injured disc (one that causes low back pain and/or leg pain), it is the disc space itself that is painful and the source of pain. This type of pain is typically called axial pain.
Any of the above three conditions can occur in the cervical (neck), thoracic (upper) or lumbar (lower) spine. They tend to be most common in the lower back because the lower back bears the most torque and force on a day to day basis.
Degenerative Disc Disease
A degenerated disc is not actually a disease—it is part of the normal aging of the spine or continued degeneration from injuries sustained that may have not been fully rehabilitated. When a spinal disc degenerates, it loses its ability to function efficiently as part of the spinal joint, which in turn can lead to back pain and possibly pain that radiates through the arms and legs (sciatica).
Lower Back Pain
Lower back pain can be caused by a variety of problems with any part of the complex, interconnected network of spinal muscles, nerves, bones, discs or tendons in the lumbar spine. Typical sources of low back pain include:
- Abnormal alignment or subluxation of the spinal bones (vertebrae)
- The large nerve roots in the low back that go to the legs may be irritated
- The smaller nerves that supply the low back may be irritated
- The large paired lower back muscles may be strained
- The bones, ligaments or joints may be damaged
- An intervertebral disc may be degenerating
An irritation or problem with any of these structures can cause lower back pain and/or pain that radiates or is referred to other parts of the body. Many lower back problems also cause back muscle spasms, which can cause severe pain and disability.
Neck pain is discomfort in any of the structures in the neck. These include the muscles, nerves, bones, and the discs between the bones.
A common cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such activities include:
- Bending over a desk for hours
- Having poor posture while watching TV or reading
- Having your computer monitor positioned too high or too low
- Sleeping in an uncomfortable position
- Twisting and turning your neck in a jarring manner while exercising
- Other causes include whiplash injuries related to car accidents
Sometimes called degenerative joint disease or “wear and tear” arthritis, osteoarthritis (OA) is the most common chronic condition of the joints. It occurs when the cartilage or cushion between joints breaks down leading to pain, stiffness and swelling.
The most common symptoms of osteoarthritis are stiffness, particularly first thing in the morning or after resting, and pain. Affected joints may get swollen after extended activity.
Osteoarthritis has no specific cause. Several factors lead to the development of OA including excess weight, injury or overuse and genes, among others.
Pain in the head, normally classified as a migraine, cluster headache or tension headache. Headache is pain in any region of the head. Headaches may occur on one or both sides of the head, be isolated to a certain location, radiate across the head from one point, or have a “vise-like” quality.
A headache may appear as a sharp pain, a throbbing sensation or a dull ache. Headaches can develop gradually or suddenly, and may last from less than an hour to several days.
A common type of headache, called cervicogenic or muscle tension headaches are often related to misaligned vertebra in the upper neck region resulting in muscle tightness and chronic headaches.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that causes numbness, tingling and other symptoms in the hand and arm. Carpal tunnel syndrome is caused by a pinched nerve in your wrist.
A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.
The carpal tunnel is a narrow passageway located on the palm side of your wrist bound by bones and ligaments. This tunnel protects a main nerve to your hand and the tendons that bend your fingers.
Compression of the nerve produces the numbness, tingling and, eventually, hand weakness usually worse at night and with use.
Auto Accident Injuries
Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash most often occurs during a rear-end auto accident, but the injury can also result from a sports accident, physical abuse or other trauma.
Common signs and symptoms of whiplash include neck pain, stiffness and headaches.
Sprains and strains are common injuries that share similar signs and symptoms, but involve different parts of your body.
A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain due to an auto accident is the neck or low back due to forces these areas are subjected to at the time of impact.
A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones.
Work related injuries are injuries that are sustained at while at work and due to the type of work that perform. Most work place injuries can be considered in one of the following categories:
Overexertion: This is the number one work place injury in the United States, and it includes injuries caused by pulling, pushing, lifting, carrying, throwing, and holding.
Slip and fall: These injuries usually occur when a worker trips over something or slips on a wet floor.
Falls from high places: Falls from elevated areas, such as ladders and roofs, can be extremely dangerous. Several hundred workers are killed by high falls every year. These accidents are most prevalent in the construction industry.
Falling objects: When large or heavy objects are dropped or fall from high places, they can cause serious head injuries to a worker below.
Motor vehicle accidents: When an employee is injured in a vehicle accident while driving for business purposes, it is considered a work-related injury.
Repetitive motion: These injuries typically build up over time until they reach a level at which irreparable damage has been caused. Repetitive motions can involve such basic tasks as sitting at a computer all day. Awkward wrist placement while typing can result in carpal tunnel syndrome, and improper posture while seated at a computer can cause severe back pain.