Slipped Disc Or Slipped Bone?

spinal stenosis

On any given day in the United States, up to 20% of the population will be suffering with some sort of back or neck complaint. Most of the time, back or neck pain is a short-lived problem involving the muscles and tendons of the spine. Muscular strains and sprains will cause pain and spasms which can last up to 3 weeks. Although uncomfortable, the pain from strains or sprains usually can be ameliorated with the appropriate short-term lifestyle modifications, gentle rehabilitative exercise and the use of anti-inflammatory medication. If the back or neck pain persists more than 3 weeks or if the pain transitions to shooting down the leg or arm, then a consultation with a physician is necessary.

The most concerning pain is that which that radiates down the arm or leg. This is commonly called "sciatica" in the leg, but in medical jargon, the more appropriate term is "radiculopathy", used to describe the pain that follows a particular nerve pattern in the arm or leg. This arm or leg pain generates from pressure on the nerves in the back or neck, which in turn, causes the extremity pain. Most patients don't relate their arm or leg pain has having its possible origin in the spine, as a lot of these patients will not have any back pain. This can be explained layman's terms as being similar to an electrical wire having a short circuit. In the lower back, the nerves that exit the spine transport the information of pain, temperature and touch from the legs to the brain, as well as transmit the information for muscular function from the brain to the legs. When there is pressure on a nerve in the lower back, the brain identifies the information as coming from the nerve that usually supplies information from the leg. The brain then interprets the information as leg pain rather than the real culprit, the disc problem in the back.

Pressure on the nerves in the back or neck can come from several causes. Nerves travel from the spine and into the arms or legs through small openings in the bones of the spine. These small holes have enough room for the nerve and a few blood vessels to pass, but not room for much else. When a piece of disc material protrudes from its normal position, it can fill the space reserved for the nerve root. We can call this a slipped disc, as a piece of disc material may "slip" out of its normal position. This extra material then puts pressure on the nerve root, and in turn, causes the nerve to become aggravated. Disc ruptures are very common in the neck and lower back, with a similar means of irritating nerves and causing pain due to the mechanical pressure.

A more dramatic way of putting pressure on the nerve root is by a slip in the bone. The technical term is "spondylolisthesis". When bones slip on each other, this also will compress the opening where the nerve root exits. The bones need to be aligned properly in the spine for the nerve to have the proper room to function. With slipping of the bones, the nerve roots can be pulled or pushed by the bones that surround them. The bones then cause pressure and irritation of the nerves, which causes the leg or arm pain.

Relief of the nerve irritation is directed toward the cause of the irritation and can start with a series of medications, physical therapy exercises or potential surgery when the pain is not otherwise improved. The goal of each of these methods is to relieve the pain and return you back to your normal activities. The treatments should be directed by a spinal specialist to ensure that the optimal method for your condition is being provided. Fellowship-trained spinal surgeons have the knowledge and training of the full spectrum of spinal conditions which allow them to treat the spinal conditions from the simple nerve root irritation to the most complex of spinal conditions requiring extensive surgical reconstruction of the bone and nerves.