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As we age, the effects of everyday use accumulates to cause wear to the vertebra, facet joints, discs and soft tissues that make up the spine. The intervertebral discs of the spine dessicate and shrink, and the ligaments and muscle tendons stiffen. Changes occur to the actual physical shape of our vertebra and to the small joints (facet joints) that join the vertebra together. This shape deformation can limit movement and contribute to the stiffness, pain and discomfort that we experience. Lumbar spondylosis is the collective term for this process in the lower back
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The joints that attach vertebrae together as known as facet joints. They are important for movement and flexibility, particularly in the lower back (known as the lumbar spine). However sometimes simple sudden abrupt awkward movements such as an unexpected trip can irritate or injure a facet joint. In most cases this is due to the fact that the muscles could not control the unexpected or abrupt movement in time to prevent injury to the joint. This often results in local pain and discomfort in the spine that becomes sharper on twisting or bending
Soft tissue structures (by this we mean muscles and ligamnets) in the spine help control movement of the spine. They are also the main tissues surrounding the spine and by virtue will be involved in most injuries. Other muscles that are common sources of discomfort are those that surround the shoulder blade (scapulothoracic muscles). These are integral to shoulder movements that involve throwing or lifting. Ligament injuries may contribute to spinal pain although it is hard to establish to the extent of involvement.
Sciatic nerve impingement can occur at any of the bottom three vertebra of the lower back. It typically occurs because of pressure from nearby structures such as an intervertebral disc or bony growths called osteophytes. The sciatic nerve travels down the back of your leg into your foot and provides both feeling and motor power to muscles in this same region. Pain is referred to these areas if the nerve is impinged at spinal level. There is also another nerve in the lower back called the femoral nerve that can also be trapped. This occurs in the top two vertebra of the lower back and causes pain on the front of the thigh for the same reasons as sciatica. There are clinically significant symptoms related to trapped nerves that are important to know.
There are various conditions that affect the spine and the most common of which are outlinned here. Ankylosing spondylitis is an inflammatory condition that generally affects young adults. It leads to a progressive stiffening and restriction in the spine. Scheuermann’s Kyphosis occurs when the front of a vertebral body does not grow as fast and develop as quickly as the back of the vertebra. The vertebra therefore becomes wedge-shaped and this typically occurs in the mid-back area. Osteoporosis is another common condition that affects us all as we grow older (although it can occur at an earlier age in ladies) . This is characterised by loss of bone density, as most of us already know. Spondylolisthesis is a condition in which a veretebra in the lower back slides forward over the vertebra below it. You may not be aware of any symptoms but it can be a common cause of general lower pain lower back.
The middle of your back has an outwards natural curve called a kyphosis and your neck and lower back have a natural inner curve called a lordosis. A small degree of both kyphotic and lordotic curvature is the ideal. However too much curving in the lower back is called ‘swayback’ (or lordosis) and a curve of more than 45 degrees in the middle of your back (or kyphosis) is also considered excessive. In both instances pain and stiffness can be evident as the body struggles to cope and compensate. Scoliosis is when you have a sideways curvatuture in your spine at an angle of more than 10 degrees that doesn't go away when you bend. Scoliosis mainly affects children but there is also an incidence rate in adults.
One of the most common presentations we see as specialists in musculoskeletal pain is lower back pain resulting from lifting. This may be moving furniture at home or doing a job in the garden or related to materials handling at work. We have enclosed a few tips for materials handling and lifting.