Back & Neck Pain

Total Spine Clinics Motif

Sciatica

The sciatic nerve is formed from a combination of nerves that runs from your lower back, through your hips and buttocks and down each leg. Sciatica is a pain that travels along this nerve. This may be due to a herniated disc or an overgrowth of bone on your vertebrae. In rare instances it may be caused by a tumour or damage to the nerve linked to disease.

Sciatica normally only affects one side of your body and can be severe. The pain may be felt anywhere along the nerve pathway and may vary from a dull ache to an excruciating pain. It may be accompanied by numbness, tingling or muscle weakness.

Certain factors may increase your risk of developing sciatica including:

  • Ageing
  • Obesity
  • Heavy lifting or driving for long periods
  • A sedentary lifestyle
  • Diabetes

It is important to see a doctor or spine specialist if the condition has lasted for a week or more, if you have trouble controlling your bladder or bowels or if you have had a significant injury, such as being involved in a road traffic accident.

Your doctor may ask you to walk or squat or lift one leg at a time while lying down. You may be referred for an MRI or CT scan.

In the first instance you are likely to be prescribed medication such as anti-inflammatories and muscle relaxants. Once the pain has subsided a physical therapist can design a rehabilitation programme to correct your posture and strengthen your back.

You may be offered corticosteroid injections to calm inflammation around the nerve. These normally last a few months. If there is significant weakness, worsening pain or loss of bladder or bowel control you may be offered surgery to remove bone spurs or a section of herniated disc.

It is not always possible to prevent sciatica however the following precautions may help:

  • Exercise regularly, paying particular attention to your core muscles
  • Sit properly with good back lower support
  • Take care how you lift, keeping your back straight and bending your knees. Don’t lift and twist simultaneously.
Causes

The sciatic nerve is formed from a combination of nerves that runs from your lower back, through your hips and buttocks and down each leg. Sciatica is a pain that travels along this nerve. This may be due to a herniated disc or an overgrowth of bone on your vertebrae. In rare instances it may be caused by a tumour or damage to the nerve linked to disease.

Sciatica normally only affects one side of your body and can be severe. The pain may be felt anywhere along the nerve pathway and may vary from a dull ache to an excruciating pain. It may be accompanied by numbness, tingling or muscle weakness.

Certain factors may increase your risk of developing sciatica including:

  • Ageing
  • Obesity
  • Heavy lifting or driving for long periods
  • A sedentary lifestyle
  • Diabetes
Diagnosis

It is important to see a doctor or spine specialist if the condition has lasted for a week or more, if you have trouble controlling your bladder or bowels or if you have had a significant injury, such as being involved in a road traffic accident.

Your doctor may ask you to walk or squat or lift one leg at a time while lying down. You may be referred for an MRI or CT scan.

Treatment

In the first instance you are likely to be prescribed medication such as anti-inflammatories and muscle relaxants. Once the pain has subsided a physical therapist can design a rehabilitation programme to correct your posture and strengthen your back.

You may be offered corticosteroid injections to calm inflammation around the nerve. These normally last a few months. If there is significant weakness, worsening pain or loss of bladder or bowel control you may be offered surgery to remove bone spurs or a section of herniated disc.

Prevention

It is not always possible to prevent sciatica however the following precautions may help:

  • Exercise regularly, paying particular attention to your core muscles
  • Sit properly with good back lower support
  • Take care how you lift, keeping your back straight and bending your knees. Don’t lift and twist simultaneously.

Slipped disc

A slipped disc or herniated disc occurs when one of the discs that separate the bones of the spine (vertebrae) tears and some of the softer jelly-like fluid inside it leaks out. You may experience pain in your buttocks, thigh and calf, or even your foot.

If you have slipped a disk in your neck, the pain is likely to be concentrated in your shoulder and arm. You may also experience numbness or weakness in your arm or leg, which may result in stumbling or an inability to lift or hold onto objects. Some people have no symptoms and only discover they have a slipped disc during an MRI scan (this is often incidental and is an age-related finding that requires no operative intervention, so don’t worry).

Age-related wear leads to disc degeneration. As the discs lose fluid content they are less flexible and more prone to tearing. Incorrect lifting of heavy objects can lead to a slipped disc and other factors like weight and genetics can play a part.

As well as a physical examination your doctor or spinal surgeon may suggest an MRI or CT scan. Dye may be injected prior to MRI or CT scan.

Treatments for a slipped disc include:

  • Medications such as anti-inflammatories and muscle relaxants
  • Cortisone injections into the spinal nerves to reduce swelling and inflammation
  • Physical therapy
  • Surgery – this will normally be recommended only after less invasive techniques have been tried or if there is loss of bladder or bowel control. It may involve removal of the protruding section of disc or the entire disc.

Factors that can help to prevent a slipped disc include:

  • Exercising the core muscles
  • Good posture and using correct lifting procedures
  • Maintaining good spine flexibility
  • Maintaining a healthy weight
Causes

A slipped disc or herniated disc occurs when one of the discs that separate the bones of the spine (vertebrae) tears and some of the softer jelly-like fluid inside it leaks out. You may experience pain in your buttocks, thigh and calf, or even your foot.

If you have slipped a disk in your neck, the pain is likely to be concentrated in your shoulder and arm. You may also experience numbness or weakness in your arm or leg, which may result in stumbling or an inability to lift or hold onto objects. Some people have no symptoms and only discover they have a slipped disc during an MRI scan (this is often incidental and is an age-related finding that requires no operative intervention, so don’t worry).

Age-related wear leads to disc degeneration. As the discs lose fluid content they are less flexible and more prone to tearing. Incorrect lifting of heavy objects can lead to a slipped disc and other factors like weight and genetics can play a part.

Diagnosis

As well as a physical examination your doctor or spinal surgeon may suggest an MRI or CT scan. Dye may be injected prior to MRI or CT scan.

Treatment

Treatments for a slipped disc include:

  • Medications such as anti-inflammatories and muscle relaxants
  • Cortisone injections into the spinal nerves to reduce swelling and inflammation
  • Physical therapy
  • Surgery – this will normally be recommended only after less invasive techniques have been tried or if there is loss of bladder or bowel control. It may involve removal of the protruding section of disc or the entire disc.
Prevention

Factors that can help to prevent a slipped disc include:

  • Exercising the core muscles
  • Good posture and using correct lifting procedures
  • Maintaining good spine flexibility
  • Maintaining a healthy weight

Lower back pain

Back pain is one of the most common reasons for absence from work or a visit to the GP. However, you can take measures to prevent back pain and keep your back functioning properly and surgery is rarely needed. Lower back pain might be experienced as an ache or shooting pain. The pain may become worse when bending, lifting, walking or standing and it may improve when you lie down.

Rarely, it can be a sign of a serious medical problem so you should always see a doctor if your back pain follows an injury to your back, leads to an onset of bowel or bladder problems or is accompanied by a fever.

Back pain can be caused by: muscle or ligament strain, a bulging or ruptured disc, arthritis, scoliosis and osteoporosis. It is more common as you age, if you are overweight or if you smoke.

After a physical examination, which may involve asking you to sit, stand and lift your legs, the doctor may refer you for an X-ray, MRI or CT scan. You may also be given a blood test to assess for infection and bone scan to look for tumours or compression fractures.

Depending on the type and cause of your pain, medications including anti-inflammatories, muscle relaxants and pain relievers might help. Your doctor may offer you a corticosteroid injection into the space around your spinal cord to reduce inflammation.

Heat, ultrasound and electrical stimulation may all be used to relieve pain and a physical therapist can recommend exercises to increase your flexibility and strengthen back and abdominal muscles. Surgery is rarely needed except in cases of narrowing of the spine or a herniated disc.

Steps you can take to avoid lower back pain include:

  • Low impact exercise such as walking or swimming
  • Abdominal and back muscle exercises
  • Maintaining a healthy weight
  • Quitting smoking
  • Yoga and Pilates
Causes

Back pain is one of the most common reasons for absence from work or a visit to the GP. However, you can take measures to prevent back pain and keep your back functioning properly and surgery is rarely needed. Lower back pain might be experienced as an ache or shooting pain. The pain may become worse when bending, lifting, walking or standing and it may improve when you lie down.

Rarely, it can be a sign of a serious medical problem so you should always see a doctor if your back pain follows an injury to your back, leads to an onset of bowel or bladder problems or is accompanied by a fever.

Back pain can be caused by: muscle or ligament strain, a bulging or ruptured disc, arthritis, scoliosis and osteoporosis. It is more common as you age, if you are overweight or if you smoke.

Diagnosis

After a physical examination, which may involve asking you to sit, stand and lift your legs, the doctor may refer you for an X-ray, MRI or CT scan. You may also be given a blood test to assess for infection and bone scan to look for tumours or compression fractures.

Treatment

Depending on the type and cause of your pain, medications including anti-inflammatories, muscle relaxants and pain relievers might help. Your doctor may offer you a corticosteroid injection into the space around your spinal cord to reduce inflammation.

Heat, ultrasound and electrical stimulation may all be used to relieve pain and a physical therapist can recommend exercises to increase your flexibility and strengthen back and abdominal muscles. Surgery is rarely needed except in cases of narrowing of the spine or a herniated disc.

Prevention

Steps you can take to avoid lower back pain include:

  • Low impact exercise such as walking or swimming
  • Abdominal and back muscle exercises
  • Maintaining a healthy weight
  • Quitting smoking
  • Yoga and Pilates