FAQ Category: Lumbar Spine

Yes, but so can disc problems and kidney problems! It’s impossible to tell without further testing. A disc problem in the upper lumbar spine (L3-L4) can cause these symptoms, but there will be other signs as well.

A recent study of older adults with thigh pain from L3-L4 disc herniation showed leg weakness and decreased reflexes were also common. These are signs of nerve pressure, most likely where the disc is pressing on the spinal nerve. Sacroiliac problems aren’t usually accompanied by neurologic symptoms.

Kidney infections, tumors, and inflammation can cause back pain that radiates around the flank and down the thigh. Thigh pain alone is possible but uncommon. And when the kidney is involved there are usually other signs like blood in the urine, frequent urinating, or burning on urination.

New symptoms in older adults are a yellow flag to caution you. A medical exam would probably be a good idea to find out the exact cause of your problem.

Groin pain is a common problem in Australian football. This game is played outdoors on natural grass. The ball is moved mostly by punt kicking. It’s the kicking and rapid change of direction that lead to these types of injuries.

Finding the cause of groin pain can be very difficult. Sometimes imaging studies are able to show stress to the pelvic bones where muscles of the groin attach. Shear forces seem to have the greatest affect on these structures.

Research shows that with chronic groin pain, one of the abdominal muscles gets off in how and when it contracts. This may add to the problem. Physical therapists (called physiotherapists in Australia) are studying groin injuries of this type.

It may be helpful to have your son visit a physiotherapist before making the trip back to the United States Restoring normal muscle contractions of the abdominal and pelvic
muscles may be all that’s needed.

Constant pain in a young athlete that doesn’t go away with treatment does raise the suspicion of a more serious problem. What kind of tests have been done and what kind of treatment has he tried so far? If he hasn’t been seen by a medical doctor, that’s the first place to start.

Groin pain can be hard to diagnose accurately. Athletes who use kicking motions and who change directions quickly on the field are often prone to chronic groin pain. X-rays or other imaging studies may be able to show signs of stress at the pubis symphysis where the two pubic bones come together. Imaging studies would also show any signs of bone tumors.

Once a medical doctor has ruled out more serious bone or joint problems, a physical therapist might be able to help with other soft tissue or muscle injuries. Sometimes after an injury, the muscles must be given some help to get back to normal.

The “tailbone” or coccyx at the end of the spine can become extremely painful in some people. Women are affected more than men for several reasons. One is trauma that occurs during childbirth.

The child moves past the coccyx as he or she descends down the vaginal canal. A large baby or awkward, twisted presentation can push the coccyx out of its normal alignment.

The second is the difference in pelvic anatomy between men and women. In females the opening where the sciatic nerve passes through the pelvis is wider than in men. The result is for the entire sacrum and coccyx to tilt backward. This angle puts the coccyx
at greater risk for injury.

In males the narrow sciatic notch tilts the sacrum and coccyx forward. There’s more protection for these body parts with the sacrum and coccyx tucked under.

When you sit straight up, you can feel the pressure on the ischial tuberosities on your bottom. These are commonly referred to as the “sit bones.” These bony prominences on the pelvis are further apart in women compared to men. When sitting, the coccyx is positioned
between these two points. A wider distance between the sit bones means more pressure on the coccyx.

Finally there may be some people who have instability of the coccygeal segments from birth. Over time abnormal motion occurs causing pain. This could be a hereditary trait but it hasn’t been proven yet.

Coccygodynia refers to pain in the tail bone when sitting and sometimes while standing. The problem is most common in women from trauma during childbirth. Other causes in men and women include trauma such as a fall at an early age. There have been some reports of sexual abuse linked to coccygodynia.

More serious diseases such as infections and tumors must be considered, too. A medical exam will rule out herniated disc, prostatitis, hemorrhoids, and cysts. Anal fissures are reported among the male homosexual community as a possible cause.

Even if your boyfriend won’t discuss the problem with you, encourage him to see a medical doctor for a diagnosis and treatment. This is a treatable condition.

Physical therapists are doing studies of athletes with chronic groin pain. They are trying to find out which muscles might be the problem. Perhaps an exercise program to
restore normal function of muscles could help patients with groin pain.

A recent study of Australian football players showed a link between poor motor control of the transversus abdominis (TrA) muscle and groin pain. The TrA is one of several abdominal muscles. It seems that lifting the leg normally activates the TrA. With groin pain, the contraction of the TrA is delayed.

Therapists aren’t sure if the groin pain causes delayed muscle contraction or the other way around. Working to restore normal muscle function is the first step to answering this
question. There aren’t a lot of other options for treating groin pain. It may be worth giving it a try.

Studies of back pain haven’t been able to find an exercise program that works yet. This may be because the studies use the same exercises for everyone. It’s likely that a “one-
exercise-program-for-all” doesn’t address the needs of each person.

A new study from Canada showed that patients got better faster when they kept all their movements in the direction that doesn’t cause pain. For example if bending forward hurts
then their activity and exercises were geared toward the opposite direction (extension). If bending to the left increases painful symptoms, then exercises moving to the right
were taught.

This approach to back exercises is called the McKenzie Method. Some physical therapists have training in the McKenzie Method. The therapist examines the patient to find which movements cause painful symptoms. Then an exercise program is devised to help
the patient move in the preferred (painfree) directions.

Ask your doctor about trying this program. He or she may know someone in your area with this type of training. You should be able to see if it will help you in a very short amount of time.

The perfect results would be full, pain free motion for the rest of your life. The artificial disc replacement (ADR) is designed to do everything a human disc does. This means normal motion in all directions. The ADR would also transmit loads across the disc spaces while protecting the joints.

Not only that but the new disc implants are expected to do all these things over and over for years and years. They should last without failure or wear for the rest of your life.

Do they really do all these things now? We don’t know yet. ADRs haven’t been used long enough to collect results years after implantation. You will be part of the early data collected and reported. Good luck!

This varies from patient to patient. A few patients wake up completely free of pain. Others have less back and leg pain than before the operation. For many patients, pain levels ease over time.

Post-operative pain levels depend on many factors. For example, some surgeons are using minimally invasive methods with small incisions through the skin. They use tiny tools and special imaging to see inside the body without a large opening. Studies show patients
tend to use fewer pain relievers with this type of operation.

Even with the more invasive surgeries, the amount of pain patients reported is different. Some people have a higher tolerance for pain than others. You’ll be encouraged to get up and move about as quickly as possible after surgery. Movement can help reduce pain levels too.

It’s not clear why some patients have these kinds of problems after this type of surgery. While patients question whether they did something wrong, insurance companies are asking if the surgeon is at fault.

It’s possible the nature of the operation and the patient’s tissues are the real keys. Rods and screws are used to hold the spine together and to add stability while healing and the final fusion take place.

In order to get the screws into the bone, the deep, stabilizing muscles of the back are cut and pulled away from the bone. At the same time tiny nerves to the joints are cut. Other supportive structures are weakened by the operation. Recovery can be slowed or complicated by problems because of these changes.

Expecting something to hurt doesn’t really produce pain, but it can affect how you breathe and how you move. These two factors can increase your awareness of pain that is already present. Muscle tension from holding your breath and avoiding movements can make your pain seem worse. Relaxation is an important key in cases like this.

Anticipating a pain response can also delay muscle contraction, or sometimes the muscle contracts too early for the intended movement. This kind of muscle imbalance can lead to spinal instability. Pain and injury is more likely when the spine is unstable.

That’s a good question that even the researchers don’t know the answer to yet. Studies are being done on patients in both situations. By comparing the results, scientists hope to be able to see how much difference there is in muscle strength before and after treatment.

They won’t know how treatment affects strength and motor control if these factors vary during periods of increased or decreased pain. It may be best to get a baseline during both phases.

Studies show that only 10 percent of back pain cases have a clear cause. That means 90 percent of chronic back pain has an unknown cause. CT scans, X-rays, and MRIs show defects in the spine when the patient doesn’t even have any symptoms. On the other hand
painful symptoms occur when nothing shows up on the imaging studies.

Many doctors and therapists think the muscles are a major part of the problem. This hasn’t been proven true yet. EMG studies have been used to measure the electrical activity of muscles during spinal movement.

EMG studies were recently used to compare the muscles of healthy subjects to people who have back pain. Researchers found that the muscles of back pain patients didn’t fatigue
as quickly as healthy subjects. This may be because patients with back pain hold back and don’t use their back muscles with as much force as healthy subjects.

The more we can find out about muscle function, the better able we will be to find a rehab program for back pain that works.

Studies show that only 10 percent of back pain cases have a clear cause. That means 90 percent of chronic back pain has an unknown cause. CT scans, X-rays, and MRIs show defects in the spine when the patient doesn’t even have any symptoms. On the other hand
painful symptoms occur when nothing shows up on the imaging studies.

Many doctors and therapists think the muscles are a major part of the problem. This hasn’t been proven true yet. EMG studies have been used to measure the electrical activity of muscles during spinal movement.

EMG studies were recently used to compare the muscles of healthy subjects to people who have back pain. Researchers found that the muscles of back pain patients didn’t fatigue as quickly as healthy subjects. This may be because patients with back pain hold back and don’t use their back muscles with as much force as healthy subjects.

The more we can find out about muscle function, the better able we will be to find a rehab program for back pain that works.

Studies suggest it may be a little bit of both. Heavy lifting is a predictor of future episodes of back pain. This could be the case of mechanical overload: lifting more than the spine is designed to handlt. Back pain is more likely to go away and stay away when there’s a decrease in the workload.

There may be a fear factor here in that a person’s back starts to hurt when the person avoids certain movements in order to prevent injury. Studies show greater psychologic distress in patients doing heavy work compared to part-time workers or workers on light duty.

Finding out your pain and activity levels can help the therapist decide what tests to do. The goals and plan of care for you are based on your current symptoms and level of function.

This gives the therapist a baseline for you. The baseline helps measure when progress is being made. Is the treatment working? Are you getting better? There’s no sense in continuing treatment when there’s no improvement.

Ninety percent of a doctor’s or physical therapist’s diagnosis is based on information received from the patient in response to questions. The tests and measures used to make the final diagnosis only make up 10 percent of the examination.

Back pain is common among adults aged 65 and older. In this age group the cause of back pain is often linked to degenerative processes. The discs start to wear thin, bone spurs develop, and the spinal canal starts to narrow.

The forward flexed position opens up the space around the spinal cord and spinal nerves taking pressure off these structures and reducing painful symptoms. Sometimes exercise and anti-inflammatories can help. Surgery may be an option when conservative care doesn’t work.

A medical examination may be needed to sort this all out. Find out first what the problem is in order to determine the best treatment. Early treatment usually brings the best results. Waiting too long may result in permanent postural changes.

It is not uncommon for older adults to have a change in mental status or to go through a stage of confusion after a general anesthetic. The cause of deterioration in mental ability is unknown. In some cases dementia appears to be triggered by the shock to the body of anesthesia and surgery. It may be a passing phase with complete recovery, although this can take weeks to months.

Mood change after surgery has been reported in adults aged 85 years and older. Sometimes impaired thinking occurs, too. In fact, one out of four adults in this age range have both depression and decreased mental processes.

esearchers aren’t sure why this happens. It does seem as though patients with many other health problems have poorer result after surgery. Talk to his doctor about your concerns. Medical treatment may help.

In some ways only your grandmother can answer this question. Pain relief often improves a patient’s ability to move around and improves quality of life. It’s hard to put a price tag on six months of improved health and increased function.

A recent study was done of patients over age 80 having surgery for spinal stenosis. Everyone got some pain relief. Many were pain free for the first time in months or years. They were able to stop taking pain medications.

This kind of improvement can actually preserve and prolong an older adult’s life. Less pain means easier movement and less chance of injuries or falls. Even at age 82 your grandmother could have lived another 10 or more years. Without knowing when life will end, some say quality of life is the guiding factor in making these kinds of decisions.

Surgery may be the next step. A laminectomy can be done when a patient has tried other methods of treatment and still has painful symptoms. In this operation a portion of the bone surrounding the spinal cord or spinal nerve is removed. This takes pressure off the nerve tissue.

Your mother may be a good candidate for this treatment. Laminectomy has been shown to be safe and effective even in adults 80 years and older. The best results occur in the “well-elderly.” This refers to older adults who don’t have significant other health concerns.