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Watch your back

Another year has passed. Each New Year’s celebration reminds us that the years are creeping by. Recently, my lower back has been sending its own painful reminder. Your back may be sending you the same message.

Another year has passed. Each New Year’s celebration reminds us that the years are creeping by. Recently, my lower back has been sending its own painful reminder. Your back may be sending you the same message.

Unfortunately, degeneration of the spine is a natural occurrence that accompanies aging. Some common reasons we have trouble with our spines are: heredity, obesity, injury, as well as normal wear and tear. The biochemical changes caused by aging can affect the discs that cushion the area between the spinal vertebrae. These changes, along with the usual wear and tear to the spine over the years, can weaken part of the discs, making them less effective shock absorbers. Sometimes bone spurs form on the spine, which can cause additional pain.

If your back is causing you pain, usually a day or two of rest will be enough to get over it. Ice packs or heat packs may help, too. However, if you haven’t improved after a few days of rest, you may have a more serious condition.

One particular degenerative spinal condition to consider is spondylosis. It affects most people over the age of 50 to some extent. Spondylosis can be found in any area of the spine, but let’s focus on this condition in your lower back: lumosacral spondylosis.

Lumosacral spondylosis, outside of age-related degeneration, is usually caused by a repetitive strain injury from an activity in which you move or hold your spine without paying attention to its ergonomic position, such as excessive hours of driving.

With lumosacral spondylosis, you’ll feel back pain and stiffness when you first wake up. Usually, this will fade as your muscles loosen up. However, lifting, bending and sitting for long periods of time can cause or increase the pain, since these activities put pressure on the lower part of your spine. If your discs have seriously degenerated, ruptured, or are irritating the nerves from a bone spur, the symptoms will be more severe. Your legs may begin tingling, getting weak, or becoming numb. They may also experience muscle spasms or numbness. In some extreme cases, you may have bowel or bladder problems.

Since there may be many causes of these same symptoms, a doctor’s diagnosis is necessary. Your medical examination should include taking your medical history, listening to your symptoms, and examining your spine for signs of abnormalities, muscle spasm or tenderness. The doctor will test your range of motion to see if you have any trouble bending, rotating or extending your spine.

Sometimes an X-ray or MRI (magnetic resonance imaging) will be given to see if there are bone spurs or narrowing between the vertebrae from disc degeneration. Interestingly, the water content in your discs can also be seen on an MRI, which lets your doctor judge how effectively they are working as shock absorbers.

Fortunately, usually non-surgical treatment can effectively relieve your symptoms. Physical therapy is most commonly prescribed in the early stages to help relieve pain and increase your range-of-motion.

During physical therapy treatment you will learn exercises that will strengthen your back (para-vertebral) muscles and stomach (abdominal) muscles. These exercises help build strength, while increasing range-of-motion and flexibility to better support your spine.

Physical therapists may also use heat, ultrasound and electrical stimulation to reduce pain and muscle spasms. Analgesics, anti-inflammatory medications and muscle relaxants may also be recommended for pain. In addition, your physical therapist will coach you on lifestyle changes that will help you improve and maintain your back health.

Special shoe inserts, orthotics, designed to keep the foot in the optimal position to support the weight of the body, can also help reduce symptoms. A properly adjusted lumbar support would really help stabilize your spine while you’re on the road. Losing weight extra weight would help, too. Ultimately, if your pain is severe and your job requires lifting heavy objects or bending, your doctor may recommend that you use an orthotic back brace or even move to a job that is less demanding to your spine.

The American Academy of Orthopedic Surgeons supports manipulation as an effective holistic treatment, which is typically done by a chiropractor, or a physical therapist. Certain movements may re-adjust the bones in the spine and result in pressure relief.

However, I recommend that you consult your doctor to make sure this treatment is appropriate for your particular condition.  In the most severe cases of lumosacral spondylosis, surgery may be needed to remove damaged discs or fuse part of the spine. This last resort is usually only considered in situations when a person’s pain is severe or when the spine is compressed.

As this year begins, make a resolution to watch your back. Eat well. Stay fit. Lose weight. And see a doctor if necessary. The future is yours.

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