Spine

There are many vertebrae in the spine, and between them are the intervertebral discs.  The discs act as shock absorbers between the vertebrae, and participate in the flexibility of the spine.  With age, there is a risk of deterioration of the discs, and this could be due to the normal wear and tear, but also from excess or unusual stress.  The weakening of the disc can cause pain in the back.  Also, arthritis of the spine can cause neck and back pain. 

Disc herniation:  The disc could also protrude, although most of the time these ‘disc bulges’ do not cause symptoms.  Occasionally, the disc protrusion can put pressure on the adjacent nerve from the spinal cord, causing pain shooting down the arm or leg.  Apart from pain, in some cases there may be numbness, weakness or even worsening of the bowel and bladder function.  If you have any of these symptoms, consult your doctor or a spine specialist. 
Majority of disc herniations get better with exercise, anti-inflammatory medications, physical therapy and sometimes, epidural steroid injections.  Surgery is considered if: 

• Intractable pain or failure of the conservative treatment
• Progressive strength loss 
• Cauda equina syndrome, where there is back and leg pain, weakness/numbness, and may have bowel/bladder functional changes. 

Neck Pain & Back Pain:  Neck and back pain can be due to many causes, including sprains or arthritis of the spine.  Knowing how to keep your spine healthy is the key to freeing yourself from back pain and back problems. Making healthy choices in all areas of your life can help prevent many of the spine diseases that are becoming increasingly common among today’s adults. Stretching throughout the day, pushing heaving items as opposed to pulling and carrying smaller objects in each hand instead of handling larger objects at the same time are simply everyday examples that can help keep your spine healthy.

Spinal Stenosis:  Low back pain is a very common complaint, and can be due to a sprain or irritation of the spine due to unusual or excessive stresses.  Back pain could also be due to arthritis of the spine.  If the pain radiates down the back into the buttocks and legs, it could be due to spinal stenosis, caused by narrowing of the spinal canal where the spinal cord or nerves are present.  Spinal stenosis in the lumbar spine can also cause back/leg pain and fatigue during walking or standing, and relieved by leaning forward or sitting.  If the stenosis is severe, it can affect the balance as well.  Narrowing of the canal where the nerves exit (foramen) can cause pressure on the nerves and mimic a disc herniation and sciatica. 
Treatment involves conservative measures, including exercise, physical therapy, anti-inflammatory medications, and if these fail, steroid injections.  If the conservative methods fail, then surgery may be considered.  The nerves are ‘decompressed’, where more room is made by removing some of the thickened bone and tissue, relieving the pressure.