It is estimated that 80% of people will have a significant episode of back pain. This is not a simple backache, but pain that limits your ability to participate in leisure, recreation, or work activities. After you have had a pain episode like this, there is a 90% chance that the pain will happen again. This is called recurring back pain. It can happen when you are starting a new or seasonal activity, when you lift incorrectly, or when you use awkward postures. If a weak disc has started to bulge, these types of activities can put extra pressure on the weakened disc, expanding the bulge. The bulge can bring on the pain by putting pressure on the joints, nerves, or ligaments of your low back. With time or treatment, the bulge may get smaller and the pain may go away.
Back pain that comes and goes can also happen when the muscles or ligaments are not able to control the movement of a spinal vertebra, leading to spinal instability. Ligaments connect bone to bone, helping to limit the amount of movement of a joint. If a ligament has been stretched, it loses its ability to hold the joint stable. Your abdominal and low-back muscles provide support for your lumbar spine much like guide-wires hold the mast of a ship. If your abdominal muscles are weak from postural changes or from not being exercised, the unstable vertebra can cause recurring pain. Daily activities can put extra strain on unstable joints, leading to extra wear and tear. It is like driving around with loose lug nuts on the wheel of your car. After a while you start to notice abnormal wear and tear. Whether the problem is from a weakened disc or from a spinal instability, you may benefit from physical therapy to strengthen and stabilize your lumbar spine.
The pain you feel in your arm can be from a problem in your neck, much like leg pain can be from the low back. This type of pain is called referred pain. When there is injury or irritation in the tissues deep inside your body, your brain is not able to determine exactly where the pain is coming from. Instead, the pain is felt further away from the actual source of the problem. For example, pain in or around your heart may be felt in the jaw or down the left arm. In the same way, problems in your neck can “refer” pain down into your arm. When the source of pain is more toward the surface of your body, your brain has an easier time figuring out where the pain is coming from. A pinprick on your palm hurts right where the pin sticks your hand. Characteristics of referred pain include the following:
The source of pain is usually deep and toward the center of your body.
It is often felt as a vague, deep, burning, or aching pain.
Intense pain radiates further.
Treatment for referred pain must address the source of pain. If your doctor determines that your arm pain is coming from your neck, you will need treatment for your neck, not your arm. Helping your neck problem should take away or reduce the pain in your arm.
Choosing a supportive mattress and pillow may help you get a better night’s sleep. A soft mattress or un-baffled water bed might not give you the support you need for your spine. You can try these tips to give your spine some extra support while in bed.
Low Back Support – when lying on your side, slide a small pillow or rolled towel just above your waist, and put a pillow between your knees. When lying on your back, you can try putting a small pillow under your knees.
Neck Support – neck rolls, cushions, and pillows can be used to give your neck extra support while you rest. One option is to roll a mid-sized bath towel and slide it length-wise between your pillow and pillowcase. The roll can help support your neck as you lie on your back or on your side. If you lie on your stomach, arrange your pillow to keep your neck from turning all the way to one direction. Avoid foam pillows because the foam pushes against the pressure of your head and keeps your neck muscles from getting a good rest. Choose a feather or synthetic material for added comfort.
Your symptoms may be a sign that a nerve is “pinched.” The medical term for this pinched nerve is radiculopathy (ra-dick-you-lop-a-thee), which happens when a nerve is irritated from something rubbing or pressing on it. This can cause numbness in your skin, weakness in your muscles, and loss of reflexes in the area controlled by the nerve. Usual causes of radiculopathy include herniated discs and bone spurs. Other causes are tumors or fractures that cause pressure on one or more nerves.
Your doctor may be describing a spine condition called spondylolisthesis (spon-dil-low-liss-the-sis), which is when the bones in your spine slip out of line. This condition often begins as a stress fracture in one pedicle of a vertebral body, called a spondylolysis (spon-dil-low-lie-sis). The pedicle connects to the vertebral body and is part of the bony ring that forms the spinal canal. If the fracture is on both pedicles, it is called a spondylolisthesis , and the facet joints are not able to hold the vertebra from slipping. The forward pressure stretches the disc. In adults, this stretching usually allows only a small amount of forward slip without the risk that the upper vertebra will slide off. In teenagers, there is an extreme form of spondylolisthesis in which the upper vertebra slips completely off the lower vertebra.
Your condition may not get worse, but you will have a higher risk for developing chronic low back pain. A supervised program of physical therapy will help you learn which postures to avoid and what exercises you can do to help stabilize and protect your back.
Not necessarily. Studies show that many people have a “bulging disc” but have no pain or problems at all. The fact you have a bulging disc is not necessarily a problem, but if you have symptoms of pain, numbness, or weakness, give us a call to further discuss the issue.