The bones of the spinal column (vertebrae) absorb substantial force. To soften the impact and cushion contact between the bones, the building blocks of the column are separated by resilient, rubbery, intervertebral discs. Normally, the structure withstands significant forces, without incident, but compression fractures occur under certain circumstances. Osteoporosis, trauma, and other pathological causes may each play a role in compression fracture.
Vertebral compression fracture comes about when an individual vertebra is squeezed, causing it to crack and/or break under pressure.
Causes of Compression Fractures
Like other broken bones, the customary cause of compression fractures is trauma to the affected area. In cases where preexisting conditions do not play a role, considerable force is required to fracture vertebra. A compression factor may result from:
- Car accident
- Sports injury
- Fall from a significant height
While the force exerted during these incidents is sufficient to break bones, some people are at higher risk than others for suffering compression fracture – prone to injury with very little trauma.
Elderly individuals experience fractures due to bone deterioration, over time, when small cracks develop in individual vertebra. The weakened bones eventually collapse, resulting compression fractures. And women, particularly those who have undergone menopause, suffer from bone density loss, called osteoporosis. Osteoporosis is a primary cause of compression fractures among those with preexisting disease. Increased risk factors for developing osteoporosis include:
- Body type – osteoporosis is more common among thin women
- Early menopause – risk increases among women experiencing menopause before age 50
- Ethnicity – white and Asian women share the highest risk for developing osteoporosis
Additional pathological causes of compression fracture are also tied to reduced bone strength. Cancer, whether originating in bones or metastasizing from another part of the body, can lead to compression fractures.
Symptoms of Compression Fractures
Compression fractures cause various symptoms, including these common complaints:
- Low back pain
- Hip and thigh pain
- Postural changes/ stooping
- Difficulty bending and/or twisting
When nerve compression is present, a compression fracture may also lead to the following symptoms:
If the fracture presses directly on the spinal cord or multiple compression fractures are present, sufferers may experience:
- Incontinence or inability to urinate
- Digestive issues
- Height loss
- Breathing problems
Herniated Disc (Lumbar)
Herniated disc is a painful condition, which may affect the lumbar spine (lower back). Comprised of 33 vertebrae, the spinal column, or vertebral column, relies on resilient, disc-shaped cushions to absorb force between bones and facilitate flexible movement. Under the pressure and rigors of use, the outer layer of a disc can lose its integrity, causing it to rupture or herniate. The lumbar region, made up of the five lowest vertebrae in the spinal column, is a frequent source of herniated disc pain.
Cause of a Herniated Disc
The lumbar spine consists of the largest of the backs’ vertebrae and is subject to higher levels of force than the thoracic and cervical portions of the spine. As a result, herniated disc occurs more frequently in the lower back, than other parts of the vertebral column.
Bearing the weight of the upper body, the lumbar spine continually absorbs the impact of everyday movements, such as walking, bending, and reaching. The flexible structure also facilitates movement and absorbs forces experienced during athletic activities. Herniated disc results from weakening of the rubber-like pads, over time, through natural degeneration, or from an isolated incident or injury. In many cases, it is difficult to pinpoint a single underlying cause, but the following may contribute to lower back pain and herniated disc in the lumbar spine:
- Heavy lifting
- Prolonged sitting
- Repetitive twisting
- Bending to the front or side
Additional risk factors for herniated disc in the lumbar region include:
- Genetic predisposition
- Strenuous work conditions
- Sedentary employment/inactivity
Description of a Herniated Disc
Discs positioned between lumbar vertebrae are filled with shock-absorbing material, surrounded by a fibrous layer. As we age, the resilient pads lose water content, making them more susceptible to damage – even during ordinary use. “Slipped” or herniated disc occurs when the tough exterior layer bursts and disc contents push through the opening. As the changes put pressure on spinal nerves, sufferers experience pain and other symptoms.
Symptoms of a Herniated Disc
A herniated disc in the lumbar spine may cause one or more of these symptoms:
- Back pain – constant or intermittent, and may be aggravated by movement
- Loss of coordination
- Muscle weakness in the lower extremities
- Numbness in the foot or leg
- Muscle spasms in the back
- Bladder and bowel irregularities
- Sciatica – pain extending from the lower back into the calf or foot
Radiculopathy results from compression or irritation of a nerve root as it leaves the spinal cord. Although symptoms may be experienced throughout the back, the lumbar (lower back) and cervical (neck) portions of the spine are most commonly impacted by radiculopathy. Degenerative changes and age-related wear and tear are frequently to blame for this type of lower back pain, but sports injury or trauma may also be responsible for pinched nerves and lumbar radiculopathy symptoms.
Causes of Lumbar Radiculopathy
The spinal column consists of nearly three dozen vertebrae, cushioned by flexible discs positioned between the bones. Through various processes, the structures naturally deteriorate with age, sometimes impinging the spinal cord and surrounding nerves. When compression, inflammation, and irritation affect nerves in the lower back, it results in lumbar radiculopathy. Common causes and risk factors for developing radiculopathy in the lower spine include:
- Excessive load or force on the spine
- Repetitive strenuous activities using the back
- Contact sports injuries
- Degenerative processes
- Genetics/family history of radiculopathy
- Osteophytes (bone spurs)
- Herniated disc with nerve compression
- Job-related back strain
- Spinal stenosis
- Thickening of surrounding ligaments
Less frequently, nerves in the lower back become compressed by a tumor growing in the area, and disorders such as scoliosis can also involve nerves on the sides of the spine, leading to radiculopathy. Scar tissue, present from a prior surgery, is another rare cause of nerve compression in the lower spine.
Description of Lumbar Radiculopathy
The effects of radiculopathy vary, according to the location of the compression and inflammation. Nerves in the lumbar region are responsible for with sensation in the legs and buttocks, so irritation in the lumbar spine typically leads to symptoms in these areas. Deep, steady pain radiating along the back of the leg and calf, moving into the foot, may involve the sciatic nerve, resulting in the complaint commonly termed “sciatica”. Nerve pain associated with radiculopathy in the lumbar may be made worse by sitting, walking, or positioning the body certain ways.
Symptoms of Lumbar Radiculopathy
Typically first appearing between the ages of 30 and 50, lumbar radiculopathy, or pinched nerve in the lower back, may present the following symptoms:
- Localized back pain
- Numbness in the legs
- Weakness in the extremities
- Cramping sensation
- Hypersensitivity to touch in the affected area
- Muscle weakness in areas controlled by the affected nerve
- Burning sensation
Spondylosis is a general term describing degeneration of the spine. More of a descriptive term than a clinical diagnosis, it is widely used to explain various spinal conditions. In itself, the designation doesn’t identify the source of lower back pain, instead indicating the presence of degenerative changes, which may result in painful nerve impingement and other symptoms. Many cases of lumbar spondylosis are in fact asymptomatic, but the age-related condition typically worsens over time, increasing the chance of developing symptoms.
Causes of Lumbar Spondylosis
Several spine disorders are associated with lumbar spondylosis, sometimes causing back pain. For example, the term commonly refers to the presence of osteoarthritis in the spine, which can be aggravated by intensive physical activity or long periods of inactivity. As the cartilage protecting facet joints in the lower back breaks down, the lumbar spine can grow stiff and arthritis symptoms may appear. This common cause of spondylosis is not the only way the condition manifests in the lower back.
Like other chronic, progressive back conditions, causes of lumbar spondylosis are most often linked to age related changes. Injury and overuse can also contribute to the development of painful lower back problems or accelerate the onset of lumbar spondylosis. When present in young people, the underlying cause of spondylosis is more likely to be related to sports or contact injuries.
Description of Lumbar Spondylosis
Lumbar spondylosis is not a single disease or disorder, but rather refers generally to pain and degeneration in the lower back. Spondylosis symptoms may be related to the following conditions:
- Stenosis in the lumbar spine, or abnormal narrowing of the spinal canal, can contribute to spondylosis symptoms in the lower back.
- Osteophytes, or bony growths, may be present with spondylosis, sometimes causing pain.
- Degenerative disc disease is a widespread, age-related source of lower back symptoms. Bulging and herniated discs may cause inflammation and irritation, even if they don’t directly compress involved nerves.
In many cases, spondylosis pain is more severe in the morning, gradually subsiding as the back warms up and becomes lubricated.
Symptoms of Lumbar Spondylosis
Depending upon its root cause, the following symptoms may appear as a result of lumbar spondylosis:
- Back pain
- Leg pain
- Tenderness near affected areas
- Numbness and tingling in the legs
- Radiculopathy, sciatica
- May be asymptomatic
- Reduced range of motion
- Muscle spasms
Lumbar Stenosis (Neurogenic Claudication)
Stenosis denotes narrowing of the spinal canal, commonly affecting the lower back. Several root causes contribute to lumbar stenosis, leading to a set of symptoms known as neurogenic claudication. Pain, tingling and weakness are frequently present, though the underlying cause of stenosis may influence the way the condition manifests symptoms in the lower back and legs. Sufferers typically experience discomfort while walking or standing for extended periods of time, often finding relief by bending or stretching to reduce pressure in the lumbar region.
Causes of Lumbar Stenosis
Age is the greatest risk factor for developing lumbar stenosis and symptoms of neurogenic claudication.
The lumbar spine is protected by spongy, hydrated discs containing gel-like material. Positioned between vertebrae, the flexible cushions absorb force and shock, enabling fluid movement. Over time, subject to wear and tear, these pads dry out and deteriorate, losing mass and resilience. As discs bulge and sometimes burst, the material can impinge nerves, causing symptoms in the lumbar spine.
Osteophytes, or bone spurs, extending from lower back vertebrae may also contribute to stenosis, aggravating nerve roots emanating from the lumbar region. As they expand, the boney growths take up space in the spinal canal, causing stenosis and related symptoms of neurogenic claudication.
Although its onset may be accelerated by a history of traumatic injury to the region, lumbar stenosis typically shows up beyond age 50.
Description of Lumbar Stenosis
The vertebral column serves as a protective channel for the spinal cord, at the same time supporting the weight of the upper body and facilitating flexible movement. The largest of the back’s vertebrae, found in the lumber spine, absorb substantial force. Through the course of everyday activities, sports demands and aging, the spinal column undergoes natural degeneration. As the bones of the spine and intervertebral discs change, the spinal column becomes vulnerable to lumbar stenosis and symptoms of neurogenic claudication.
Symptoms of Lumbar Stenosis
Lumbar stenosis is responsible for various symptoms in the lower back, legs and buttocks, including the following signs of the disorder. Symptoms may be more pronounced on one side of the body.
- Discomfort standing for long periods of time
- Activity-related symptoms- walking, etc.
- Tingling in the lower back
- Intermittent back pain
- Reduced sensation in affected area
- Leg pain/sciatica
- Numbness radiating from lower back to upper legs
Scoliosis (Curvature in Spine)
Scoliosis refers to irregular curvature of the spine.
Normally, when viewed from the front or rear, a person’s spine appears straight. Scoliosis causes it to curve laterally (to the side). Although it may affect any part of the spine, thoracic (chest) and lumbar (lower back) scoliosis are most common. Several factors influence the onset of scoliosis, which is particularly prevalent among young people approaching puberty.
Causes of Scoliosis
The exact cause of scoliosis isn’t always known, but certain factors increase risk for developing the condition. Scoliosis may be related to these contributing causes:
- Neuromuscular conditions – Cerebral palsy and muscular dystrophy can play a role in the development of scoliosis. Abnormal muscle and nerve function associated with these and other neuromuscular conditions interfere with stages of growth and development, leading to curvature of the spine.
- Family history – Many people diagnosed with scoliosis have a family history of back problems, including family members sharing the malady.
- Gender– Women are more likely to develop scoliosis than their male counterparts.
- Degenerative processes – As the bones of the spine change with age and protective intervertebral discs break down, scoliosis may be traced to various associated conditions, such as compression fractures, osteoporosis, or a history of traumatic sports injury.
- Birth abnormality– Congenital causes account for cases of scoliosis present at birth.
Idiopathic scoliosis is the most common type of the disorder, occurring without identifiable causes. Lacking another explanation, idiopathic cases of scoliosis are thought to be inherited.
Description of Scoliosis
Scoliosis frequently sets-in during the period of rapid growth and bodily changes, usually occurring shortly before puberty takes hold. Conservative treatment includes exercises designed to strengthen and straighten the spine. Braces may also be used to halt the progression of the curve and support normal growth. Corrective surgery is required only in the most severe scoliosis cases, which can present significant physical limitations.
Symptoms of Scoliosis
Depending upon the age of the patient and the area affected, scoliosis may present one or more of the following symptoms:
A baby with scoliosis may show these signs of the condition:
- Bulge on one side of the spine
- Infant favors a curved position when lying down
Scoliosis occurring in children may show these signs and symptoms:
- Head is not centered
- One shoulder blade appears higher than the other
- Rib cage is asymmetrical
- Child leans to one side
- Uneven waist/one hip is more prominent than the other