Lumbar Strain | What is causing your low back pain?

This is a replay of the live broadcast with Todd Wegerski DC, chiropractor in Cary NC

Lumbar strains are one of the most causes for individuals to experience lower back pain. We decide to clean out the garage, paint the shed, or spread 100 bales of pine straw and then the next day we can’t move. Nothing that we did was overly taxing on our bodies, but it was enough to send our lower back into spasm.

Lumbar Strain

So just what is a strain? There is general confusion with people and they typically will interchange the words sprain and strain. So a little clarification first. A sprain is stretching or tearing of a ligament, a strain is stretching or tearing of a muscle. It’s easy to remember this by saying, “he sprained his ankle” and “strained his lower back”. When you roll your ankle, it’s injuring the ligaments of the ankle joint itself. It’s really hard to sprain your lower back, there typically needs to be some kind of trauma involved.

In this case study, we follow Jason who decides to get a truckload of mulch dumped on his driveway, and then spend the next 2 days spreading that mulch around his yard with a wheelbarrow, shovel, and rake. Then the following weekend he decides to rip up his rotting deck and repair and renovate it with some new planking. In the following days he really struggles getting around. His wife is having to help get him dressed. He’s having a hard time sitting at work, it’s a struggle for him to make it through the day.

We discuss the benefits of using ice vs heat, the use of topical creams and gels such as Ben-Gay or Tiger Balm, and the relatively quick recovery period for these types of injuries.

The audio for the show can be found on iTunes or on Stitcher. Subscribe to the Back Talking podcast today!

 

Annular tear | What is causing your low back pain?

Annular Tear - MRI

Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 2969

This is a replay of the live broadcast with Todd Wegerski D.C., Chiropractor and Acupuncturist in Cary NC.

Annular tears, or annular fissures as they are now known as, fall under the category of degenerative disk disease. The intervertebral disc has 2 distinct components, the annulus fibrosus and the nucleus pulposus. A disruption in the annulus, typically from degenerative changes can result in an annular tear or fissure.

Annular Tear or Fissure

The annulus fibrosus is the tough cartilage part of the disc. It is comprised of 15-20 concentric layers that encircle the inner nucleus pulposus. Its job is to help contain the nucleus and resist the compressive forces of the spine. The nucleus pulposus is the inner part of the disc. It has a toothpaste like consistency, and its job has a hydraulic function to help spread the compressive forces of the spine over a greater surface area of the vertebra.

The disc relies on the neighboring vertebra for its nutrition of oxygen, glucose, and water. Recent research now shows that genetics is the #1 cause of disc degeneration. The disc loses the ability to attract oxygen, glucose, and water which leads to decreased cell metabolism and eventually cell death and death of the disc. This has been linked to genes that cause “poor manufacture” of some of the components of the nucleus pulposus.

This degeneration causes the disc to lose the ability to handle the compressive forces imposed on the spine. Those concentric layers of the annulus can then start to break down and develop fissures or tears. A radial tear can develop from the inside-out of the disc or a concentric tear can develop in between the layers.

Surprisingly, most annular tears or fissures are asymptomatic and are not picked up by MRI or CT scans. However, some are painful when they allow for disc material to leak onto surrounding nerves.

 

Spondylolisthesis | Low back Pain

This is a replay of the live broadcast with Todd Wegerski, Chiropractor and Acupuncturist in Cary NC.

Spondylolytic spondylolisthesis, now that is a mouthful! When we take a look at the word origins, it comes from both latin and greek and translates into a slipped and burst vertebrae. Well that doesn’t sound too good either does it!

Spondylolisthesis

The are 6 different classifications to the above diagnosis. But the two most common forms seen are those caused by a fracture to the pars interarticularis region on a vertebra and by degenerative changes to the vertebra itself. The former are more commonly seen in adolescents, and the latter are typically seen in the senior population.

In this show we are discussing the spondylolistheses caused lytic type injury. The mechanism of injury for this type is thought to be the repetitive cycling of the spine between flexion and extension, eventually leading to either a stress fracture or a complete fracture through the pars. To give an example, think of when you attempt to break a green stick in half. You bend it back and forth, back and forth until it finally snaps. There have been identified several high risk activities. Gymnastics with the repetitive flexing and extending with all of the flips and tumbles that they do. Football players, going down into a 3 point stance and then arching up to contact the lineman across the line of scrimmage. Pole vaulters, with the massive amount of hyperextension to their spine trying to get up and over the bar.

In this case study, we follow Jessica. She is a 17 year old volleyball player at one of the local high schools. She is on the school team and belongs to several other club teams in the area. She has been playing year round for about three years now. She began to develop what became debilitating lower back pain and was eventually diagnosed with a spondylolytic spondylolisthesis. Take a look!