Almost everyone experiences back pain at some point. Rush Medical Center estimates 70 to 85 percent of people have had a bad back at least once in their lives. Back pain can be a minor annoyance or it can prevent a person from working, cleaning house and other activities of daily living. As the human body ages, certain parts of the body, including the spinal column, begin to degenerate from wear and tear.
Anatomy
The spine is made of many small bones, called vertebrae, stacked on top of one another to form the flexible spinal column which connects the skull to the pelvis. The spine protects the spinal cord, which is a bundle of nerves that originates in the brain and travels down the back. Nerve roots branch out from between the vertebrae to serve the various areas of the body. Between the vertebrae are disks filled with a gelatinous substance; these disks serve as shock absorbers which prevent the vertebrae from grinding against one another or compressing the nerve root branch.
Causes
The disks between the vertebrae are made of two layers--a tough outer layer and a gooey inner layer. The outside layer of the disk may grow brittle with age, losing some of its water content, according to MayoClinic.com. A ruptured or herniated disk occurs when the tough outer layer ruptures, allowing the jelly-like contents of the disk to spill. This irritates the nerve roots as they emerge from the spinal cord, producing pain and numbness in the back, neck, arm or leg.
Symptoms
Pain often starts slowly, getting worse after sitting, standing or sleeping at night. Sometimes discomfort is worsened after walking, sneezing or coughing. Pain in the back is a common symptom, and the discomfort is usually located on only one side of the back. Severity of the ache can vary greatly, from a mild tingling sensation to pain so intense the patient cannot move. Some people also complain of numbness, a burning or dull ache.
Herniated disks in the lower back may cause leg pain, or sciatica. The leg may feel weak, and symptoms may travel all the way to the feet and toes. A slipped disk in the neck can cause pain when moving the head or neck. Discomfort may also be present near the shoulder blades or down one arm.
Diagnosis
A doctor will examine the patient thoroughly and take a detailed medical history. She may also perform a neurological examination to test reflexes, sensation and muscle strength. She may ask the patient to sit on the exam table and left the affected leg straight up--pain usually indicates a herniated disk. Blood tests are not usually necessary unless other conditions, like fever, are present. X-rays of the back will be ordered.
Treatment
The patient is told to rest. Anti-inflammatory drugs like ibuprofen may be taken to reduce pain and swelling. Physical therapy may be ordered after the pain has eased. Some patients require steroid injections. Surgery is usually not necessary.
Risks
Herniated disks are most commonly found in the lower back. A slipped disk in the neck occurs in about 8 percent of cases, while herniated disks in the middle back are least frequent, according to MedlinePlus. Middle age and older men are the most likely to develop a herniated disk, especially after engaging in physical activity.
