Two of the most common pain generators in the lumbar spine are 1) the discs, and 2) the facet joints, with facet oriented pain being more common the older you get, and discogenic pain being more common overall. If you’re suffering back pain, it is important to know the difference between these two causes. First, let’s take a look at discogenic injuries:
Discogenic pain occurs as the condition of the discs in the spine either gradually changes over time or as a result of acute trauma, such as in a car crash. The majority of people experience discogenic pain in the lumbar spine area. Pain can occur from just sitting still or it can be from activity that irritates the affected area(s). The most common symptoms of discogenic pain occur in the lower back area. Pain can be centralized or radiate to one or both legs, on the side of one or both legs, the buttocks, the groin, or feet Typically, the pain will be exasperated by bending over, sitting, or standing, for short or long periods of time. Some people find relief by laying down flat or in a cradled position in an easy chair. Walking sometimes will relieve the pain as well as standing and shifting weight from one leg to another. It is recommended that lifting and/or bending be avoided.
Proper Diagnosis and Treatment for Discogenic Injuries
The lumbar spine has 5 vertebrae with soft discs in between. Each disc has a tough outer ring surrounding a soft nucleus. When young, the discs consist predominantly of water. As we age, however, they lose hydration and become more susceptible to cracking and fissures known as annular tears. These tears lead to inflammation and pain.
Because back pain has so many different causes, it’s important to have a skilled practitioner properly diagnose your problem. MRIs are helpful in identifying signs of disc degeneration. However, since some degenerated discs do not cause pain, skilled doctors will recognize the need for other tests, such as discography to identify all problematic discs.
Physical therapy and anti-inflammatory medications are usually the first steps in treating discogenic back pain. If these measures do not bring significant relief, there are other non-surgical options that can prove successful in providing long lasting relief. For example, epidural corticosteroid injections can be very effective in resolving discogenic pain. Of course, sometimes surgery is the only option left should conservative care fail to resolve the pain.
Common Facet injuries and Associated Symptoms
Facet joints are surrounded by a thick flexible membrane that secret a viscous fluid to lubricates the joint. These joints help to support the weight of the body and facilitate movement between each vertebrae. They work in conjunction with the intervertebral discs so the whole spine can move.
Frequent symptoms correlating to facet joint pain consist of muscle spasms, which may force the spine out of alignment causing back and/or neck pain. For example, a patient may experience a muscle spasm while simply bending over to pick up an item; this may freeze the joint as it slips out of place. When facet joints freeze it typically occurs abruptly and without notice. Symptoms vary greatly and are often confused with spinal disc issues. Facet locking syndrome can create a sudden painful attack but it can be resolved by releasing the frozen joint or joints and thereby returning the facets to normal function.
Facet joints are made up of rigid cartilage which are filled with a lubricating fluid in the joint capsule. This allows movement while also providing stability. When they are functioning properly, facet joints allow the spine to move freely while helping to control the range of motion.
Facet joint pain may arise from aggravation or nerve irritation of joint. When this happens, the nearby muscles spasm in an effort to help protect the area from further damage by preventing movement.
Proper Diagnosis and Treatment for Facetogenic Injuries
Fortunately, facet joint injuries can be seen on just normal X-rays. Occasionally, a CT scan is ordered so that more detail of the structures around the spine is shown. CT scans can help rule out other possible issues with the facets. An MRI scan is another method of finding structural issues. Lastly, injectible dye can be used during an X-ray , called a facet joint block. In this method, a local anesthetic is used along with cortisone and in the injectible dye in order to light up the areas of concern. This allows the radiologist to see very detailed information about the areas of concern.
Therapies recommended can be either cold or hot compresses but always check with your physician before starting any treatment. The typical order is, 15 minutes of the ordered therapy every 2-3 hours, again consult your physician though. NSAID’s (also known as anti-inflammatories) like ibuprofen can be helpful however, they can cause stomach issues so check with your doctor before starting them. If possible, attempt to move slowly. Do not push yourself and listen to your body. If you are in pain, stop what you are doing. If the pain persists, sometimes a massage can help relieve the spasm but be sure you let the therapist know of your issue before the massage starts. Another option is to seek out a qualified chiropractor for help. Be sure they are qualified by researching the therapist before making an appointment. Also be sure to give very detailed information about what happened, how it happened, and where the pain is. Lastly, exercise has been shown to improve spasms and stiffness. However, it is imperative that you speak to a medical professional first. By doing exercises and not knowing the extent of your pain, you may actually cause more harm than good.
How Car Accidents Cause Neck and Back Pain
Car accidents involve a tremendous amount of science when evaluating the impact on a vehicle occupant’s body. Whiplash is a common cause of most neck and back injuries (Accident Related), whether the injury is discogenic or facetogenic in nature. In a vehicle crash the shear speed and force create such dramatic acceleration/deceleration that the body is not prepared for, particularly when the vehicle is stopped. Sometimes these injuries can be repaired through physical medicine or pain management intervention as we have previously discussed. Dolman Law Group works tirelessly to assist victims in obtaining a proper recovery to offset damages caused by a negligent party.
If you are experiencing any pain in your neck or back as a result of a traffic collision or slip and fall, getting accurate diagnosis of your injuries is crucial. It is important to stay informed, and to utilize qualified medical professionals as well as experienced attorneys to help you fully recover. Give the Clearwater car accident attorneys at Dolman Law Group a call today: 727-451-6900.
Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765