COMMON INJURIES & CONDITIONS

Information about common causes of pain

What is radiculopathy/nerve impingement?

Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a “pinched nerve.” Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

What is a bulging/ruptured/herniated disk?

The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a “bulging” disk. This condition may or may not be painful and is extremely common.

Herniated disks are often referred to as “slipped” or “ruptured” disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually “slip,” strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk.

If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.

If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.

What is a stress fracture?

A stress fracture is a microscopic crack in a bone that occurs from overuse. Muscles normally absorb the shock of physical activities, but when they become too fatigued to do so, they transfer the stress to the bones which results in a hairline-sized fracture.

Stress fractures usually develop in the weightbearing bones of the feet and lower legs, often after a rapid increase in the duration or intensity of exercise or from wearing improper or worn out athletic shoes.

What is arthritis?

The most common form of arthritis, osteoarthritis, can affect any joint in the body, but most often afflicts the knees, hips, and fingers. Most people will develop osteoarthritis from the normal wear and tear on the joints through the years. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff after long periods of activity or inactivity.

What are muscle spasms?

When muscles become inflamed, they can also spasm, or contract tightly, as a response to injury. While they are the body’s way of protecting itself from further injury, they often produce excruciating and often debilitating pain. Muscle spasms are common in the low back (lumbar) muscles.

What is degenerative disk disease?

Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).

Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur.

Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.

What is spinal stenosis?

Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine’s vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers.

As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.

What is sciatica?

In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

What is the difference between a sprain and a strain?

A strain occurs when a muscle is stretched or torn. A sprain occurs when a ligament is stretched or torn.

Strains are often the result of overuse or improper use of a muscle, while sprains typically occur when a joint is subjected to excessive force or unnatural movements (e.g., sudden twists, turns, or stops). Sprains can be categorized by degree of severity:

  • A first-degree sprain stretches the ligament but does not tear it. Symptoms include mild pain with normal movement.
  • A second-degree sprain is characterized by a partially torn ligament, significant pain and swelling, restricted movement, and mild to moderate joint instability.
  • In a third-degree sprain, the ligament is completely torn with mild to severe pain, swelling, and significant joint instability.