Spinal Stenosis :

Spinal stenosis is term that is often used to describe a narrowing of the spinal canal. This problem is common in people over the age of 60, but it can occur in younger people as well. Spinal stenosis usually causes intermittent back and/or leg pain that is worsened by activities such as standing and walking. With rest, these symptoms often disappear.

Spinal stenosis usually results from thickening of the ligaments around the spinal canal and bone spurs around the facet joints and disc spaces. These changes push into the spinal canal, thereby decreasing the area within the spinal canal. If the stenosis is advanced, there may not be enough space for the spinal nerves to fit comfortably.

Low back or leg pain, numbness, or tingling may result due to pressure on the nerves. The lack of space can also cause the supply of blood and oxygen to the spinal cord to be reduced. This can lead to numbness and pain in the nerves that are affected. Stenosis can occur in all areas of the spine, but it is most common in the lumbar spine.

To confirm a diagnosis of spinal stenosis, xrays and an MRI of your lumbar spine will be performed. If these studies show spinal stenosis, and your symptoms warrant further treatment, your provider may order physical therapy, lumbar epidural steroid injections, or in severe cases, surgery.

Spondylolysis :

Spondylolysis is a term used to describe a specific type of fracture in the spine where a segment of the vertebrae which joins two vertebra together has fractured. Spondylolysis is a type of stress fracture of the pars interarticularis. This is often seen in patients who perform activities that require repetitive hyperextension (backward bending) of the low back.

Many adolescent gymnasts, dancers, and high school football linemen may develop spondylolysis but may not experience pain until years later; some patients may never develop pain. In most cases, the fracture occurs during adolescence but fails to heal properly. This fracture may occur on one side of the spine (unilateral) or on both sides (bilateral). When there is bilateral spondylolysis, the stability of the spine must be assessed to determine if a spondylolisthesis, or forward slipping of the vertebrae, is present.

In most cases of unilateral spondylolysis or bilateral spondylolysis without spondylolisthesis, physical therapy is useful to alleviate back pain. In certain cases, injections into the area of the fracture is beneficial. If there is a spondylolisthesis present, further diagnostic imaging may be required to assess the stability of the spine and spinal canal. In patients where the vertebrae continues to slip forward over time, a spinal fusion may be necessary.

Lumbar Spondylolisthesis :

Lumbar Spondylolisthesis is a term used to describe the slip of one vertebra on the one below it. This is usually caused by arthritis in the joints of the lumbar spine. As the joints overgrow and become arthritic, they allow the vertebra to slip forward and alter the normal alignment of the spine. This movement may cause degeneration of the disc between the two vertebrae, causing Lumbar Degenerative Disc Disease.

The forward movement also decreases the room the nerves have within the spinal canal, and may cause Spinal Stenosis. During your visit, your healthcare provider will perform a detailed history and complete physical exam to evaluate the cause of your pain. X-rays, MRI, or CT scan may be ordered to visualize the structures in your lumbar spine. Your provider will then discuss appropriate treatment options with you.

Lumbar Radiculopathy /Lumbar Herniated Disc :

Lumbar Radiculopathy is a term used to describe pain, numbness, or tingling sensations that begin in the neck low back, buttock, or hip and radiate down the leg. The cause of radiculopathy is often a herniated disc or spondylosis (bone spur) in the lumbar spine, which places pressure on a nerve within the spinal canal. This nerve extends down the leg, sending and receiving signals from the skin and muscles of the leg.

The sensations may be present in one or both legs, and may or may not cause weakness in certain muscle groups. Your healthcare provider will perform a detailed history and complete physical exam to evaluate the cause of your pain and/or weakness. X-rays, MRI, or CT scan may be ordered to visualize the structures in your lumbar spine.

Your provider will then discuss appropriate treatment options with you. In most cases, lumbar radiculopathy that is due to a herniated disc will resolve on its own in 6 to 8 weeks. Your provider may recommend a course of physical therapy or epidural steroid injections during this time to speed the healing process and alleviate pain. Radiculopathy that has been present for over 8 weeks, unbearable pain, or weakness to the lower extremity muscles may warrant further treatment.

Lumbar Degenerative Disc Disease :

A common cause of low back is Lumbar Degenerative Disc Disease. Patients with degenerative discs often report an aching pain in the center of the low back, which is often worse with sitting or bending forward. This low back pain is rarely associated with lower extremity pain, numbness, or tingling. The cause of this pain is an unhealthy disc, which may be the result of normal wear-and-tear, previous disc herniation, spondylolisthesis, smoking, or obesity.

During your visit, your healthcare provider will perform a detailed history and complete physical exam to evaluate the cause of your pain. X-rays, MRI, or a procedure called a discogram may be ordered to visualize the structures in your lumbar spine. Your provider will then discuss appropriate treatment options with you.