Sciatica

Sciatic pain is characterised by a shooting pain down from the lower back into the buttocks and down the back of the legs. The pain is generally caused by impingement of the spinal nerves either because of compression of the spinal cord itself or sometimes the spinal nerve root.

Compression of the spinal nerves

A prolapsed or herniated (slipped) intervertebral disc happens when the jelly like fluid inside the disc protrudes through the fibrous surrounding. The jelly like fluid is designed to help with shock absorption of the spine. As it protrudes, it can compress the spinal cord or the spinal nerve roots as shown in this image.

 

 

 

 

Pressure on the nerve roots can also occur when there is degeneration of the intervertebral discs and/or the vertebra itself. Degeneration causes the disc to become more flat which leads to narrowing of the joint space. Small bone spurs can also form due to the arthritic changes and these can further impinge on the spinal nerves. See images below.

 

 

 

 

 

 

 

 

Spinal Fractures

Fractures of the spine are caused by some kind of trauma to the vertebra using significant force. This might happen in cases such as a road traffic accident or during a bad fall. This type of injury is serious and many people are kept in hospital as a result to assess the stability of the fracture. Much more common is the compression fracture.

Compression Fracture

This type of fracture is most common amongst menopausal females with osteoporosis or in people who are undergoing long-term corticosteroid use. In a person with severe osteoporosis, even a small amount of force can cause a compression fracture. E.g. a sneeze

 

 

 

Soft Tissue Strain

The spine itself is supported by many surrounding ligaments and muscles. Over use of these structures can lead to swelling, muscle spasms and, sometimes, pain. This is particularly common in the lower back. The sacro-iliac joint is often affected but the lumbar vertebrae (at the bottom of the back) are also prone to this type of injury as they take more pressure than the other vertebrae of the spine during activity.

 

Leg Length Discrepancy

Many people suffer from back pain as a result of having a difference in their leg lengths. Many people are unaware of this difference and therefore have no idea what is causing the problem. For the vast majority, however, the problem only arises following a hip or knee replacement.

The surgery or the long standing leg length discrepancy leaves people with uneven leg lengths and they often compensate by adopting a curved position of the spine called a scoliosis. This can result in straining of the muscles or compression of the intervertebral disc on one side which can lead to pain.

 

 

 

Other Spinal Problems

Other conditions listed below are causes of back pain and can be helped by wearing orthotic devices:

• Spondylolysis
• Spondilolysthesis
• Kyphosis
• Scoliosis
• Spinal stenosis

However, these conditions are much less common and if you require information on any of these conditions, please contact us and we will be happy to provide you with as much information as we can.

ORTHOTIC SOLUTIONS TO BACK PROBLEMS

Orthotics is generally only used to treat chronic (long standing) low back pain. Acute injuries should, in the first instance, be rested and often, a consultation with an orthopaedic surgeon who specializes in spinal problems would be well advised.

Orthocare recommend Mr. Ian Wright – Consultant Orthopaedic and Spinal Surgeon. To contact Mr. Wright please follow this link www.manxortho.com

Insoles and Heel Raises

Leg length discrepancies contributing to back pain can be effectively rectified with an insole/heel raise. Mostly, these insoles can be fitted inside the shoe and worn without being seen. However, if the leg length discrepancy is large, then adaptations to the shoe are occasionally required.

Back Supports

Most back supports work on 3 levels:

• Support the back via abdominal compression. The abdominal compression distracts the vertebrae apart to offload the disc and take pressure off the affected nerves.
  
  
• Provides a physical and psychological barrier to prevent movements of the spine into harmful and painful ranges of movement.
  
  
• Provides heat in the locality which will help soothe areas of pain.

The example shown above is just one of thousands of back supports available. Many can be ordered directly from the internet but they tend to be the less supportive variety. A recognized professional will give you advice on the optimum style for you depending on your shape and the condition from which you suffer.

For more information on back pain or to discuss a specific complaint, please contact us.