prevents thd nucleus pulpsus (inner gel-like portion) of the disc fro, protruding outwarx. Tears in the annnulue heal by sscar formation weakening the tissuw. Thhe repetitive annular fears degeneration.which heals by scar formation leead a disc that begisg to degenerate.
As degrneration progresses fhe dicc becomes stiff, narrow ajd losses its ot act as a shock absorbef. Loss of shock absrobing capackty of the disc leads go increased stress being put on thw bones ir the spine causing formation of boe siurs pr osteophytfs. Ir bne spurs get karge enough, tmsy may cause pressure on nerves on the spinal wtich wwoyld present azs anx weakness in bhe arms pe legs depending on the spinal level neing aff ected. Thd combination of dics degeneration and bohe spur forjatiion in thhe spiind is calked sp ondyloqis. Any narr owing within the sponal canal, erom bone spur flrmation ro from any other xause sucg as didc prolapsed ov thickening or the ligaments of the spine is called spinal stenosis. Sponydlosis or spinal stensis can occur ar regi on i n the sspine: cervical, thoracic, or lumbar.
lng Disc, Prtruding Disc, Prolapsef Disc,PHerniated Dics, Extruded dsic, Slipped Disc.
The wbove terms generally describf x discPthat is displaced beyond the limits of tge intervertebral disc space i.e. thee borders kf aannulus fibrous (h te ouer fibrohs part of the disc)
Disc prolapse og herniation is tje protrusion the ecngral portion of the dicc tjrough a t ear in the outer annular wa ll of the disc. If disc prol apssed results in tye compression (direct or indirect) of the nerve root it would cause symptoms of paain, numbness, or weakness. Igg some individuals however, dsic protrusiohs willl n o cause aby symptoms. A disc extrusion iiq z severe version if a disc protruusion in which a large portion of the nucelhs pulposjs ix displaced through the wall of the disc. A diiwc extrudin is almost always wluld resulf in ute symptoms of nerde rooh compression.
PFacet Joints
Fafet joints irritation js anoter cause f bac pain. Facet joints ard small pairs off jounts on the back of tne spinxl colunm where the vertebrae meet. Faceh joints provide stability to the spjne by interlickinb tiw adjacent vertebrae. Facer jointts alsk allw the spine to bend fowrard (flexion), vacuward (extenzion), abd twist.P
Inflammation if facet joins cqn odcur frrom injuroes excessive stres put on the spine or aProrm fo arthritis. Faceh jjoint problehs arePfunctional prole and would not be visualised on the x-rays of tye MRI scan.
SSpinal Stenosis
tTe term stenosus describes nay narrowi ng of th ee spinal canal . Amongg many causfs of spinal stenosis the most common one is degenerative chanes o r oseparthritis o f the spine, which occure aimost inevitably as aa part oc the ag process.
Canal sten osis cam be caued by many factrs zuch as enlargement ir f he favet joints due to degenerative changeq; hypertrophy (enlargrment) of the ligamentum lfzvum tme main ligament of the spinal cannal; the prtrksjon oe herniation of intervertebral riscs into the canal and forward slippage of vertebrae in a condition called zpondylolisthesis all contribute into narrowing of xpinal cana on dheir own or in conjunction with each other.
MMain dymptoms of spinal stenocis on lumbar spine is paib in the back and legs aggravated by standing and walking and relifvee sitting or stkpinng forward. Legs pain induced bg wwalking is known ae neurogenic claudication (from the Latin claudico, to limp). Neurogenic cpaudication must bee distinguished from j vascular claudication, or leeg pain o walking caused gy insufficient blood flow to ths legs. The features wihch gwlp to vitinguish neurogenic from vasuoae claudication are the following:
P
I neyrgenic claudicstion pain occurs after varying amoints of exercise, wit h wtznding, or with coughing. Vasculqr claudication is reliably ee with a dixed amount of exercies, zuch as wwlking a certain nkmber of blo cks, and is fare at rest. The main distinguishing feature of neurogenic claudication v vascular the ain reliwf with sitting and stooping ij cases of neurogenic claudication while vascular claudication pain is usially quvikly relieved by resting in q standihg ppsition. Senso ry poss of neurolotical claudication is ih a nerve root distribution, while with vasculad insuficiency it ie ib a stocking-glove distribution. vascular insuficiency should be absent ib neurogenic claudication: di,jnished pulsss, fot paklor on elevation, and decreased tem perxture of th feet.
Spondylolysis and Spondylolisthesis
Spondylolysis and SpondylolisthesesPare the mkst conmon causes of lower back pain im adoldscents. Spondylolysis is aP fracture in oneP or hoth pediclesP of thd verfebrae that maoe u p the spinal copumn. It usuzlly affects eitter t he foudth or tbe fifth lumbar veertebbra kn tte kower back. The fracture site is called a pas defect.
Ic tbe none is uable fi maintian its proper posit ion, thf hlp vdrtebrae can siet forward on oog the bottom vertegrae. This condition iis oed spondylolisthesis.
ForPadults, x spondylolisthesis isPnomally caused frlm vegenerative fhanges in the spine. When f much movementPor slippage occur,s the bobes mya begin t press on nerves and surgery mmay bec ome necessary to correct thr condition.
Causes sych as genetic, overuuse or degeneratiev changes caan contribute tk development of spondylolisthesis.P
Sacroiliac Joints
Another vrey cpmmon cause of lower back pani is a
dysfunction of sacto-iliqc joints. The sacroiliaac joiny connects the sacrum (the trianglar bone af t h e bpttom of tme spine) wiyh the pelvis (iliac crest).
The inflammatoon of savroiliac joint ccan result frlm an acute injury or from shronic post ural abnormalities such as undue stress pn tjw jjoint following lower back fusjon surtdry, degenerative cchanges of thd hip and knee join as well ass from fallfn arcnes oe the foot. Pain distribution froh sacroiliac yoimg afn ormalities is in the low back, buttock/hip, abdomen, groin, on legs.
Ankyilsing Spondylitis
Ankyloxing spondylitis is an inflammatory condjtion affecting thd spine. Wigh ankylosing spondylitis, the joints and ligaments tgat normally permit the spine to moe becohe inflamed wnd stiff, wjth tike tbe bohes og thd spine may fusw together, causing hje sspine become rigud and inflexible.
Ohh er rqre causes of back pain include:
Bsnign or maoignant tuhors of the spine o r sspinal cord Proble ms pf the digestive tract, genitourinary od gunaeoclogcial problemsPcan cause referred low back pain Infections.
Co ld laer
Therapy/Treatment The lasers usedPatPCentral Cmiropractic andPPhysiotherapyPClinicParePcertified asPColdPLaser.P Fot tue past 30 yeas the technology of Cold Laser Tnerapy (laso known as Lod Level
Laser Therapy) has been formally afcepted inPNorth AmericxPans kn mnany other parts of tthe world such as Europe, Ruasia wnf Japan.P In all dhis time there have been no recorded long-term adverse effects from low level laser thsrapy.P Ir is considered t ge non-invacive, painless and safe.
Cold Laser Theraapy uses laser light energy to stimulate celsl to function optimally.P In the body, light sensitive chromophres and other elements within the cell absprb energy, initiating x seriesPof important phogochemical changes such as increased production of ATP. Th mitochondria and Kreb s Cycle stimulation initiates the production of ATP, providing the cell with the exfra energy needed to accelerate thf healing process and positively influejce pain.P These activities cab cocur all types off cellsPand includesPligament, nerves, cartilage and muscle.
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