- Back Pain: Where Does It Hurt?
- Lower Left Back Pain from Internal Organs
- What Could Be Causing Pain on the Left Side of Your Middle Back?
- Right Side Back Pain
- What Is Causing Pain in My Upper Right Side?
- “I’m experiencing roundness in my shoulder, a bend in my knees when I walk, forward/backward head leaning, back pain, muscle fatigue, headaches, and stiffness in my joints.”
- “I’m experiencing chest pain, upper right back pain, difficulty/pain when breathing, fever, and coughing.”
- “I’m experiencing sudden pain in my abdomen, discomfort in between my shoulder blades, pain after eating a meal high in fat, irritation in my right shoulder, and nausea.”
- “I’m experiencing a dull type of pain in my upper right abdomen (below the ribs), backaches especially in my right shoulder, abdominal swelling, nausea, and loss of appetite.”
- Diagnosing the Lumbar Pain in My Lower Right Back Region
- “I’m experiencing pain that comes and goes, stiffness (usually in the morning), numbness, tenderness, lower back pain that runs down to my buttocks and thighs, difficulty walking or bending, and an aching type of discomfort.”
- “I’m experiencing dull pain near my belly button, sharp pain when I move or twist my right abdomen, loss of appetite, nausea, fever, sharp pain in my right lower back, constipation, and severe cramps.”
- “I’m experiencing severe pain on one side of my back (below my ribs), deep pain, pain located in my abdomen sometimes spreading down to my groin, painful urination, nausea, and fever/chills.”
- “I’m experiencing cloudy/blood urine, the need to go to the bathroom frequently, pain or burning when urinating, and cramping or pressures in my right lower abdomen and lower back.”
- “I’m experiencing soreness or tenderness in my back, pain that occurs suddenly, muscular spasms, pain that increases when I stand, walk, or twist, stiffness in my back, and sore muscle/tendon weakness.”
- “I’m experiencing sharp, radiating, or piercing pain in my legs/hip, numbness or tingling sensation, muscle weakness, and pain that worsens when I move.”
- Sciatica and Sciatic Nerve Low Back and Leg Pain
- 4 Facts About Sciatica Pain and Symptoms
- Where Sciatica Starts, How Sciatic Pain Travels
- What can cause sciatica symptoms to develop?
- Can over-the-counter medications help relieve sciatica symptoms?
- Is surgery necessary to relieve sciatica symptoms?
- What type of spine surgery may be recommended to treat the cause of sciatica?
- Continue reading: Sciatica Symptoms and Causes
- Back Pain Map
Back Pain: Where Does It Hurt?
When to See Your Doctor About Back Pain
Some back pain symptoms—and the location of these symptoms —are cause for greater concern. Although rare, back pain can be a symptom of a more serious medical condition, and you should seek medical attention promptly if:
- You have back pain that spreads down your legs, especially if it spreads below your knee. This could be a sign that you have a bulging or herniated disk.
- Your legs are weak, numb, or tingling. This means that there is involvement of the nerves and requires immediate attention.
- You have new bowel or bladder problems. This could signal a serious problem called cauda equina syndrome, a rare disorder that affects the bundle of nerves at the base of your spine and requires emergency medical attention.
- You have blood in your urine. This may be a sign of kidney stones. Kidney stones can cause sharp back pain that may become worse during urination. The pain is usually on one side.
- You have a fever or abdominal pain. This could be a sign of an infection or a condition that requires surgery, such as appendicitis. Infections of the vertebrae, disks, or even the pelvis or bladder can also cause back pain.
- You have had a fall or an injury to your back. Your doctor should evaluate you after any new injuries.
- You have been losing weight and can’t explain why. This could be a sign of cancer of the colon, rectum, or ovaries.
- The pain is a deep, dull ache in one specific spot over a bone, or it is continuous, even when you lie down and at night. These could be a sign of a tumor in the bone.
Lower Left Back Pain from Internal Organs
It is possible for left-sided back pain to be caused by a problem with one or more internal organs, such as from the kidney or colon.
See Lower Back Pain Symptoms, Diagnosis, and Treatment
Several common internal causes of lower left back pain include:
Kidney Stones. Lower left back pain from a kidney stone may be felt when a stone moves inside the left kidney, or moves through the ureters, thin tubes connecting the kidneys to the bladder. Other symptoms include pain with urination, difficulty urinating despite a persistent need to do so, blood in the urine, and nausea and/or vomiting.
Kidney Infection. An infection in the left kidney can cause dull or intense lower left back pain. Kidney infections usually start in the urinary tract and bladder, and from there can spread to the kidneys, causing local inflammation and pain in the kidney. Additional symptoms may include fever, nausea and/or vomiting, and painful or stinging urination. Pain is typically felt next to the spine above the hip, and typically worsens with movement or pressure.
Gynecological Disorders. Fibroids and endometriosis, two common conditions in women, can cause lower left back pain. Pain from endometriosis is usually sporadic, sharp and stabbing, and is caused by excess uterine tissue growing outside the uterus. Other symptoms many include abdominal pain, fatigue, and severe pain with menstruation. Fibroids—typically benign masses growing in the uterus—can cause lower left back pain, as well as abnormal menstruation, frequent urination, and pain with intercourse.
Ulcerative Colitis. An inflammatory bowel disease, ulcerative colitis is marked by persistent inflammation mostly in the large intestine, also called the colon. Inflammation usually causes chronic digestive issues such as diarrhea, rectal pain, and weight loss. Abdominal cramping is a common symptom of ulcerative colitis, causing sharp back and abdominal pain on one or both sides of the body.
In This Article:
- A Guide to Lower Left Back Pain
- Lower Left Back Pain from Spinal Structures
- Lower Left Back Pain from Internal Organs
- Causes of Lower Back Pain Video
Pregnancy. One-sided lower back pain can occur during pregnancy as the baby develops and the mother’s body accommodates. Pain can vary from a dull, constant ache to a sharp, stabbing pain. Exercise, stretching, rest, and some complementary therapies can help ease the pain.
See Back Pain in Pregnancy
Pancreatitis. This condition involves inflammation of the pancreas, which may cause upper abdominal pain that spreads to the lower left quadrant of the back. Patients may describe the pain as a dull sensation that may be aggravated by eating, especially foods high in fat.
View Slideshow: 7 Ways Internal Organs Can Cause Lower Back Pain Slideshow
A thorough diagnostic process by a qualified health professional should check for the above, and additional, possible causes of lower back pain. Sometimes, additional testing such as x-rays, CT scans, and/or blood tests may be recommended. It is important to seek prompt medical attention if the above conditions are suspected.
See Getting an Accurate Back Pain Diagnosis
What Could Be Causing Pain on the Left Side of Your Middle Back?
Middle back pain refers to pain that occurs below the neck and above the bottom of the rib cage.
The area contains numerous bones, muscles, ligaments, and nerves. Pain can come directly from any of these. It can also come from nearby organs that can cause referred pain that’s felt in the middle back.
There are a number of bone and muscle issues that can cause middle back pain on your left side.
A muscle strain occurs when a muscle is overstretched or torn. Heavy lifting or overworking your arms and shoulders can cause a muscle strain in your middle or upper back. When this happens, you may develop pain on one or both sides.
If you have a muscle strain, you may also notice:
- pain when you breathe
- muscle cramps
- muscle spasms
- stiffness and trouble moving
Poor posture often places extra strain on your muscles, ligaments, and vertebrae. This extra strain and pressure can cause pain in your middle back.
Common examples of poor posture include:
- hunching while using a computer, texting, or playing video games
- standing with your back arched
- slouching when sitting or standing
Other symptoms of poor posture include:
- neck pain
- shoulder pain and tightness
- tension headaches
According to the Centers for Disease Control and Prevention (CDC), more than 30 million people in the United States have osteoarthritis (OA). It develops when the cartilage within a joint begins to break down, usually over time due to wear and tear.
OA can affect any part of the spine and cause pain on one or both sides of the back. Other common OA symptoms include:
- limited range of motion or flexibility
- back stiffness
A pinched nerve can result from pressure that’s put on a nerve by surrounding tissues, such as cartilage, bone, or muscles. Depending on the location of the pinched nerve, you may feel pain on one side of your back.
Other symptoms may include:
- tingling or numbness in your arm, hands, or fingers
- sharp pain with movement
- muscle weakness in your back
A herniated disc can occur when one of the discs between your vertebrae is injured and ruptures. That causes the inside disc gel to leak and protrude through the disc’s outer layer. Pain in the area of the affected disc is the most common symptom.
You may also have:
- pain that extends to your chest or upper abdomen
- numbness or weakness in your legs
- leg pain
- poor bladder or bowel control
Spinal stenosis is the narrowing of the spinal canal. It can place pressure on the spinal cord and nerves within. Aging most often causes it, such as aging associated with the degenerative process of OA in the spine.
Along with pain on one or both sides of your back, you may also have:
- pain that radiates down one or both of your legs
- neck pain
- arm or leg pain
- tingling, numbness, or weakness in your arms or legs
Myofascial pain syndrome is a chronic disorder in which pressure on trigger points in your muscles cause pain. The pain is felt in the muscles and can also radiate to other parts of the body.
A common cause is the repeated contraction of a muscle due to repetitive motions from sports or job activities. It can also be the result of muscle tension from stress.
Other symptoms may include:
- deep muscle aches
- persistent or worsening pain
- tender knots in the muscles
An injury to any of the bones or tissues in your middle back can cause pain. Common causes of injuries are falls, sports-related injuries, and motor vehicle accidents. These can cause:
- muscle strains and sprains
- fractured vertebrae or ribs
- herniated discs
Symptoms of a back injury depend on the exact location and severity of the injury. Pain from a minor injury usually improves within a week or two.
A more serious injury can cause severe pain that doesn’t go away over time and interferes with your daily activities.
Right Side Back Pain
What Is Causing Pain in My Upper Right Side?
Are you having pain or discomfort in your upper right back area but can’t figure out what’s causing it? Don’t worry, we’re here to help! Read the symptoms below to help diagnose the pain in your upper right back.Your upper back plays an important role in your everyday movements so it’s no surprise that injuries and conditions can occur in your thoracic spine. But good news – injuries to your upper back are considerably less common in comparison to lower back injuries! The thoracic back and neck are less flexible than your lumbar spine, which is why a lot of underlying causes of right upper back pain frequently involve the internal organs that are protected by your rib cage. Since your ribs are located directly against your upper back muscles, rib cage irritation directly places stress on those muscles.
“I’m experiencing roundness in my shoulder, a bend in my knees when I walk, forward/backward head leaning, back pain, muscle fatigue, headaches, and stiffness in my joints.”
You Likely Suffer From Poor Posture
Practicing good posture has become more and more common due to the vast amount of desk and technology occupations that require individuals to sit at a desk for a long period of time. But many individuals are still unaware of the importance of correcting their posture and the benefits that’ll occur if they do so such as reducing migraines, promoting weight loss, increasing your oxygen and energy levels, and more. Having poor posture is highly correlated with back/spine pain because stress is placed on your joints, muscles, and bones in your back when your spine is in an unnatural position. Wondering what your current posture level is? Take our quick posture quiz to find out!
Ways to get rid of back pain from poor posture:
- Wearing a posture corrective brace
- Core strengthening exercises/stretches
“I’m experiencing chest pain, upper right back pain, difficulty/pain when breathing, fever, and coughing.”
You Likely Have a Respiratory Infection or Pneumonia
Pneumonia is commonly confused with a pulled muscle because it typically causes pain in the middle back region. Back pain is related to the lungs because of the location in which your lungs lie, and the problems can be referred directly to the muscles in your upper back. It’s important to know whether you have a family history of lung issues to determine if your upper back pain is a lung problem.
Treatment options for respiratory infections:
- Taking preventative methods such as washing your hands, covering the face while sneezing/coughing
- Antibiotics/Penicillin (if diagnosed with pneumonia)
- Drinking a lot of fluids
“I’m experiencing sudden pain in my abdomen, discomfort in between my shoulder blades, pain after eating a meal high in fat, irritation in my right shoulder, and nausea.”
You Likely Have Gallbladder Issues
The gallbladder lies directly below your liver and functions as a storage for bile or waste. The formation of gallstones is linked to high cholesterol levels, too much bilirubin (a chemical produced by the breakdown of red blood cells), if your gallbladder can’t empty properly.
Getting rid of gallstones by:
- Surgery to remove the gallstones
- Ask your doctor for bile salt
“I’m experiencing a dull type of pain in my upper right abdomen (below the ribs), backaches especially in my right shoulder, abdominal swelling, nausea, and loss of appetite.”
You Likely Have Liver Pain
The liver is located in the upper right quadrant of your abdomen, directly below your diaphragm. It’s a vital component of your body as it plays many roles such as detoxifying your body, correcting your metabolism, regulating your hormones, and more. There are many different conditions that could occur in your liver such as liver inflammation, fatty liver disease, liver abscess, and liver cancer. It’s advised to speak with your doctor to help determine further your liver condition or problem.
Liver pain remedies for men and women:
- Drinking a lot of fluids
- Avoiding fatty/heavy foods
- Sitting up with good posture
- Losing weight
- Lowering your cholesterol
Diagnosing the Lumbar Pain in My Lower Right Back Region
“I’m experiencing a sharp pain radiating down my back and one side of my buttocks or calf, pain that increases when I sit, a numbness/burning sensation, and weakness in the right side of my back.”Experiencing lower back pain? Don’t worry, that’s common! Lower back pain is extremely common due to the amount of stress and weight your lumbar spine holds. Your lower back functions as a support system when you walk, twist, turn, jump, and move around. That’s why the right lower back region is prone to numerous conditions and injuries causing pain/discomfort. To help further diagnose your lower right back pain, see if any of those statements below describe your symptoms!
You Likely Have a Pinched Nerve/Sciatica
Sciatica is actually a symptom of another injury and not a condition itself, confusing right? Sciatica occurs when the sciatic nerve is compressed or pinched as a result of another spinal injury such as a herniated disc, degenerative disc disease, spondylolisthesis, spinal stenosis, and si joint dysfunction to name a few.
Ways to get rid of my pain from a pinched nerve:
- Physical therapy
- Applying hot/ice packs
- Exercises and stretches
- Anti-inflammatory medications
- Sciatica/pinched nerve compression braces
“I’m experiencing pain that comes and goes, stiffness (usually in the morning), numbness, tenderness, lower back pain that runs down to my buttocks and thighs, difficulty walking or bending, and an aching type of discomfort.”
You Likely Have Arthritis/Osteoarthritis of the Spine
The term ‘arthritis’ refers to the swelling or inflammation in your joints. If you’re diagnosed with osteoarthritis or arthritis in your back, your facet joints have become inflamed. For every bone in your spine, you have three joints accompanying it; two facet joints and one spinal disc. These discs have a lot of stress and tension placed on them as they work to hold together your spine. Many individuals over 50 years of age are at a high risk for some sort of spine arthritis.
Best ways to treat arthritis in your back:
- Anti-inflammatory medications
- Hot/cold therapy
- Medical braces
You Likely Have Appendicitis
The condition appendicitis is when your appendix becomes inflamed. Your appendix is a large tissue that connects the small intestine to the large intestine and is located on the lower right side of your abdomen. If you’re experiencing appendicitis, your appendix is inflamed and if left untreated, could burst or rupture. Appendicitis typically occurs in ages between 10 and 30 years old.
Treatment options for appendicitis or appendix pain include surgery to remove the inflamed appendix (appendectomy). After surgery you should:
- Support abdomen region if you have to cough
- When ready to move around, start slow and increase your level of activity gradually
“I’m experiencing severe pain on one side of my back (below my ribs), deep pain, pain located in my abdomen sometimes spreading down to my groin, painful urination, nausea, and fever/chills.”
You Likely Have Kidney Issues
Your two kidneys function as the removal of excess fluid and waste from your body and are located in the upper abdominal area lying directly against the muscles in your back. One common cause of kidney pain is having kidney stones or kidney flank pain. Kidney stones are small mineral deposits that are formed inside of your kidneys, and when they stick together, the passing of kidney stones occur.
How to eliminate kidney stones:
- Drink plenty of water
- Anti-inflammatory medications
- Using medical therapy – alpha blockers
- Surgery procedure – for large stones
“I’m experiencing cloudy/blood urine, the need to go to the bathroom frequently, pain or burning when urinating, and cramping or pressures in my right lower abdomen and lower back.”
You Likely Have a Bladder Infections/UTI
A bladder infection (also called UTI), occurs when there’s a bacterial infection in your bladder and is a common cause of back pain on the right side of your body. Women or females are more prone to such infections due to the length of their urethra compared to men.
Treatments for a bladder infection/UTI for a woman:
- Drink a lot of water, especially in the initial hours
- Drink cranberry juice
- Urinate frequently
- Intake foods with a large amount of vitamin C such as oranges, kale, brussel sprouts, strawberries, and grapefruit.
- Apply heat to your abdomen
- Avoid caffeine, spicy foods, acidic foods, sugar, and dairy products
“I’m experiencing soreness or tenderness in my back, pain that occurs suddenly, muscular spasms, pain that increases when I stand, walk, or twist, stiffness in my back, and sore muscle/tendon weakness.”
You Likely Have a Muscle Strain/Pull/Tear
Muscle strain happens when the muscles and ligaments in your body are over-stretched or torn. This type of strain usually causes the area to become inflamed. This inflammation can create a lot more problems for an individual, including back spasm – which can be extremely severe.
Eliminating pain from a muscle strain/pull/tear:
- Anti-inflammatory medications
- Muscle relaxants
- Physical therapy
- Ice and hot therapy
- Back support braces
“I’m experiencing sharp, radiating, or piercing pain in my legs/hip, numbness or tingling sensation, muscle weakness, and pain that worsens when I move.”
You Likely Have a Herniated or Slipped Disc In Your Spine
At birth, your spinal discs are composed of around 80% of water but as you age, you tend to lose some of this water content. In order for your spine to function properly, these discs must be well hydrated. When these discs lose that water content, they become less flexible, leading to a herniated disc. A herniated disc is when the inner core ruptures, it then pushes through the crack of the outer piece.
Common treatments for a herniated disc in your spine:
- Physical therapy
- Chiropractic manipulation
- Anti-inflammatory medications
- Epidural injections
Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg.
The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg.
It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.
Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood.
Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.
Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.
The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body. Sometimes the pain switches between right and left sides.
Some patients also report:
Pain in the rear or leg that is worse when sitting
Burning or tingling down the leg
Weakness, numbness, or difficulty moving the leg or foot
A constant pain on one side of the rear
A shooting pain that makes it difficult to stand up
Pain from sciatica often begins slowly, gradually intensifying over time. For some people, the pain from sciatica can be severe and debilitating. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse.
In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements. Seek immediate medical attention with any symptoms of progressive lower extremity weakness and/or loss of bladder or bowel control.
Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, how often you have the pain and what activities lessen or intensify the pain.
Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your ranges of motion. X-rays may be taken of your back.
Finally the doctor will arrive at a diagnosis and treatment will begin that first visit.
For most people, sciatica responds very well to conservative care, especially chiropractic. Keeping in mind that lower back pain is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem. Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation.
A chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, TENS or electric stimulation, soft tissue or manual therapy, traction, Kinesiotaping and rehabilitative exercises.
Depending on the severity of the condition, the patient will need to be treated multiple times. The doctor will explain your treatment plan at the second visit.
Why multiple visits? This can be compared to working out. If you don’t exercise for a long time, your body is out of shape and it takes several trips to the gym to get in shape and build up your strength and endurance. Similarly, if you have never been adjusted, and do not practice good back health, it takes a few visits to put your body back in alignment and proper posture.
Call Coughlin Chiropractic at 317-546-9882 for your appointment.
Contact Us for additional information
Sources: ACAToday, WebMD
Sciatica and Sciatic Nerve Low Back and Leg Pain
Written by Stewart G. Eidelson, MD
Sciatica is pain that radiates from the lower back along the sciatica nerve. Sciatica is a type of lumbar radiculopathy; a condition described as pain and/or sensations (eg numbness, tingling) that travels downward into one or both legs. Pain is the hallmark sciatic symptom and classic sciatica radiates below the knee.
Typically, sciatica causes pain, numbness and/or tingling in one side of the lower back and the associated left or right leg. The sciatic nerve has several smaller nerves that branch off from the main nerve and enable movement and feeling (motor and sensory functions) in the thighs, knees, calves, ankles, feet, and toes.
Leg pain that descends below the knee is the classic hallmark of sciatica, a type of lumbar radiculopathy. Photo Source: 123RF.com.
4 Facts About Sciatica Pain and Symptoms
- Sciatica symptoms may begin gradually or suddenly.
- Pain is characterized as being sharp, shooting or electric shock-like.
- Movement, such as walking can intensify pain.
- Sometimes pain feels uniformly distributed through the leg, but frequently some areas of the leg may be more painful.
Where Sciatica Starts, How Sciatic Pain Travels
The sciatic nerve is the longest and largest nerve in the body; its diameter is about three-quarters of an inch. It originates in the sacral plexus; a network of nerves in the lower back (lumbosacral spine). The lumbosacral spine refers to the lumbar spine (lumbo) and the sacrum (sacral) combined.
The sciatic nerve exits the sacrum (pelvic area) through a nerve passageway called the sciatic foramen. At the upper part of the sciatic nerve, two branches form; the articular and muscular branches. The articular branch goes to the hip joint. The muscular branch serves the leg flexor muscles (muscles that enable movement).
Other complex nerve structures are involved—the peroneal nerves and tibial nerves. The peroneal nerves originate from the nerve roots at the fourth and fifth lumbar spine (L4-L5) and first and second levels of the sacrum (S1-S2). After the peroneal nerves leave the pelvis, they travel down the front and side of the legs, and along the outer side of the knees, to the feet.
The tibial nerves originate from the nerve roots at L4-5 and S1-3. The tibial nerves pass in front of the knees and downward into the feet (eg, heels, toes).
What can cause sciatica symptoms to develop?
Sciatic nerve compression causes sciatica symptoms sometimes referred to as a lumbar or low back radiculopathy. Common sciatica causes include disorders affecting the lumbar spine, such as herniated disc, degenerative disc disease, osteophytes (bone spurs) or spinal stenosis. Rarely does a spinal infection or tumor cause sciatica symptoms.
Can over-the-counter medications help relieve sciatica symptoms?
Is surgery necessary to relieve sciatica symptoms?
Most patients with sciatica symptoms or lumbar radiculopathy respond well to non-surgical treatments, such as medication and physical therapy. Seldom is spine surgery required to treat sciatica. However, there are situations when spine surgery is recommended.
- Bowel and/or bladder dysfunction (rare)
- Severe leg weakness
- Non-surgical treatments are not effective, or no longer reduce sciatic symptoms
What type of spine surgery may be recommended to treat the cause of sciatica?
The type of surgery recommended depends on the diagnosis, number of spinal levels requiring treatment and surgical goals. Spinal decompression is a procedure the spine surgeon performs to remove whatever is pressing on the sciatic nerve—such as a disc herniation. Many patients are able to undergo decompression surgery in an outpatient or ambulatory spine center without being hospitalized. Also, many surgical procedures can be performed minimally invasively.
Traditional discectomy is performed open, meaning through a long incision whereas microdiscectomy is the same procedure performed minimally invasively through tiny incisions. During either procedure, the surgeon removes the entire disc or the portion of the disc compressing nerve(s).
Both procedures involve a part of the spine called the lamina—a thin bony plate that protects the spinal canal. The lamina is located at the back or posterior spine between two vertebral bodies. The difference between these procedures is the amount of lamina removed to access bone, disc or other soft tissue compressing spinal nerve roots.
- Laminotomy involves partial removal of the lamina.
- Laminectomy involves total removal of the lamina.
By partially or entirely removing a lamina, the surgeon can access the bulging or herniated disc from the posterior spine. Of course, the surgeon may remove other tissue (eg, bone spur) pressing on a spinal nerve root at a particular spinal level (eg, L4-L5).
Continue reading: Sciatica Symptoms and Causes
Updated on: 12/23/19
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PainSpot was created by Douglas Roberts, MD, an independent clinical rheumatologist with 30+ years of experience diagnosing and treating patients with arthritis and musculoskeletal diseases. Dr. Roberts saw firsthand how his patients struggled to understand the causes of their pain while experiencing frustrating delays getting to the right doctor, the right diagnosis, and the right treatment plan. Dr. Roberts developed the first version of PainSpot — an online risk assessment tool that is easy to use and accessible to everyone — based on the clinical decision-making tools that doctors use to diagnose patients.
The aim of PainSpot is simple: to educate and empower you to better understand your health so you can get diagnosed and treated faster.
PainSpot is offered to you for free, as it is now part of the Global Healthy Living Foundation, a patient-centered non-profit organization with the mission to improve the quality of life for people with chronic illness. GHLF is also the parent organization of CreakyJoints, the digital arthritis community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research via ArthritisPower®, the first-ever patient-centered research registry for joint, bone, and inflammatory skin conditions.
PainSpot can help you figure out what is causing your pain but should never replace the guidance of your health care professional. Once you receive a diagnosis from a qualified health care provider, GHLF, CreakyJoints, and ArthritisPower are here to help you manage and live your best life, despite your diagnosis. We will never ask you for money or a donation.
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Doctors can use several tests to “look inside you” to get an idea of what might be causing the pain. No single test is perfect in that it identifies the absence or presence of disease 100% of the time
If there are no “red flags,” there is little reason for imaging during the first 4 to 6 weeks of acute back pain. Because about 90% of people have improved within 30 days after the pain starts, most doctors will not order tests in the initial evaluation of acute, uncomplicated back pain.
Plain X-rays are generally not considered useful in the evaluation of back pain, particularly in the first 30 days. In the absence of red flags, their use is discouraged. They may be needed if there is significant trauma, mild trauma in those older than 50, osteoporosis, or prolonged steroid use.
Myelogram is an x-ray study in which a radio-opaque dye is injected directly into the spinal canal. Its use has decreased dramatically since MRI scanning and the test is now usually done along with a CT scan. Even then, it’s only done in special situations when surgery is being planned.
An MRI is a highly sophisticated test and is very expensive. The test does not use x-rays but very strong magnets to produce images. Their routine use is discouraged in acute back pain unless a condition is present that may require immediate surgery, such as with cauda equina syndrome or when red flags are present and suggest infection of the spinal canal, bone infection, tumor, or fracture. An MRI may be considered after 12 weeks of symptoms to rule out more serious underlying problems.
MRIs are not problem free. Bulging of the discs is noted on many MRIs done on people without back pain. Such findings can lead to unnecessary treatment.
Electromyogram or EMG is a test that involves placing very small needles into the muscles. Electrical activity is then monitored. Its use is usually reserved for more chronic pain and to predict the level of nerve root damage. The test is also able to help the doctor distinguish between nerve root disease and muscle disease.