Sciatica Back Pain and Other Medical Terms You've Heard Used

Degenerative Disc Disease

The discs consist of two layers: a tough, fibrous outer ring or cylinder (annulus fibrosus) and a gelatinous core (nucleus pulposus). A disc is like a jelly donut, only sealed at top and bottom to neighboring vertebrae.

Disc breakdown may range from mild disc bulge, to more severe disc bulge (herniation), to rupture of the disc with extrusion of disc material, to conversion of the disc into bone (fusion). Disc breakdown may occur anywhere in the spine, including the neck.

While defined as a disease, Degenerative Disc Disease is no more a disease than a blowout of an overloaded tire is a disease of the tire. The breakdown comes from mechanical causes -- overcompression.

Tight muscles of the back (the spinal extensors) pull neighboring vertebrae together, compressing the discs in between. Over time, the combination of overcompression and movement causes discs to break down.

Breakdown can be stopped by relieving the pressure caused by spinal muscles. Then, healing can begin.

Herniated (Bulging/"slipped") Disc

A sign of of disc overcompression, discs herniate when overcontracted back muscles tighten along the spine and pull vertebrae too closely together for a long time. The pressure causes the jelly center to push against the containing outer cylinder of the disc (annulus fibrosus). This pressure causes bulging, much as overpressure on an overloaded tire causes the tire to bulge -- or imagine what happens if you squeeze a jelly donut.

Over time, the disc may break down under the pressure and the bulge increases, sometimes to the point of rupture, and at other times, to the point of weakening the disc wall.

Ruptured Disc

Disc Tear or Torn Disc

A consequence of violent injury, disc tear may appear symptomatically similar to a bulging disc but cannot be treated effectively by muscular retraining, traction, massage or other non-invasive techniques because the muscular contractions are protective in nature. The muscular contractions are stabilizing a length of spinal column that has lost its structural support.

A torn disc is a surgical situation.

Spinal Fusion

A surgical procedure, spinal fusion is a man-made way of recreating a natural end-process of disc breakdown: the growth of bone to replace degenerated discs. In the procedure, the ridges (spinous processes) and rear wall (laminae) of vertebrae are surgically removed (laminectomy), the disc or discs removed, bony material (generally the size and shape of matchsticks) placed to grow over the surgical wound, and the patient placed in a torso cast. The result is a rigid spine incapable of its normal flexibility, but stabilized to prevent nerve impingement. Pain sometimes remains due to reflexive muscular contractions at the surgical site.

Spinal Subluxations

The term, originating in Chiropractic, refers to misalignments of neighboring vertebrae. Such misalignments adversely affect posture, movement, and organ function by affecting nerve signal transmission.

Bones go where muscles pull them. Abnormal (habituated) tensions in the spinal muscles pull vertebrae out of alignment. As muscular functioning normalizes, spinal alignment usually normalizes spontaneously.

Scoliosis

Abnormal curvature of the spine. While a normal spine exhibits curves and the natural curvability that allow flexibility, some people exhibit spinal curvatures that interfere with normal movement and distort posture.

Scoliosis has been classified into several categories that describe type of curvature and degree of severity. Without going into detail about the varieties of scoliosis, it can be said in general that scoliosis can be classified into "structural" and "functional" types. Structural scoliosis involves distortions of bone growth. While not correctible by non-surgical means, some procedures can improve comfort and mobility within the limits of the scoliosis. Functional scoliosis arises from muscular pulls that may arise from injury and subsequent casting of an extremity. It is often correctible by non-surgical means (see below).

Common medical treatments for scoliosis involves casting, the wearing of a brace, insertion of metal rods along the spine, or spinal fusion surgery.

Back Injury vs. Muscle Spasm

People commonly confuse spinal injuries with muscle spasms.

Spinal injuries involve changes in bone structure or soft-tissue consistency: fractured vertebrae, degenerating discs, torn or stretched ligaments, nerve damage. Spinal injuries require substantial healing time -- or may never heal.

Muscle spasms -- painful muscular contractions -- though painful, do not constitute an injury. Though symptoms of nerve impingement (tingling, burning, numbness, loss of muscular control) may accompany muscle spasms and mimic a spinal injury, these symptoms often disappear nearly instantly, once muscle spasms relax. Muscle spasms can often be induced to relax through somatic methods relatively quickly.

Referred Pain

This term, familiar to physical therapists, has to do with pinched nerves (nerve impingement). It refers to pain at a location other than at the location where the nerve pinch exists.

Sensory nerves end at brain connections corresponding to the body part they sense. A nerve that reports on the state of the foot ends in a brain connection that corresponds to the foot. That nerve “refers” to the foot.

If the nerve to the foot gets pinched, the brain interprets the nerve signal that results as a sensation of the foot. If the nerve that reports on the state of the buttock area gets pinched, the brain interprets the nerve signal as a sensation of the buttock.

Facet Joint Syndrome

The facet joints are bony projections on vertebrae. Generally, these bony projections on neighboring vertebrae don’t touch each other, but muscular contractions along the spine pull neighboring vertebrae together and may cause those facet joints to meet with undue pressure and friction.

Another type of face joint exists where ribs meet vertebrae. Excessive tension of the muscles that control rib movement may also cause a kind of facet joint syndrome.

Radiculopathy

This is another term familiar to physical therapists. It refers to tingling and numbness in the extremities that result from nerve impingement (a pinched nerve). The term implies damage to a nerve root where it exits the spinal column.