Thank you for joining me again this evening for our nightly podcasts. I perform these podcasts in the hopes that you will be able to education yourself on the topics discussed so you can make better informed medical decisions regarding your health in the future. I am doctor Harrison Campbell of Restoration Health a premier sugar land chiropractors office. Previously we discussed sciatica, potential conditions where the term sciatica is incorrectly used, and some treatments which can benefit patients suffering from sciatica. Tonight, we will be discussing low back pain and we will be differentiating from facet syndrome and disc herniations specifically.
Low back pain is a broad category when it comes to describing conditions which people suffer from. You can have back pain with anything from pulled muscles to constipation, menstrual cramps to disc herniations, facet syndrome to cancer. The symptoms associated with these conditions help sugar land chiropractors differentially diagnose them to apply the correct treatment to help the patient return to health as quickly as possible pending the potential for recovery.
We have discussed disc herniations several times in the past ad we will cover it again tonight. The intervertebral disc is a shock absorber for the spine. There are two main components of this disc which sugar land chiropractors call the nucleus pulposus and the annulus fibrosis. The Nucleus pulposus is the jelly like core of the disc while the annulus fibrosus is the tough fibrocartilaginous shell providing strength and flexibility to the disc. During a disc herniation, the fibers of the shell tear weakening the shell allowing for a bulge to occur. This bulge irritates the nerve root which sits behind the disc in the spinal canal.
These irritated nerve roots are where the radicular and neurological symptoms come from in a disc injury. The nerve is a sensitive structure and when irritated sharp pains can travel down the length of the nerve, which for the low back means down the legs to the feet. Additionally, there can be numbness and tingling along the dermatome for the nerve which is irritated or the more progressive form of sensation loss. Motor control can also be affected which means there is decrease muscle contraction or loss of muscle control completely.
On the other hand, we have only discussed facet syndrome once. Facet joints are the small joints which connect one vertebra to another and allow for the motion we enjoy via our spines. As sugar land chiropractors can tell you these small joints can cause big problems should there lose their normal motion. In lumbar facet syndrome of more accurately lumbar dorsopathy the facet joint locks in place preventing normal motion. This creates inflammation and pain in a diffuse pattern. The location of the pain pattern depends in which facet joint is affected.
Now low back pain is the number one cause of pain in the United States today and the tow conditions mentioned above are two of the most common conditions plaguing patients with this pain. The best way to differentiate these conditions from one another is typically the radicular symptoms and the motions which aggravate the pain.
Typically in facet syndrome there are not radicular symptoms means that numbness and tingling, loss of sensation, decreased motor skill, or loss of motor function are not usually seen with facet syndrome. Now the tricky part comes in with the referral pattern for facet syndrome pain. Facets in the low back as sugar land chiropractors can tell you can create pain into the glutes or down the back of the leg in the referral pattern. This can seem like radiating pain or traveling pain to the patient.
Motion wise, facet syndrome pain levels increase with extension. The reason for this, is due to extension placing pressure on the facet joints as it brings them in closer approximation to each other. For a disc herniation the motion as sugar land chiropractors know is a little less specific to the condition as a whole and more sensitive to each individual disc herniation. For instance most disc herniations are not directly posterior but more posterolateral. This means that a right posterolateral disc herniation with usually have the patient antalgic to the left with a slight bend forward at the waste. This is instinctually pulling the disc herniation away from the nerve root that is irritated most likely. If you have the person stand straight and lean right their pain would increase dramatically, but if you take someone who has a left posterolateral disc herniation, the exact opposite would be true. Generally for motion in disc herniations though as flexion increase the strain on the disc fibers increases which result in increased levels of pain.
Some people may also be wondering why the level of pain cannot be used to distinguish these conditions. The simply fact is that there are times when facet syndrome can top the pain scales depending on the situation and the individual. As sugar land chiropractors will tell you, no two patient pain scales are alike. What is a six out of ten on the scale for you may be an eight out of ten for someone else. Or it can be a four out of ten. Or it can be a one out of ten. The downside of the numerical pain scale is it is dependent on the levels of pain the patient has experienced in their past, or the pain levels they recall having experienced in the past. This can render the pain experienced by the two conditions as a non-reliable factor for differential diagnosis.
Thank you for joining me again this evening for another great podcast. I hope you enjoyed the discussion on the differences between a disc herniation and facet syndrome. As always should you or someone you know require a sugar land chiropractors services or simply have more questions on what was discussed please call Restoration Health today. We would love to schedule you an appointment and get you on the path to better health today. Thank you once again for joining us. Have a good night.