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Disc Herniation- A herniated disc in the lower back may cause pain if the disc is irritating a nerve. The pain usually affects the buttocks, thigh, and calf. A disc herniation may also cause pain in the foot. Other symptoms of a disc herniation in the lower back includes numbness, tingling, and weakness in the leg.
Risk factors for developing a herniated disc includes obesity, smoking, and having a physically demanding job.
Treatment for a disc herniation is dependent on the severity of the symptoms. Treatment may
include oral medication, epidural steroid injections, physical therapy, and chiropractic care.
Lumbar spondylosis- refers to age related changes of the spine. These changes include osteoarthritis, the development of bone spurs, and the shrinkage of disc in the lower back. Some patients with lumbar spondylosis do not have any symptoms. However, symptoms of spondylosis include back pain, stiffness, tingling, numbness, and weakness in the legs. Risk factors for developing lumbar spondylosis includes age and smoking.
MRI of the lumbar spine is used to determine areas in which a nerve is pinched. Electromyography testing is also used to determine nerve function.
Treatment of lumbar spondylosis helps reduce pain and improve mobility. Treatment options include oral medication, epidural steroid injections, radiofrequency ablation, physical therapy, and chiropractic care.
Spinal stenosis- A condition in which the spaces of the spine become narrow. Spinal stenosis can cause nerves to be irritated which causes pain. Symptoms also include tingling, numbness, and weakness of the legs and may become more severe as time progresses. Patients with lumbar spinal stenosis may have pain in the back and legs when they stand and walk. Severe spinal stenosis may cause progressive paralysis and incontinence if untreated.
Imaging of the lumbar spine is used to diagnose spinal stenosis and evaluate the severity of the condition. Treatment varies based on the severity of the spinal stenosis. Treatment options include oral medication, epidural steroid injection, physical therapy. Surgery may be advised if other forms of treatment are not effective or to prevent worsening symptoms.
Compression fracture-a compression fracture occurs when the bones in the spine become weak. Sudden collapse of the vertebral can sometimes be triggered by a fall, bending, lifting, coughing or sneezing.
In some cases, pain medication and back brace to restrict movement can allow the fracture to heal on its own.
If the pain is severe, an injection of cement into the fractured vertebral body is useful to relieve the pain. This is an xray guided procedure and is performed as an outpatient, with patients returning home the same day.
Given compression fractures are often related to osteoporosis, medications to improve bone strength are often prescribed to lower the chance of additional fractures in the future. Examples of such medicines include Prolia, Forteo and Tymlos.
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