Back pain can arise from a sudden injury to a disc, muscle or joint, or a problem can develop over time without a specific known cause. The neck and lower back are the areas most often affected. Surgery is usually not necessary, as many conditions improve with rest, activity modification and physical therapy.

Disc Herniation

If someone tells you they have a "slipped disc," they are talking about a herniated disc, a fairly common condition that can cause neck and back pain, sometimes radiating down the legs.

Over time, the ability of the discs in our spine to absorb force and facilitate movement deteriorates and their structure weakens. This is why we are more likely to develop a herniated disc as we age.

A herniation, or rupture, occurs when a portion of the disc buckles in response to excessive pressure or force.

As we get older, our discs become less flexible. They begin to shrink and the spaces between the vertebrae get narrower. Conditions that can weaken the disc include:

  • Improper lifting

  • Smoking

  • Excessive body weight that places added stress on the discs

  • Sudden pressure, even slight

  • Repetitive strenuous activities

The weakened discs may leak the jelly-like inner material, which may occupy space within the spinal canal. If this occurs, nerves exiting the spinal cord may become compressed, causing radiating pain down the buttocks and/or leg, along with tingling and numbness. Surrounding muscles may also become overly tight to protect the spine against further herniation, and this can lead to muscle strain.

Spondylolisthesis

Spondylolisthesis is a condition in which a vertebra (small bone) in the lower part of the spine slips out of the proper position onto the bone below it. In adults, the most common cause is a degenerative disease such as arthritis.

Spondylolisthesis can cause symptoms ranging from mild to severe. A person with this condition may have no symptoms at all or may end up needing surgery.

The condition becomes painful when it causes a compression of the spinal cord or nerves. This can generate symptoms of radiating pain, tingling or numbness down one or both legs. This typically occurs in the low back. In some people, spondylolisthesis requires surgery to correct the problem and prevent further injury.

Facet Arthropathy

This condition occurs when the articulating joints of two or more segments of the vertebrae become misaligned. As a result, movement at the misaligned joints will be limited. Spinal vertebrae above and below the misalignment may take on more load and movement and/or develop abnormal postures and movement patterns. This can cause regional pain or pain that radiates to other parts of the body.

Spinal Stenosis

Spinal stenosis occurs when the space around the spinal cord narrows. This can happen due to disc degeneration or arthiritic changes in the vertebrae or degeneration of the spinal discs.

The narrowing can put pressure on the spinal cord and the nerves, and can cause radiating pain, numbness or weakness in the buttocks or legs. Spinal stenosis occurs mostly in people older than 50.