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The process of aging may have multiple impacts and/or effects on the spine, with myriad symptoms expressed. Some symptoms of a more severe, underlying condition may include neck pain, back pain, and sciatica nerve pain, also known as sciatica. Some consequences of aging that lead to pain are degenerative disc disease, spinal stenosis, and herniated discs. In addition to these conditions or pathologies, an individual may develop osteophytosis, bony spurs or bridges from one vertebral body to the next, osteoarthritis, sacroiliac joint dysfunction, and a myriad of other, often related pathologies. Sciatica is often a consequence of one or more of the above mentioned conditions. The medical term for sciatic nerve pain, also known as sciatica, is radiculopathy. Radiculopathy is a term that means, in layman's English, that the disc in between the vertebral bodies is out of position and is irritating the nerve root, the radicular nerve. Sciatica may be experienced at any point along the nerve route. Specifically, sciatica is a symptom or set of symptoms. Sciatic nerve pain is not the ultimate diagnosis but rather an expression of the pain itself. In its simplest expression, sciatica is pain that generally radiates across the buttocks and down one or both legs. The reason sciatica is referred to as a set of symptoms instead of as a diagnosis is because it does not explain the underlying cause of the pain. In fact, there may be many causes and or many factors that are contributing to what we commonly referred to as sciatica. Sciatica may range from a slight discomfort in the buttocks or behind the knee to a severe, debilitating, and even disabling and/or crippling level of pain. In most cases, sciatic nerve pain will affect or impact only one side of the body, pain may be limited to a single region or it may express itself all the way down the leg and even into the toes. The actual sciatic nerve pain or sciatica may range from mild discomfort and tingling to a burning sensation that worsens upon sitting. Weakness, loss of feeling, and even loss of function may be a consequence of sciatica. Because the condition is a symptom and not the ultimate diagnosis, if it should last more than 48 to 72 hours, a medical practitioner should be consulted. Degenerative disc disease is but one cause of sciatic nerve pain or sciatica. However, it is one of the most common, if not the most common, of the many causes of not only sciatica but also back pain and neck pain. Degenerative disc disease is one of the most misunderstood of all spinal pathologies. Because it is termed "degenerative" people often assume that there is a progression, ultimately worsening with age. In fact, the opposite seems to be true, the degeneration of the intervertebral discs (IVDs) is a natural consequence of aging. Pain associated with degenerative disc disease, like sciatica itself, ranges in its expression from mild to severe. Degenerative disc disease is, in fact, completely mislabeled, for it is neither degenerative in the sense that it is a relentless, ongoing pathology, nor is it a disease in the sense that it is an illness. It is not! Finally, if diagnosed with degenerative disc disease, you are not doomed to a progression ultimately leading
to disability but, rather, it is within your power to deal effectively with the symptoms of low back pain and sciatica. Spinal stenosis or simply stenosis generally refers to a narrowing of the nerve canal through which a nerve or bundle of nerves pass through. So, if you picture a small hole, one that over time becomes narrower and narrower, eventually becoming so restrictive that the nerve becomes pinched and pain ensues, you have a basic idea, a picture, of what stenosis is. There are many causes for stenosis, some having to do with bone deposition due to stress, others with inflammation, still others with a complex of factors. Ultimately, they all lead to the same set of symptoms, neck pain, back pain, and/or sciatica. Stenosis may be the most difficult condition, pathology, to deal with and may ultimately require surgery to reopen the passage so the nerve can pass through unrestricted. However, there are alternative treatments strategies available for those unwilling or unable to undergo surgery. Herniated discs often cause severe, even debilitating neck pain, back pain, and sciatica. The condition is most common in white males 35 to 40 years old, and older. The IVDs most affected are those of the secondary curvatures of the spine, the cervical (neck) and lumbar (low back) areas or curvatures. However, other sectors of the population and the other curvatures of the spine can be and are affected as well. Picture a jelly doughnut, that's right, a jelly doughnut! The intervertebral disk or IVD is very much like a jelly doughnut. The IVD is made up of circular rings of cartilage surrounding a fluid center. When a disc herniates or ruptures, the fluid center bulges out from the center placing pressure on the nerve root. The pressure on the nerve root causes neck pain, back pain, and/or sciatica, varying from mild to debilitating. Once again, as with spinal stenosis, the prognosis depends on the severity of the herniation or rupture, and degree of damage or possibility of damage to the surrounding area. A herniated disc, putting pressure on the nerve root, depending on the level affected, may express itself in myriad ways. In all cases in which pain presents itself for more than 48 to 72 hours, a medical practitioner should be consulted. Age-progressive phenomena such as osteoarthritis, osteophytosis, and others will be discussed more completely in a subsequent article. However, many age-progressive phenomena are a consequence of a complex of issues related to aging, combined with muscle atrophy, due to a sedentary lifestyle, and our body's attempt to strengthen the primary and secondary curvatures of the spine. Because we stand erect, our secondary curvatures, those of the cervical and lumbar regions of the spine come under tremendous stress and pressure, particularly as we age and muscles weaken. The complex of weakening muscles, aging, and other factors leads to an adaptive response by the body, particularly by the spine, to strengthen an area under stress. Osteophyte bridges, also known as bone spurs or bony bridges, occur as an adaptive response to the weakening of muscles responsible for supporting the curvatures of the spine, particularly the secondary curvatures. Ultimately, this condition is avoidable, through a program of exercise and stretching to maintain those muscles, avoiding excess stress and pressure in the IVD and the vertebrae themselves. Degenerative disc disease, spinal stenosis, herniated discs, and even osteophytosis may be effectively dealt with by adding an individualized and intelligently maintained exercise and stretching program to your daily routine. Because there are so many factors involved in any pain complex, particularly when expressed as neck pain, back pain, and/or sciatica, when unsure we should always defer to our medical practitioner. A pain reduction strategy that includes exercise, stretching, ice-compression braces, the proper shoes, orthotics for those times when soft-soled
shoes are inappropriate and even anti-inflammatory medication may be more than adequate for most expressions of neck pain, back pain, and sciatica symptoms and/or expressions. Once again, should pain continue for more than 48 to 72 hours, individuals suffering from severe back pain and sciatica should see their medical practitioner.
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