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The lumbar spine is composed of five vertebrae; each one is connected to the next by the intervertebral disc and two facet joints. The discs between each vertebra are made up of a tough outer ring called an annulus and a soft inner core called the nucleus pulposis.
The annulus is a ligament like material that connects the vertebra together around the outer edge. It provides a tough strong connection between the vertebrae and holds the soft jelly like nucleus pulposis in place. The intervertebral disc acts as a shock absorber, and allows limited motion Each Level.
The facet joints are a zygapophyseal joint, which means that they have two smooth surfaces that glide across each other contained inside of a joint capsule. The joint capsule is filled with synovial fluid that lubricates the joint. These work with the intervertebral discs to control of the motion of the lumbar spine.
As we age, the annulus becomes dry and stiff, and the nucleus pulposis loses its water content becoming hard and fibrous. At the same time, the facet joints are getting worn and irregular, and possibly developing bone spurs. This makes your back stiff and painful when you try to move.
Trying to live your life in spite of this pain is not always easy, but there are some things you can do. Over the counter pain medicine, staying thin, and staying active and involved with your life can all help. Carefully avoiding bending and lifting will help to avoid exacerbations of pain.
When you must bend and lift, bend at the hips not in your back. Hire a teenager to help with the yard and do chores around the house.
Physical therapy can help improve your posture and strengthen your core to protect your back. General conditioning and aerobic exercise can stimulate the release of endorphins which help control pain.
Steroid injections are sometimes helpful when one specific pain generator can be identified, but in most cases the pain is widespread and the condition exists at multiple levels. There are some surgical options but none of them are very good. A lumbar fusion is possible, but it is usually very difficult to identify which level is causing the pain, and you can't fuse every level.
You should always check with your doctor before beginning any new medication, but over the counter anti-inflammatory drugs can provide relief of the arthritis in your back. There are other topical agents that will also help.
Staying thin and staying fit will help because any weight you carry in front pulls on your back. Exercises to strengthen your abdominal muscles as well as exercises to strengthen your back will go a long ways toward relieving the pain of degenerative disc disease and arthritis in your back.
Staying active and choosing to be happy can also help relieve pain. Being involved at your church and with other activities can distract you from your pain and bring periods of relief. The pain of degenerative disc disease and back arthritis will likely never be relieved 100%, but with a little bit of help and a good attitude we can learn to live with it.
David Stevens PA-C
http://www.living-with-back-pain.org/
http://www.living-with-back-pain.org/back-pain-treatments.html
David Stevens is a physician assistant with 12 years experience working with a spine surgeon and he has recently taken a position with a pain management physician. He brings a special perspective to caring for his patients with pain, because he has been living with back pain ever since a motorcycle accident as a teenager crushed two vertebrae in his spine. His website at Living with Back Pain provides information and inspiration for people living with back pain. Learn more about the treatments for back pain at Back Pain Treatments.
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