At The Clementine Churchill Hospital, the most typical structural lower back pain conditions are slipped (prolapsed or herniated) discs and nerve compression.
Slipped disc
A slipped disc is one of the most common reasons people book an appointment with a back specialist at The Clementine Churchill Hospital and Circle Health Group. It is typically caused by wear and tear as we age.
“However, we also see young people with disc prolapse and herniation and middle-aged people with them,” said Mrs Mitchener.
When you have a slipped disc, the tissue between the bones bulges out and presses on the nerve roots. The results are lower back pain or neck pain, numbness and tingling, difficulty straightening or bending the back, and sometimes sciatica (the disc presses on the sciatic nerve causing pain in the buttocks, hips or legs).
Narrowing of the spine (spinal stenosis)
A herniated disc or spinal osteoarthritis can cause the spaces around the spinal cord to narrow, compressing the nerves and making walking painful.
Nerve compression occurs mainly in older people. It primarily affects the lower back, and the symptoms include leg weakness, difficulty balancing, numbness or burning in the buttocks, and difficulty lifting the foot.
Your consultant at The Clementine Churchill Hospital may suggest lumbar spinal decompression surgery if non-surgical methods such as painkillers have not relieved it.
Sciatica
Sciatica is a burning pain that radiates from the spine down the buttocks to the leg and is due to pressure on the nerve root. It’s typically caused by a disc problem or general wear and tear.
The pain you get in the arm, the equivalent of sciatica is called brachialgia — a term spinal surgeons use. A trapped nerve in the neck causes it.
Your spinal consultant may recommend spinal injections for sciatica before exploring surgical options.
Spinal osteoarthritis (spondylosis)
Around nine million people in the UK have osteoarthritis, which happens most often in people from 45 or older (although you can get it when you’re younger).
Spinal osteoarthritis is a long-term degenerative condition in which the spine’s joints, discs and bones wear down and cause inflammation and bone spur (osteophyte) growth.
Your spinal surgeon at The Clementine Churchill Hospital may call the condition spondylosis.
Osteoporosis
is a painful condition where the bones lose density resulting in vertebrae fractures, also known as compression fractures. Thinning bones is a structural change, and osteopenia is when bone begins to thin.
Spondylolisthesis
Mrs Mitchener explains, “With spondylolisthesis, there is specific slip of one vertebra on another. It can be a sideways or a front-to-back slip, and it can cause a curvature of the spine (scoliosis) to develop. Scoliosis is a form of mechanical back pain but can also be congenital.”
Scoliosis (curvature of the spine)
Our consultants regularly treat people for scoliosis, where the lateral curvature of the spine is twisted and curved. The skilled surgery required by the orthopaedic surgeon or neurosurgeon involves correcting and straightening the curvature.
Rheumatoid arthritis
At The Clementine, we treat many patients for rheumatoid arthritis, where the immune system attacks and destroys the joints. A specific form of arthritis affecting the back is ankylosing spondylitis.