Back Pain: Finding the Right Doctor
Lift the sofa to straighten the rug underneath, carry a case of soda from the car...and you may feel a shot of pain so severe you think you've broken your back. Far more likely: You have a strain, sprain, or spasm — an extremely common cause of back pain. And while you may be in agony, these uncomplicated muscle aches usually ease within two weeks and disappear in six.
After years of wear and tear (or, rarely, a sudden trauma), the gelatinous pads that act as cushions between bony vertebrae can become thinner, leaving back bones with less of their natural shock absorbers. The vertebrae crunch closer together and shift from side to side, putting extra strain on the joints and on the muscles and ligaments that support the spine. A disc may also begin to bulge out, or the gel may start to leak out of a rupture — a condition officially known as "herniated," though often called "slipped" (and, if the disc is pressing on a nerve, sometimes by names that can't be printed here). If it's the sciatic nerve that's hit, you'll feel it down your leg, as sciatica — which is painful, but rarely permanent. Herniated discs tend to shrink on their own, which reduces the pain-causing pressure. It may feel like three centuries, but within three months, as many as 90 percent of sufferers feel much better.
Your back has small joints, linking the vertebrae, that allow you to bend and twist. If the cartilage in these joints is worn down — a result of injury or simply use over time — the bones underneath rub together, causing pain and swelling: spinal arthritis. This generally occurs in the neck (with pain sometimes felt in the shoulder area) or lower back (pain may be in the buttocks or leg).
Arthritis, as well as aging or a herniated disc, can cause growths on the vertebrae called bone spurs, which crowd the space through which the spinal cord and nerves run. This narrowing — stenosis — doesn't always cause problems. But when it does, you might develop chronic back pain, muscle weakness, and, rarely, nerve damage.