Oh, My Aching…Leg?
September 11, 2009
Certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back. When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg. When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks. The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments. The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.
When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.
When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot. It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).
When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way. Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.
To learn more about Leg and Lower Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
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