#15-03 Mt. Elizabeth Medical Centre
3 Mt. Elizabeth, Singapore 228510
3 Mt. Elizabeth, Singapore 228510
90% of low back pain occurs when a nerve that travels from the spinal cord through the bones of the spine is pinched or irritated. This results in the muscles of the back tensing up and causing the patient low back pain. The solution to this problem depends on why the nerve is irritated in the first place.
The spinal cord which arises in the brain is an intricate network of nerves, discs and bones. It is protected by the spinal column as it runs down the back. All our body movements are controlled by the spinal cord. The nerves that run out of the spinal cord to control our movements are called the motor nerves.
Nerves that run from the spinal cord to the brain are the sensory nerves and they take messages from the body back to the brain. Together, both the motor and sensory nerves form more than 50 nerve roots, which run through holes called foramina, in the bones of the spinal column. Each one of these nerves roots can potentially cause a problem.
The spinal cord is in a protective canal adjacent to a soft, flexible disc that separates each bone (vertebrae) in the spine. This disc acts as a shock absorber. The outside rim of the disc is rigid (Annulus), but the inside is soft and gel-like (Nucleus). Any sort of activity, stress or a mechanical problem in the spine can cause a disc to bulge. The bulging disc may put pressure on a nerve root causing low back pain or leg pain in the patient.
In more severe cases, the disc bulge may cause disc rupture or herniation putting even greater pressure on the nerve root. The nerve roots of the lower back cause not only back pain but also pain that radiates down one or both legs called Sciatica. There may also be muscle weakness, numbness and changes in reflexes in the legs. The key to treatment is to relieve nerve irritation before nerve damage occurs.
Causes of disc injury or wearing out, resulting in chronic back pain include prolonged sitting, prolonged standing, sports injuries including running on hard ground and other high impact activities, frequent lifting of heavy objects especially with the back bent and from the floor, falls and accidents. Its best to see your Spine Specialist to assess your spine and order the necessary tests including MRI spine scans to determine the spine problems that have occurred.
If low back pain occurs acutely because of a recent, specific injury, such as a fall, lifting a heavy weight or a sports injury you should consult your Spine Specialist immediately.
Serious causes of Back Pain that require immediate and early attention, diagnosis and treatment to prevent weakness and paralysis from spinal nerve damage include
Our spine also ages just like the rest of our body. As we age, our bodies dehydrate (lose water) and in the spine this causes the discs that cushion and separate our vertebrae to dry out. They become less effective as shock absorbers. The ligaments and facet joints in the spine also become thickened and less flexible. This results in narrowing of the spinal canal which is called stenosis. This narrowing over time can worsen and can compress the nerve roots in the lower back causing back pain and other symptoms when standing or walking. This condition is diagnosable and treatable using modern spine tests and spine technologies.
Common diagnostic tests include X-Rays of the Spine. X Rays of the spine show the bones clearly but cannot show the soft parts of the spine such as the discs and nerves well. An MRI of the spine is better able to visualize the discs and bone and helps your Spine Specialist Neurosurgeon determine the diagnosis and severity of the problem. The findings of the MRI are compared with the patients symptoms before the neurosurgeon-Spine Specialist considers a treatment plan including medical therapy, physiotherapy, Laser Therapy, Infrared Therapy, and advanced no surgery day treatments and procedures including Discoplasty, Annuloplasty, Nucleoplasty and Micro Radio Therapy. In general non invasive and less invasive treatments are recommended before actual surgery on the spine.
Neurosurgeon-spine specialists who have been trained in the US like Dr Prem Pillay, have throughout their long residency program been trained on all treatment options available for diseases of the spine including less invasive and non invasive day therapy and can determine the best treatment option for a particular spine condition. Less Invasive and day treatments such as Discoplasty and Micro Radio Therapy may be used where appropriate before actual spine surgery with implants. Spine microsurgery involves operating in the region of the spinal cord and the nerves, and therefore precision and delicacy are the keys to a successful and safe procedure. Neurosurgeons often use a special spine operating microscope to help magnify the nerves and discs. This allows for greater precision and a smaller incision including key hole incisions. Endoscopes may be used. Robotics is now available in selected cases to improve the accuracy of spine and spine disc treatments. After any type of spine surgery or less invasive procedure, it is important that patients continue to work with their neurosurgeon spine specialist on a rehabilitation program which includes physical therapy, medications and reduced activity.