Facts About Degenerative Disc Disease and Sciatica

Article featured on MedicineNet

Sciatica can result from lumbar disc herniation (“ruptured disc”) or spinal osteoarthritis when nerves in the low back are irritated by the abnormal anatomy in the low back.

What is the design of the spine?

The vertebrae are the bony building blocks of the spine. Between each of the largest part of the vertebrae are the discs. Ligaments are situated around the spine and discs. The spine has seven vertebrae in the neck (cervical vertebrae of the cervical spine), 12 vertebrae in the mid-back (thoracic vertebrae of the thoracic spine), and five vertebrae in the low back (lumbar vertebrae of the lumbar spine). In addition, in the mid-buttock beneath the fifth lumbar vertebra are five sacral vertebrae — usually fused as the sacrum bone followed by the tailbone (coccyx).

What is the purpose of the spine and its discs?

The bony spine is designed so that vertebrae “stacked” together can provide a movable support structure. The spine also protects the spinal cord (nervous tissue that extends down the spinal column from the brain) from injury. Each vertebra has a bony arch behind the spinal cord that shields the cord’s nerve tissue. The vertebrae also have a strong bony “body” in front of the spinal cord to provide a platform suitable for weight-bearing.

The spinal discs are pads that serve as cushions between each vertebral body that serve to minimize the impact of movement on the spinal column. Because the discs are situated between vertebrae, they are sometimes referred to as intervertebral discs. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus) surrounded by a firmer ring of tissue (annulus fibrosus). With injury or degeneration, this softer component can sometimes rupture (herniate) through the surrounding outer ring (annulus fibrosus) and irritate adjacent nervous tissue. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae and surround each of the discs. When ligaments are injured as the disc degenerates, localized pain in the area affected can result.

Degenerative Disc Disease Symptom

Low Back Pain

Pain in the low back can be a result of conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.

What is degenerative disc disease? What causes degenerative disc disease?

As we age, the water and protein content of the cartilage of the body changes. This change results in weaker, more fragile, and thin cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). The gradual deterioration of the disc between the vertebrae is referred to as degenerative disc disease, sometimes abbreviated DDD. Wear of the facet cartilage and the bony changes of the adjacent joint is referred to as degenerative facet joint disease or osteoarthritis of the spine. Trauma injury to the spine can also lead to degenerative disc disease.

Degeneration of the disc space and its contents is medically referred to as spondylosis. Spondylosis can be noted on X-ray tests or MRI scanning of the spine as a narrowing of the normal “disc space” between the adjacent vertebrae.

What are degenerative disc disease symptoms?

Degeneration of the disc tissue makes the disc more susceptible to herniation. Degenerative spondylosis is another name for degeneration of disc tissue. Degeneration of the disc can cause local pain in the affected area. Any level of the spine can be affected by disc degeneration. When disc degeneration affects the spine of the neck, it is referred to as cervical disc disease. When the mid-back is affected, the condition is referred to as thoracic disc disease. Disc degeneration that affects the lumbar spine can cause low back pain (referred to as lumbago) or irritation of a spinal nerve to cause pain radiating down the leg (sciatica). Lumbago causes pain localized to the low back and is common in older people. Degenerative arthritis (osteoarthritis) of the facet joints that can be detected with plain X-ray testing is also a cause of localized lumbar pain. The pain from degenerative disc or joint disease of the spine is usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.

What are the symptoms of radiculopathy and sciatica?

Radiculopathy refers to nerve irritation caused by damage to the disc between the vertebrae. This occurs because of degeneration (“wear and tear”) of the outer ring of the disc or because of traumatic injury, or both. Weakness of the outer ring leads to disc bulging and disc herniation. As a result, the central softer portion of the disc can rupture through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column.

It is important to note that many people have degenerative spines without having any symptoms. When nerves are irritated in the neck from degenerative disc disease, the condition is referred to as cervical radiculopathy. This can lead to painful burning or tingling sensations in the arms. When nerves are irritated in the low back from degenerative disc disease, the condition is called lumbar radiculopathy, and it often causes the commonly recognized “sciatica” pain that shoots down a lower extremity. This condition can be preceded by a localized low-back aching. Sciatica pain can follow a “popping” sensation at onset and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, lumbar radiculopathy can be accompanied by incontinence of the bladder and/or bowels.

How do health care professionals diagnose degenerative disc disease, radiculopathy, and sciatica?

Degenerative disc disease, radiculopathy, and sciatica are suspected when the symptoms described above are noted. The doctor can sometimes detect signs of irritated nerves during the examination. For example, increased radiating pain when the lower extremity is lifted supports the diagnosis of lumbar radiculopathy. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect the nerve irritation. Health care professionals can visualize degenerative spondylosis using plain film X-ray imaging of the spine, CAT, or MRI scanning. The actual disc herniation can be detected with radiology testing, such as CAT or MRI scanning.

What is the treatment for degenerative disc disease, radiculopathy, and sciatica?

The treatment of degenerative disc disease, radiculopathy, and sciatica ranges from nonsurgical (medical) management to surgery. Medical management of radiculopathy includes patient education of the condition, medications to relieve pain (NSAIDs, analgesics) and muscles spasm (muscle relaxants), cortisone injection around the spinal cord (epidural injection), physical therapy (heat, exercises, massage, ultrasound, electrical stimulation), chiropractic manipulation and rest (not strict bed rest, but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (producing a small hole in the bone of the spine surrounding the spinal cord), laminectomy (removal of the bony wall adjacent to the nerve tissues), by needle technique through the skin (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.

What is bony encroachment and spinal stenosis?

Any condition that results in movement or growth of the bony vertebrae of the spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foramen narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body), spondylolisthesis (slipping of one vertebra relative to another), and spinal stenosis (narrowing of the spinal canal causing by compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). For example, lumbar spinal nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities.

Spinal stenosis (narrowing of the spinal canal) can occur at any level of the spine, but it’s most common in the lumbar spine of the low back. Symptoms depend on the level affected. For example, lumbar spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking poor circulation of the lower extremities).

Treatment of these conditions varies (depending on the severity and condition of the patient) from rest to epidural cortisone injection and surgical decompression by removing the bone that is compressing the nervous tissue.

What is the outlook (prognosis) of degenerative disc disease, radiculopathy, and sciatica?

The outlook of degenerative disc disease, radiculopathy, and sciatica depends on the severity of the condition, its precise cause, and the interventions used to treat the patient. When patients respond to conservative treatments, the result can be complete healing. Surgical repairs can require postoperative rehabilitation, including physical therapy.

Is it possible to prevent degenerative disc disease, radiculopathy, and sciatica?

Avoiding injury can prevent degenerative spondylosis and resulting nerve irritation. When the disease already exists, aggravation of existing symptoms can be avoided by limiting stressing or overusing the involved spine.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

3 Signs You Have a Slipped or Bulging Disc

Article features on Spine-Health

When a disc in your lower spine bulges or tears, you may feel pain in your lower back and/or your leg. Here are 3 unique signs of a herniated or protruding disc to help you identify the underlying cause of your lower back problem:

1. Pain while sitting

An activity that exerts tremendous pressure on your lower spinal discs is sitting. If you have a herniated or bulging disc, this increase in pressure within your disc may cause the bulge to become more pronounced, which may aggravate your lower back pain when you sit.

2. Radiating pain into your leg (sciatica)

The discs in your lower back typically herniate or bulge in the posterior (back) and/or lateral (side) region, which is in close proximity to your spinal nerve roots. Herniated discs may affect these nerve roots through one or both of the following 2 methods:

  • Direct compression. When the disc’s bulge or leaking inner contents directly press on a spinal nerve root as it exits the spinal canal.
  • Chemical irritation. When a herniated disc leaks out acidic chemical irritants from the disc material, which may cause inflammation and irritation in the area around the nerve root.

The function of the affected nerve root is then altered, and you may feel a burning pain along with numbness, weakness, and/or tingling along the front and/or back of your thigh, leg, and/or foot. These symptoms are commonly referred to as sciatica. The symptoms and signs of sciatica typically affect one leg at a time.

3. Pain aggravated by specific activities

Your lower back pain and/or sciatica may worsen when you perform certain activities, such as:

  • Bending forward/down
  • Lifting a heavy object
  • Pushing or pulling a heavy object
  • Coughing
  • Sneezing

Lumbar herniated disc pain usually comes on fast. In most cases, there is no single, clear reason for the pain, such as a specific injury or traumatic event. Yet, the pain feels sudden.

This condition can be very painful, but for most people, the symptoms don’t last too long. Nearly 90% of people who experience painful lumbar disc herniation report within 6 weeks that they no longer feel the pain, even if they received no medical treatment for it.

Warning signs and when to see a doctor

Visit your doctor if you exhibit these 3 telltale signs of a herniated disc. Your doctor may recommend a combination of nonsurgical treatments, such as pain-relieving medications and a guided physical therapy program, as well as referral to an interventional pain specialist for image-guided lumbar injections—to help decrease inflammation and relieve the pain.

If you experience any difficulty in controlling your bowel and/or bladder movements, numbness in your inner thigh and genital area, and/or problems in starting urination, consult your doctor immediately. These symptoms and signs may indicate cauda equina syndrome, a serious medical emergency, which is possible with certain severe lower back disc herniations.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Tips on Managing Back Pain

Article featured on Brigham Health Hub

Managing back pain can be challenging, because it’s often non-specific and may be the result of many different conditions. In this post, Dr. Jason Yong, an anesthesiologist and Medical Director of the Pain Management Center at Brigham and Women’s Faulkner Hospital, offers some guidance for people suffering from back pain.

Seeking Treatment

Not all back pain requires treatment from a physician. Patients with acute low back pain (lasting less than three weeks), for example, can often get sufficient relief by using over-the-counter anti-inflammatory pain medications, physical therapy exercises, and temporary restrictions on lifting while the body heals itself. Generally, treatment by a physician is advised when pain is limiting a patient’s ability to walk, sit, or stand for prolonged periods of time, or if pain is greater than a 6 (on a scale from 0 to 10). Spinal surgery is usually considered for patients with intense, unrelenting pain (10 on a scale from 0 to 10), weakness, incontinence, or structural instability.

Role of Injections

Steroid injections typically provide short-term pain relief and can be combined with other forms of therapy. An injection may be provided, for example, prior to physical therapy to help a patient complete a regimen of important exercises.

Implantable Devices for Pain Management

Patients now have access to a wide range of implantable pain management devices. These include intrathecal pumps that infuse medication into the spinal fluid and use much lower doses of medications when compared with oral therapies. Spinal cord and peripheral nerve stimulators are other devices that can decrease the patient’s sensation of pain.

Importance of Multidisciplinary Care

Patients who have persistent back pain, including those considering spinal surgery, should work with a multidisciplinary team of specialists with expertise in treating back pain, because it may be caused by many conditions, including spinal stenosis, disc herniation, or instability. A multidisciplinary team is best suited to advise on the many modalities available to treat back pain, including benefits and risks associated with each approach.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Nighttime Back Pain

Article featured on WebMD
Nighttime back pain is a special type of lower back pain that could indicate a serious problem with your spine.In the U.S., up to 80% of the population experiences some form of low back pain at some time in their lives. It’s the second most common reason people see their doctor. But as debilitating as back pain can be, most instances of it are manageable, and people who get adequate rest and proper exercise often see improvement within a matter of weeks.With nighttime back pain, however, people can’t get the rest they need because they can’t get relief from their pain.

What Is Nighttime Back Pain?

The majority of people with back pain are able to adjust how they sleep to get relief from the pain they experience during the day. But with nighttime back pain — also called nocturnal back pain — the hurting doesn’t stop when a person lies down, no matter what adjustments they make. For some, the pain actually gets worse. And for others, the pain doesn’t even start until they lie down.

A person can actually go through a day virtually pain-free. But then at night, they might find it nearly impossible to get a full night’s sleep.

What Causes Nocturnal Pain?

Just as with normal back pain, the cause of nighttime back pain isn’t always clear. Among other things, back pain can be caused by any of the following:

  • Problems with the way the spine moves or other mechanical problems, the most common of which is disc degeneration. Discs are tissue between the vertebrae that function as a type of shock absorber; the discs can break down with age.
  • Injuries such as sprains or fractures or more severe injuries such as a fall or an auto accident.
  • Diseases and conditions, such as scoliosis, a curvature of the spine, or spinal stenosis, a narrowing of the spinal column. Kidney stones, pregnancy, endometriosis, certain cancers, and various forms of arthritis can all lead to back pain.

A large number of the participants in the British study suffered disc degeneration. Sometimes the cause of back pain might not be determined.

Can Nocturnal Back Pain Be a Sign of Something Serious?

Guidelines for discovering serious spinal health problems list a number of “red flags,” among them nocturnal back pain.

Nocturnal back pain can be a symptom of spinal tumors. It could be a primary tumor, one that originates in the spine, or it could be a metastatic tumor, one that results from cancer that started elsewhere in the body and then spread to the spine.Nocturnal back pain is also a symptom of spinal bone infection (osteomyelitis) and ankylosing spondylitis (AS), a condition that can cause the spine to fuse in a fixed, immobile position.Other “red flags” include:

  • Back pain that spreads down one or both legs
  • Weakness, numbness, or tingling in legs
  • New problems with bowel or bladder control
  • Pain or throbbing in your abdomen
  • Fever
  • Spots warm to the touch
  • Unexplained weight loss
  • History of cancer
  • History of a suppressed immune system
  • History of trauma

If one or more of these symptoms accompanies back pain — especially if you have a history of cancer — see your doctor right away. It’s also important to call the doctor if your back pain is the result of a recent injury.

It’s important to note that it’s rare that nighttime back pain is caused by a tumor, infection, or AS.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

4 Reasons You May Have Back Pain on Only One Side

Article featured on Penn Medicine

The pain may come on suddenly, as a sharp stitch on the left side of your back. Or it may throb to life on your right side, growing slowly worse each day. No matter its exact location, though, one thing is sure: Back pain isn’t fun—but it’s a familiar foe.

Some 80% of the population in the U.S. will have a back problem in their lifetime, and Americans spend upwards of $50 billion a year treating it, according to the American Chiropractic Association.

That pain can radiate from the bones, joints, ligaments, muscles, or a combination of sources. Lifestyle plays its part in back pain, too. Everything from sports injuries and poor posture to obesity and psychological stress can contribute to back pain.

When the pain is isolated to one side, though, you may wonder what exactly is going on. The pain could represent something minor from which your body will heal itself, or it could indicate a more serious condition.

One-sided back pain is a fairly common issue,” says Bradley Tucker, MD, a Penn Medicine Physician and Assistant Professor of Clinical Physical Medicine and Rehabilitation.

Read on to learn symptoms to watch for and what back pain on one side may mean. Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back and neck pain.

Tissue Injuries

Injuries to the spinal structures can happen in the muscles, discs, or joints, and make up the most common cause of back pain on just one side. They often occur after minor injuries or from an impact in sports or a car accident.

Tissue injuries typically cause pain central to the spine, but they can lead to pain entirely on either the right side or the left side of the back. And of tissue injuries overall, muscle strains are the most common cause of lower back pain on one side.

Poor posture is another possible culprit for this type of one-sided back pain, according to Dr. Tucker. “Typically when you sit, everything should be at a 90 degree angle: knees, ankles, hips, and elbows,” he explains.

Muscle Strain Symptoms Include:

  • Limited range in motion
  • Tenderness or swelling
  • Muscle spasms
  • Pain the improves with rest, ice or NSAIDs
  • Pain that worsens after sitting or getting out of bed

Bone Issues

Arthritis, bone spurs, or spinal stenosis (a narrowing of the spinal column) also all may cause pain on one side of the back. The pain may radiate down the leg or cause weakness. For instance, Dr. Tucker says, “If someone has right hip pain from arthritis, they may walk in a way meant to prevent falling and minimize hip irritation. But then they might have left-side back pain as a result.

He adds that this compensation might not be something your body does consciously. “It’s just the body protecting itself from worsening pain, which causes muscles and other joints to be overused or over-fatigued,” he says.

Your treatment options depend on how badly the issue interrupts your daily life: walking, sitting, and other activities you enjoy. Your physician will discuss your optimal treatment options based on the severity of your symptoms.

Treatments may include pain medication and hot/cold packs. They may also range from physical therapy to surgery. Keep in mind that while frustrating, finding the right treatment that works for your specific back pain will likely take time, trial, and error.

Internal Organ Problems

Though you may not think of them at first, pain on the right side or left side of your back may actually come from the organs in your mid-back, abdominal, or pelvic area. That pain may signify infection, inflammation, or irritation, and the potential affected organs include:

  • Kidneys
  • Pancreas
  • Colon
  • Uterus

There are a lot of one-sided issues you could have from pelvic or abdominal structures, but it’s not the typical back pain people think of,” says Dr. Tucker. “For instance, kidney stone pain tends to radiate from the flank down to the groin.

Your kidneys live toward your lower back and can cause pain if infected. However, if you’re experiencing kidney stones or a kidney infection, you’ll likely have other symptoms, too, including pain when urinating, nausea, or fever.

Chronic inflammation of the large intestine, called ulcerative colitis, can also cause back pain—along with abdominal cramping, digestive issues, weight loss, and fatigue, as well. And in women, pelvic pain from endometriosis or fibroids can radiate into the lower right back. This pain often comes with other issues, too, including abnormal menstruation, frequent urination, and pain during intercourse.

Emergency Symptoms

Nobody wants to rush to the Emergency Room over back pain, but it’s important to take right-side or left-side back pain seriously. Go to the emergency room if your back pain is severe or if you believe it could be an emergency, such as a serious health problem or injury.

You’ll also want to recognize if it’s happening in conjunction with other symptoms, such as spinal tenderness, swelling, or bowel or bladder problems.

One such issue is a serious nerve condition called cauda equina syndrome, which involves nerve compression at the end of the spinal cord. “Usually, symptoms include numbness around the groin, significant leg pain, loss of bowel/bladder control, and paralysis,” explains Dr. Tucker.

But emergency symptoms that cause back pain don’t necessarily have to do specifically with the back. An abdominal aortic aneurysm causes the abdominal aorta to balloon and, in some cases, rupture. If the aneurysm ruptures, there is often associated sudden and severe abdominal or chest pain radiating to one side of the back. It’s important to familiarize yourself with emergency symptoms and seek medical attention immediately if you suspect you may be having an issue.

In general, remember: It’s better to be overly cautious when dealing with back pain on your right or left side, especially if the pain interrupts your daily life or comes on suddenly and doesn’t go away with rest or medication.

Talk with your doctor or go to an emergency room to solve exactly what’s going on behind your back.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

What Good Posture Means and How to Improve It

Article featured on Harvard Health Publishing

“Stand up straight.” That’s timeless advice we’ve probably all heard at one time or another. It’s worth heeding. Good posture is important to balance: by standing up straight, you center your weight over your feet. This also helps you maintain correct form while exercising, which results in fewer injuries and greater gains. And working on balance can even strengthen your abilities in tennis, golf, running, dancing, skiing — and just about any other sport or activity.

Not an athlete? It still pays to have good balance. Just walking across the floor or down the block requires good balance. So do rising from a chair, going up and down stairs, toting packages, and even turning to look behind you.

Poor posture isn’t necessarily a bad habit, either. Physical reasons for poor posture include:

  • Inflexible muscles that decrease range of motion (how far a joint can move in any direction). For example, overly tight, shortened hip muscles tug your upper body forward and disrupt your posture. Overly tight chest muscles can pull your shoulders forward.
  • Muscle strength affects balance in a number of ways. The “core muscles” of the back, side, pelvis, and buttocks form a sturdy central link between your upper and lower body. Weak core muscles encourage slumping, which tips your body forward and thus off balance. Strong lower leg muscles also help keep you steady when standing.

The good news: You can improve your posture with a few simple exercises. Balance-specific workouts address posture and balance problems with exercises that build strength where it counts and stretches that loosen tight muscles. Quick posture checks in the mirror before and during balance exercises can also help you get the most from your regular workout. And increasing your core strength and flexibility can help you improve your posture noticeably in just a few weeks.

Good posture means:

  • chin parallel to the floor
  • shoulders even (roll your shoulders up, back, and down to help achieve this)
  • neutral spine (no flexing or arching to overemphasize the curve in your lower back)
  • arms at your sides with elbows straight and even
  • abdominal muscles braced
  • hips even
  • knees even and pointing straight ahead
  • body weight distributed evenly on both feet.

When sitting down, keep your chin parallel to the floor; your shoulders, hips, and knees at even heights; and your knees and feet pointing straight ahead.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Managing Neck and Lower Back Pain

Article featured on Cone Health

According to Dahari Brooks, MD, neck and lower back pain is often caused by muscle strain, degenerative disc disease or arthritis.

“If the pain comes on suddenly and out of the blue, you may have pulled a muscle and can begin with at home treatments,” shares Dr. Brooks.

If you suspect a pulled muscle, Dr. Brooks suggests resting for a day. You can treat pain with over-the-counter anti-inflammatory medications. In the first 24 hours or so, cold therapy can help minimize pain and swelling. Place an ice pack on the painful area for 10 minutes followed by 20-minute breaks. Later, you can consider cold and/or heat therapy for relief. Ease back into exercising with walking and stretching.

“On the other hand, if your chronic pain has worsened over time or you experience a sudden onset of arm or leg weakness, pain or numbness, it is time to make an appointment,” adds Dr. Brooks. “A comprehensive physical examination will help determine the cause of your problem.”

During office visit, you will be examined for issues such as a pinched nerve. You may need to take an x-ray to rule out structural issues. Often, physical therapy or steroid injections can offer improvement. If not, soft tissue imaging can reveal bone spurs or discs that have herniated, degenerated or broken down over time.

“If you are experiencing horrific or radiating pain, weakness or numbness in the neck or limbs or lack of balance, make an appointment to be seen right away,” concludes Dr. Brooks. “These types of symptoms can signal a more serious issue and require more immediate attention.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Back Strains and Sprains

Article featured on Cleveland Clinic

A back strain is an injury to either a muscle or tendon, while a back sprain is the stretching or tearing of a ligament. The symptoms, causes and treatment of back strains and sprains are discussed.

Overview

The back is a complex structure of bone and muscle, supported by cartilage, tendons and ligaments, and fed by a network of blood vessels and nerves. The back—especially the lumbar, or lower back—bears much of the body’s weight during walking, running, lifting and other activities. It makes sense, then, that injuries to the lower back—such as strains and sprains—are common.

What is a strain?

A strain is an injury to either a muscle or tendon. Tendons are the tough, fibrous bands of tissue that connect muscle to bone. With a back strain, the muscles and tendons that support the spine are twisted, pulled or torn.

What is a sprain?

A sprain is the stretching or tearing of a ligament. Ligaments are the fibrous bands of tissue that connect two or more bones at a joint and prevent excessive movement of the joint.

How common are back strains and sprains?

Strains and sprains are very common injuries. Next to headaches, back problems are the most common complaint to healthcare professionals.

Symptoms and Causes

What causes a back strain or sprain?

Twisting or pulling a muscle or tendon can result in a strain. It can also be caused by a single instance of improper lifting or by overstressing the back muscles. A chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.

A sprain often occurs after a fall or sudden twist, or a blow to the body that forces a joint out of its normal position. All of these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.

In addition, several factors can put a person at greater risk for a back strain or sprain, including:

  • Curving the lower back excessively
  • Being overweight
  • Having weak back or abdominal muscles, and/or tight hamstrings (muscles in the back of the thighs).

Playing sports that involve pushing and pulling—such as weightlifting and football—also increases the risk of a low back injury.

What are the symptoms of a back strain or sprain?

Symptoms of a strain or sprain include:

  • Pain that gets worse when you move
  • Muscle cramping or spasms (sudden uncontrollable muscle contractions)
  • Decreased function and/or range of motion of the joint (difficulty walking, bending forward or sideways, or standing straight)

In some cases, the person may feel a pop or tear at the time of the injury.

Diagnosis and Tests

How are back sprains and strains diagnosed?

Mild strains and sprains can usually be diagnosed based on a medical history—including a review of the symptoms and how the injury occurred—and a physical examination by a healthcare provider. In cases of more severe strains and sprains, especially when there is weakness or loss of function, an X-ray may be taken to rule out a fractured (broken) or herniated (bulging) disc as the cause of the back pain.

Management and Treatment

How are back strains and sprains treated?

The treatment for strains and sprains is similar, and often takes place in two phases.

The goal of the first phase is to reduce the pain and spasm. This may involve rest, and the use of ice packs and compression (pressure), especially for the first 24 to 48 hours after the injury. An over-the-counter nonsteroidal anti-inflammatory drug, may be recommended to help reduce pain and swelling.

After the first 24 to 48 hours, returning to normal activities, as tolerated, is advisable. Extended bed rest or immobility (nonmovement) simply prolongs symptoms and delays recovery.

Most people with lumbar strain/sprain symptoms improve in about 2 weeks. If symptoms continue for more than 2 weeks, additional treatment may be required.

What complications are associated with back strains and sprains?

The most common complication of a back strain or sprain is a reduction in activity, which can lead to weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of the body.

Prevention

How can back sprains and strains be prevented?

It is not possible to prevent all back injuries, but you can take some steps to help lower the risk of a sprain or strain:

  • Eat a healthy, well-balanced diet to keep your bones and muscles strong.
  • Maintain a healthy weight. Excess weight puts added stress on the structures of the lower back.
  • Exercise regularly, including stretching, to keep your joints flexible and your muscles in good condition.
  • Practice safety measures to help prevent falls, such as wearing shoes that fit properly, and keeping stairs and walkways free of clutter.
  • Use good body mechanics when sitting, standing and lifting. For example, try to keep your back straight and your shoulders back. When sitting, keep your knees bent and your feet flat on the floor. Don’t over-reach, and avoid twisting movements. When lifting, bend your knees and use your strong leg muscles to help balance the load.
  • Stop smoking. Nicotine interferes with blood flow to the muscles.

Outlook/Prognosis

What is the prognosis (outlook) for people with back strains and sprains?

Most people with back strains and sprains have a full recovery with treatment within 2 weeks.

Living With

When should I contact my healthcare provider about a back strain or sprain?

Call your healthcare provider if:

  • You have severe pain and cannot walk more than a few steps.
  • You have numbness in the area of injury or down your leg.
  • You have injured your lower back several times before.
  • You have a lump or area with an unusual shape.
  • You have pain that interferes with sleep.
  • You have obvious weakness in an extremity (hands or feet) after an injury.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How should you sleep if you have lower back pain?

Article feature on MedicalNewsToday, Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA

Lower back pain can affect a person’s sleep as well as their daily activities, and sleeping in certain positions can cause or worsen the issue.

Below, learn about some appropriate sleeping positions for people with lower back pain. Then, find advice about choosing the right pillows and mattresses.

We also explore what having good sleep hygiene entails and when to see a doctor.

The best sleeping positions

Certain positions can place unnecessary strain on the neck, hips, and back, worsening, or even causing, back pain.

It is important to maintain the natural curve of the spine when lying in bed. To do this, make sure that the head, shoulders, and hips are aligned and that the back is properly supported. Sleeping on the back may help achieve this.

However, many people find that sleeping on their backs is uncomfortable or leads to snoring. Luckily, several other positions may also help improve the quality of sleep and reduce back pain.

Anyone with lower back pain might try the following sleeping positions:

On the back with knee support

Lying on the back evenly distributes the body’s weight, helping to minimize pressure and ensure a good alignment of the head, neck, and spine.

Placing a small pillow under the knees may provide additional support and help maintain the natural curve of the spine.

To get comfortable in this position:

  1. Lie flat on the back facing the ceiling. Avoid tilting the head sideways.
  2. Position a pillow to support the head and neck.
  3. Place a small pillow under the knees.
  4. For extra support, fill any other gaps between the body and mattress with additional pillows. Try placing one beneath the lower back.

On the side with a pillow between the knees

Lying on the side can be comfortable, but it can pull the spine out of alignment, straining the lower back.

It can be easy to correct this issue by placing a firm pillow between the knees. This raises the upper leg, restoring the natural alignment of the hips, pelvis, and spine.

To get comfortable in this position:

  1. Get into bed and carefully roll to one side.
  2. Use one pillow to support the head and neck.
  3. Pull the knees up slightly, and place another pillow between them.
  4. For extra support, fill any gaps between the body and mattress with more pillows, especially at the waist.

Anyone who usually moves from their side to their front may also want to try hugging a large pillow against their chest and stomach to help keep their back aligned.

In the fetal position

For anyone with a herniated disk, sleeping in the fetal position may help. This is because lying on the side with the knees tucked into the chest reduces bending of the spine and helps open up the joints.

To get comfortable in this position:

  1. Get into bed and carefully roll to one side.
  2. Position a pillow to support the head and neck.
  3. Draw the knees up toward the chest until the back is relatively straight.

On the front with a pillow under the stomach

This is generally considered the least healthy sleeping position — but for people who struggle to sleep any other way, placing a slim pillow beneath the stomach and hips can help improve spinal alignment.

Also, sleeping on the front may actually benefit anyone with a herniated disk or degenerative disk disease.

To get comfortable in this position:

  1. Get into bed and carefully roll onto the stomach.
  2. Place a slim pillow beneath the abdomen and hips.
  3. Use a flat pillow for the head, or consider sleeping without one.

On the front with the face down

Sleeping on the front is generally unhealthy when a person turns their head to the side, twisting the spine and placing additional stress on the neck, shoulders, and back.

To avoid this, try lying face down. To do so comfortably:

  1. Get into bed and carefully roll onto the stomach.
  2. Place a slim pillow beneath the abdomen and hips.
  3. Position a pillow or a rolled-up towel under the forehead to create enough breathing space between the mouth and mattress.

On the back in a reclined chair or bed

This might help people with lower back pain, particularly those with isthmic spondylolisthesis, a condition in which one spinal vertebra slips over the vertebra right below.

If a person gets significant relief from resting in a reclined chair, it may be worth investing in an adjustable bed that can be positioned in the same way.

Choosing a pillow

A pillow should maintain the natural position of the neck and help support the spine. Ideally, it should be comfortable and adaptable to different positions, and it should keep its overall shape.

Someone who sleeps on their back may be better suited to a thinner pillow because raising the head too much can strain the neck and back. Some thin pillows are specifically designed to support the neck.

Thin pillows are also ideal for placing under the hips, for people who sleep on their stomachs. Overall, memory foam may be a good option because it conforms to the shape of the head and neck.

People who sleep on their sides may be suited to thicker pillows. These should fill the space between the neck and mattress completely. A gusseted pillow might be an excellent choice.

People who sleep on their stomachs should use thin pillows or none at all because pushing the head backward places pressure on the neck.

Or, a person might try sleeping face down with a small, firm pillow propping up only their forehead. This leaves enough room to breathe but helps ensure that the neck stays straight.

Choosing a mattress

A mattress should be well made, supportive, and comfortable. Some people believe that a firm mattress is better for the back, but some evidence suggests that a medium-firm mattress is better for people with long-term lower back pain.

Body shape and size can help determine how much support a mattress should have. A person with wider hips may be better suited to a softer mattress, and a person with narrower hips may need a firmer one to keep their spine properly aligned.

Although they can seem more comfortable, softer mattresses provide less support. Sinking too deep can cause the joints to twist and the spine to come out of alignment.

A foam mattress topper can provide additional support to a spring mattress. Alternately, placing a plywood board beneath a mattress can increase firmness.

Sleep hygiene

Back pain can significantly disrupt sleep. Even so, it is best to try to maintain a regular schedule with consistent sleep and wake times, rather than sleeping in to compensate for lost sleep.

Most adults need 7–9 hours of sleep in every 24-hour period.

General sleep hygiene tips include:

  • avoiding stimulants, such as caffeine, in the evenings
  • avoiding heavy exercise in the hours leading up to bedtime
  • winding down before bed by reading, taking a warm bath, listening to relaxing music, or doing gentle yoga
  • making the bedroom a relaxing place by dimming the lights and removing distractions, such as computers and phones or TVs

When to contact a doctor

Anyone with severe or worsening back pain, particularly after a fall or injury, should speak with a doctor. Also, do so if any back pain gets worse after resting or sleeping.

Seek immediate medical guidance if back pain is accompanied by any of the following:

  • fever
  • chest pain
  • numbness in the legs, buttocks, or groin areas
  • difficulty passing urine
  • a loss of bladder or bowel control
  • unexpected weight loss

If back pain is causing long-term lack of sleep, speak with a doctor about treatment options and other strategies that can help.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Causes of Sciatica

From Medical News Today

Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.

The pain can feel like an intense cramp or burning electrical sensations.

Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.

Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.

This article reviews what sciatica is, what causes it, and how to treat it.

Why is my sciatica not going away?

Sciatica happens when something presses on or traps the sciatic nerve.

The most common cause is a herniated disk in the lower spine.

Another risk factor is spinal stenosis, a condition that causes the spinal column to narrow.

Herniated disk

Doctors do not know why some cases of sciatica become chronic.

Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.

Injury

People with herniated disks often remember a specific injury that triggered the pain.

An injury does not mean that the pain will be chronic.

However, people who have a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.

Inflammation

Inflammatory conditions can trap spinal nerves, causing sciatic pain.

People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition gets worse.

Treating the underlying condition may help treat the sciatica.

Infection

An infection in or around the spine can cause an abscess, which is a swollen and infected mass. This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms.

A person with an abscess may develop a fever, have pain in other areas of the body, or find that sciatica begins after they have another infection.

Spinal mass or cancer

Any type of mass in or near the spine may trap spinal nerves, causing sciatic pain.

Some masses are cancerous. In other cases, an epidural hematoma, which is a swollen blood spot near the spine, can cause the pain.

It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when sciatica does not go away.

Wear and tear

As a person ages, the normal wear and tear on their spine can cause the spinal column to narrow, resulting in spinal stenosis.

For some people, spinal stenosis causes chronic or worsening pain.

Lifestyle issues

Several lifestyle factors may increase the risk of sciatic pain or extend the healing time.

People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

As sciatica often follows an injury, people may also find that the symptoms do not improve if they continue the activity that caused the original injury.

Spinal misalignment

When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae.

This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Will my sciatica come back?

Sciatica can and does come back, especially when a person has a chronic medical condition.

People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

 


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm