Archive for category: Back Pain

How to Prevent Back Pain When You’re Traveling

Article featured on HealthPartners

Few things can ruin a vacation faster than a sore neck or back. And unfortunately, back pain from driving – especially long distances – is common. (Plus, back pain and flying often come together, too.)Here are a few key tips I give them to avoid back pain from driving, sitting in a car, flying or sleeping somewhere new.

1. Motion is lotion for your body! Even when traveling, it’s important to stay active to prevent back pain.

  • Use the 30-minute rule.

If you are sitting or standing for 30 minutes, change position. Even if it is only a brief change, it can help prevent back pain. Really, I promise, your back will thank you in the long run.

  • Take regular stretch breaks.

Back pain from driving is common. Stop every 60-90 minutes to get out and walk around while traveling by car, or get out of your plane seat and walk the aisle if permitted.

  • Do simple exercises while seated to help keep your back from getting stiff.

You can do something called a pelvic tilt while sitting on a plane or in the car to mimic the sit-to-stand motion.

2. Stress can contribute to the intensity of low back pain. The better you can manage stress, the better you can prevent back pain and the less you will hurt.

  • Don’t hesitate to ask for help.

Make things easier on yourself and let those who offer to help do so. If the flight attendants will help you lift your bags to the overhead compartment, let them.

  • Plan ahead.

Make a list of everything that needs to get done, and allow extra time to do them all in case things don’t go according to plan. That will make it easier to adjust if something unexpected comes up at the last minute (like, traffic or long security lines). If nothing goes awry, you’ll have extra time to relax!

  • Practice deep breathing and other mindfulness techniques.

I recommend giving progressive muscle relaxation exercises a whirl. They can be a less time-intensive alternative to yoga or meditation. And since they can easily be done in an airplane seat, they can be very helpful in counteracting the issues that can come from back pain and flying.

3. There are certain activities that may lead to back pain from driving or flying. So when you’re traveling, make simple changes to what you’re doing to prevent back pain from flaring up.

  • When you’re spending a long time in a car or plane…

Use a rolled up towel, sweatshirt, lumbar roll or a water bottle to give your back the proper support it needs for a long trip. Place the object just below the small of your back, above your hips.

  • When you’re sleeping in a car or plane…

Use a neck pillow – they really do help. Having a neck pillow will keep your spine in better alignment. And that will decrease the stress that resting in an upright position can put on your neck. If you don’t have a neck pillow, roll up a towel, sweatshirt or small blanket and wrap it around your neck.

  • When you’re standing in lines…

Keep your weight equal between both feet, or shift your weight back and forth. When it comes to the issue of back pain and flying, waiting to go through airport security is often a culprit. You can also try propping a foot up on a bag or curb to decrease the stress to your spine.

  • When you’re lifting luggage or heavy items off the ground…

Use a wide stance with your feet and squat down using your legs. Keep your butt back and put your weight into your heels.

  • When you’re picking small objects off the floor…

Try a technique called the “golfer’s lift.” Kick one leg behind you and bend at the hip like a pendulum, keeping your low back straight. Reach to pick up the object with one arm while using the other to hold a stationary object for support.

  • When you’re sleeping in a different bed…

Use blankets to help cushion a hard mattress if you prefer softer surfaces. If you’re lying on your back, prop up pillows under your knees. Or if you’re lying on your side, put a pillow between your knees. This will help you prevent back pain by keeping your spine in a better position.

 


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

Pulled Back Muscle and Lower Back Strain

Article featured on Spine-health

Most episodes of low back pain are caused by damage to the soft tissues supporting the lower spine, including muscles, tendons, and ligaments.

The lower spine, also called the lumbar spine, depends on these soft tissues to help hold the body upright and support weight from the upper body. If put under too much stress, the low back muscles| or soft tissues can become injured and painful.

While a pulled back muscle or strain may seem like a minor injury, the resulting pain and muscle spasms can be surprisingly severe.

Types of Lower Back Strain

There are two common types of soft tissue injuries in the low back:

  • Muscle strain occurs when fibers in a muscle begin to tear from being overstretched or overused (commonly called a pulled muscle).
  • Lumbar sprain occurs when ligaments are overstretched or torn. Ligaments are tough, fibrous tissues that connect bones together.

A specific diagnosis of ligament sprain or muscle strain is usually not needed, as both have almost identical symptoms and receive the same treatment. This article refers mainly to lower back muscle strains, but applies to sprains or other soft tissues injuries as well.

Inflammation and Muscle Spasm

When soft tissues in the low back are stretched or torn, the surrounding area will typically become inflamed.

Inflammation, or local swelling, is part of the body’s natural response to injury, in which blood is rushed to an injured tissue in order to restore it. Inflamed muscles may spasm, feel tender to the touch, or cramp , and contract tightly, causing intense pain.

The Course of Lower Back Muscle Strain

The hip, pelvis, buttock, and hamstring muscles assist low back muscles in supporting the lumbar spine. When these muscles are injured, pain or tightness may be felt across the low back and into the hips or buttocks.

Symptoms are typically limited in duration and follow a pattern:

  • Pain is most intense for the initial few hours and days. It is normal to experience increased pain with certain movements or positions, such as bending forward, backward, or standing upright.
  • Ongoing moderate pain and stiffness is usually felt for 1 to 2 weeks while muscles heal. Pain when holding certain movements (such as anything that jars the spine) or positions (such as standing for a long period), stiffness, and local tenderness are typical.

Compared to many other kinds of back injuries, a pulled muscle is usually straightforward to diagnose and easy to treat, and symptoms usually resolve within 4 to 6 weeks. Some severe muscle injuries, such as a complete muscle tear, can take months to heal.


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

7 Lower Back Stretches to Reduce Pain and Build Strength

Article featured on Healthline

Lower back pain is a fairly common health concern, as so many things can cause it.

In some cases, it might be a symptom of an underlying condition, like kidney stones or acute pancreatitis. Other times, it’s simply a side effect of a sedentary lifestyle or repetitive motions.

While stretching isn’t a remedy for all lower back pain, in many instances, it can provide relief. If you’ve been living with some mild discomfort or stiffness, these seven stretches may help reduce the pain and strengthen the muscles in your lower back.

First, a few quick tips

Stretch your lower back with safety and care. Be especially gentle and cautious if you have any type of injury or health concern. It’s best to talk with your doctor first before starting any new types of exercise.

You can do these stretches once or twice a day. But if the pain seems to get worse, or you’re feeling very sore, take a day off from stretching.

Be mindful of your body’s limits and don’t push your body to do too much. Listen to your body and do what feels best for you in each moment.

As you go through these stretches, take your time and pay close attention to your breathing. Use your breath as a guide to make sure you don’t strain or overdo it. You should be able to breathe comfortably and smoothly throughout each pose or stretch.

1. Child’s Pose

This traditional yoga pose gently stretches your gluteus maximus, thigh muscles, and spinal extensors. It helps relieve pain and tension all along your spine, neck, and shoulders.

Its relaxing effect on your body also helps loosen up tight lower back muscles, promoting flexibility and blood circulation along the spine.

To do Child’s Pose, follow these steps:

  1. With your hands and knees on the ground, sink back through your hips to rest them on your heels.
  2. Hinge at your hips as you fold forward, walking your hands out in front of you.
  3. Rest your belly on your thighs.
  4. Extend your arms in front of or alongside your body with your palms facing up.
  5. Focus on breathing deeply and relaxing any areas of tension or tightness.
  6. Hold this pose for up to 1 minute.

You can do this pose several times during your stretching routine. Feel free to do it between each of the other stretches you do.

Modifications

If you feel like you need some extra support, you can place a rolled-up towel on top of or underneath your thighs.

If it’s more comfortable, widen your knees and rest your forehead on a cushion.

2. Knee-to-chest stretch

This stretch relaxes your hips, thighs, and glutes while promoting overall relaxation.

To do a knee-to-chest stretch, follow these steps:

  1. Lie on your back with both knees bent and your feet flat on the floor.
  2. Keep your left knee bent or extend it straight out along the floor.
  3. Draw your right knee into your chest, clasping your hands behind your thigh or at the top of your shinbone.
  4. Lengthen your spine all the way down to your tailbone, and avoid lifting your hips.
  5. Breathe deeply, releasing any tension.
  6. Hold this pose for 30 seconds to 1 minute.
  7. Repeat with the other leg.

Modifications

Place a cushion under your head for extra padding. You can also wrap a towel around your leg if it’s hard for your arms to reach.

To deepen the stretch, tuck your chin into your chest and lift your head up toward your knee.

3. Piriformis stretch

This stretch works your piriformis muscle, which is found deep in your buttocks. Stretching this muscle may help relieve pain and tightness in your buttocks and lower back.

To do a piriformis stretch, follow these steps:

  1. Lie on your back with both knees bent and your feet flat on the floor.
  2. Place your right ankle at the base of your left thigh.
  3. Then, place your hands behind your left thigh and pull up toward your chest until you feel a stretch.
  4. Hold this position for 30 seconds to 1 minute.
  5. Then do the opposite side.

Modifications

To make the stretch more comfortable, keep your bottom foot planted on the floor. Rest your head on a cushion for support.

4. Seated spinal twist

This classic twist stretches your hips, glutes, and back. It increases mobility in your spine and stretches your abdominals, shoulders, and neck. The pressure of this stretch also stimulates your internal organs.

To do a seated spinal twist, follow these steps:

  1. Sit on the floor with both legs extended out in front.
  2. Bend your left knee and place your foot to the outside of your right thigh.
  3. Place your right arm on the outside of your left thigh.
  4. Place your left hand behind you for support.
  5. Starting at the base of your spine, twist to the left side.
  6. Hold this pose for up to 1 minute.
  7. Repeat on the other side.

Modifications

To make this pose more comfortable, keep both legs straight.

For an extra stretch, add in neck rotations during this pose by inhaling to look forward and exhaling to turn your gaze backward. Do 5 to 10 on each side

5. Pelvic tilt

Pelvic tilts build strength in your abdominal muscles, which helps relieve pain and tightness in your lower back. They also have a beneficial effect on your glutes and hamstrings.

To do a pelvic tilt, follow these steps:

  1. Lie on your back with both knees bent and feet flat on the floor.
  2. Engage your abdominal muscles as you flatten your back against the floor.
  3. Breathe normally, holding this position for up to 10 seconds.
  4. Release and take a few deep breaths to relax.
  5. Do 1 to 3 sets of 3 to 5 repetitions.

6. Cat-Cow

Cat-Cow is a great way to wake up your spine while also stretching your shoulders, neck, and chest.

To do Cat-Cow, follow these steps:

  1. Come onto all fours in a tabletop position (hands and knees on the ground).
  2. Press into your hands and feet as you inhale to look up, allowing your belly to fill with air.
  3. Exhale, tucking your chin into your chest and arching your spine toward the ceiling.
  4. Continue this pattern of movement, moving with each breath.
  5. Do this for 1 to 2 minutes.

Modifications

If you have wrist concerns, place your hands slightly forward instead of directly under your shoulders. If you have any knee concerns, place a cushion under them for padding and support.

For deeper holds, simply remain in each position for 5 to 20 seconds at a time instead of moving with each breath.

7. Sphinx stretch

The sphinx stretch is a gentle backbend that allows you to be both active and relaxed. This baby backbend stretches and strengthens your spine, buttocks, and chest.

To do the sphinx stretch, follow these steps:

  1. Lie on your stomach with your elbows underneath your shoulders and your hands extended in front, palms facing down.
  2. Set your feet slightly apart. It’s OK for your big toes to touch.
  3. Gently engage your lower back, buttocks, and thighs as you lift your head and chest.
  4. Stay strong in your lower back and abdominals, breathing deeply.
  5. Press your pelvis into the floor.
  6. Gaze straight ahead or gently close your eyes.
  7. Hold this pose for 30 seconds to 1 minute.

The bottom line

You use your lower back for a lot of things, from walking and running to simply getting out of bed in the morning. Regular stretching is a great way to create and keep flexibility, relieve tension, and help build strength.


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

Upper Back Pain Between Shoulder Blades: Is it Serious?

Article featured on MedicalNewsToday

Poor posture, injury, or problems with the spine can all lead to upper back pain. A common cause of pain between the shoulder blades is muscle strain. Treatments for mild upper back pain include stretching exercises and pain relievers. Some cases of pain between the shoulder blades are preventable. Someone with underlying spinal problems may need advice from a doctor or physical therapist to reduce pain and discomfort.

Causes

Stretching, maintaining good posture, relieving stress, and avoiding heavy lifting can help alleviate or prevent shoulder pain.

There are several muscles of different shapes and sizes in the upper back, which help with neck, shoulder, and arm movements.

Injuries to these muscles can cause upper back pain. The feeling can be a dull ache or a sharp pain.

Exercise

Some forms of exercise increase the risk of injuring the upper back.

Throwing a ball overhead, lifting weights, and performing some swimming strokes can strain muscles between the shoulder blades. The repetition of these movements over time is a common cause of muscle strain.

Other symptoms of muscle strain include a feeling of weakness in the area, swelling, and muscle cramps. People can treat a mild strain with ice, rest, and pain relievers. Most mild strains should heal within a couple of weeks.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling. It is important to try to avoid activities that strain the back muscles. Applying an ice pack for up to 20 minutes every few hours can also reduce pain and swelling. Gently moving the shoulders at regular intervals can help reduce any stiffness.

Posture

How someone sits or stands can cause pain between the shoulder blades. Some positions that may put a strain on muscles in the upper back include:

  • sitting at a desk for much of the day
  • using an uncomfortable chair
  • leaning over a laptop for long periods
  • crossing the legs when sitting down

These postures can cause a dull ache between the shoulder blades.

Gently stretching the muscles in the upper back can help ease the pain. People can try rolling the shoulders forward and backward to reduce stiffness. Linking the hands behind the back and gently pulling the arms downward might also help.

Stress

Stress causes muscles in the body to become tense. The neck and shoulders are a common area of tension, which can cause pain between the shoulder blades. Stress can also cause headaches if the shoulder muscles are tense for a long time. Addressing the causes of stress, having a good support network, getting enough sleep, and exercising regularly can all reduce stress.

Lifting or carrying

Carrying or lifting something heavy can strain the upper back. People should take care to use safe lifting practices when pushing, pulling, or lifting items.

Carrying a shoulder bag puts weight on the shoulders, pulling on the muscles between the shoulder blades. Holding heavy shopping bags can also strain the arms and the muscles in the upper back.

People can avoid carrying too much weight on the shoulders by choosing backpacks with two straps to spread weight evenly and only carrying essential items. If necessary, a person can make more than one trip to avoid carrying several heavy bags at once.

Muscle injury

Injury to muscles in the upper back can cause pain between the shoulder blades.

Injuries might occur as a result of exercising, lifting something heavy, or falling. A tear can cause severe pain.

The rotator cuff muscles attach the arm to the shoulder blade. Injuring one or more of these muscles can cause pain in the upper back and shoulder. Such injuries can also cause difficulty in moving the arm or shoulder.

Treatment for mild or moderate muscle tears includes resting, applying an ice pack, and doing strengthening exercises. In some cases, a doctor may prescribe steroid injections to reduce swelling. For about 20% of rotator cuff injuries, surgery is necessary to reattach a tendon.

Scoliosis

Scoliosis is a condition in which the spine has a sideways curve. A person’s shoulders or hips may look slightly uneven, or one shoulder might stick out.

Scoliosis does not always cause symptoms, but some people with this condition may experience back pain. Exercise will help strengthen muscles in the upper back and shoulders, which can reduce muscle strain and pain.

Myofascial pain syndrome

Myofascial pain syndrome is a long-term health condition that causes pain in specific muscle groups. Unlike with other chronic pain conditions, pain does not occur throughout the body.

A trigger point in a muscle will cause pain in the area. In the upper back, it may cause pain across the group of muscles around the spine, neck, and shoulders. Treatment can include laser therapy, steroid injections, lifestyle changes, and massage.

Osteoarthritis

Gradual wear and tear of the joints over time can cause osteoarthritis. The symptoms include stiffness, pain, and swelling, which can cause difficulty in moving the joints.

Injuring or overusing the joints can increase the risk of osteoarthritis.

Some people have a job that requires frequent reaching overhead or heavy lifting. This work can lead to osteoarthritis in the shoulder joints and upper back pain later in life.

Maintaining good posture, keeping the muscles in the shoulders and upper back strong, and avoiding heavy lifting can help prevent pain between the shoulder blades.

People who sit at a desk for long periods may benefit from a comfortable chair to prevent upper back pain. They should try to keep the spine in a natural position without hunching the shoulders or pushing the neck forward.

Regular exercise can help a person maintain a moderate weight, which reduces strain on the back. Stress can cause tension in the upper back and shoulders. Yoga or stretching exercises can help ease tight muscles.

Summary

It is easy to strain muscles in the upper back and cause pain between the shoulder blades. Common causes are leaning over a laptop, carrying heavy bags, or sitting in an uncomfortable seat for long periods.

Most causes of upper back pain are mild. However, some more serious problems can cause pain between the shoulder blades. It is important to seek medical advice for symptoms of scoliosis, osteoarthritis, or a muscle tear.


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

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