Symptom

Not necessarily. Studies show that many people have a "bulging disc" but have no pain or problems at all. The fact you have a bulging disc is not necessarily a problem, but if you have symptoms of pain, numbness, or weakness, you should see a doctor or a spine specialist.

Your doctor may be describing a spine condition called spondylolisthesis (spon-dil-low-liss-the-sis), which is when the bones in your spine slip out of line. This condition often begins as a stress fracture in one pedicle of a vertebral body, called a spondylolysis (spon-dil-low-lie-sis). The pedicle connects to the vertebral body and is part of the bony ring that forms the spinal canal. If the fracture is on both pedicles, it is called a spondylolisthesis , and the facet joints are not able to hold the vertebra from slipping. The forward pressure stretches the disc. In adults, this stretching usually allows only a small amount of forward slip without the risk that the upper vertebra will slide off. In teenagers, there is an extreme form of spondylolisthesis in which the upper vertebra slips completely off the lower vertebra.

Your condition may not get worse, but you will have a higher risk for developing chronic low back pain. A supervised program of physical therapy will help you learn which postures to avoid and what exercises you can do to help stabilize and protect your back.

Your symptoms may be a sign that a nerve is "pinched." The medical term for this is radiculopathy (ra-dick-you-lop-a-thee), which happens when a nerve is irritated from something rubbing or pressing on it. This can cause numbness in your skin, weakness in your muscles, and loss of reflexes in the area controlled by the nerve. Usual causes of radiculopathy include herniated discs and bone spurs. Other causes are tumors or fractures that cause pressure on one or more nerves.

Watch for pain or numbness that spreads into your arms or legs. This can be a sign that severe irritation in your spine is causing your symptoms to radiate outward. Problems with your central nervous system (your brain and spinal cord) can also cause feelings of numbness. These symptoms are often felt in more than one limb, such as your arm and leg on one side or both arms or legs.

A second possibly serious condition is called cauda (caw-da) equina (e-kwine-a) syndrome. This can happen when a herniated disc in your low back gets so big that it fills your entire spinal canal. The immediate pressure on the nerves in your spine may cause paralysis of the muscles that control your bowels and bladder. People with back pain who lose control over their bowels or bladder should contact their doctor immediately. This requires immediate medical attention because if the pressure is not relieved right away, the nerves that go to your bowels and bladder can be permanently damaged.

Pain or symptoms that start for no apparent reason may also be a "red flag." Pain can begin from many sources. Pain originating from your kidneys can spread pain into your mid to low back. A problem with your gall bladder can radiate pain into your mid back and right arm. Other causes of pain that is felt around your spine can include aortic (ay-or-tick) aneurysm (an-your-is-im) and stomach ulcers. So when spine pain or symptoms start without obvious injury or trauma, it can be a signal that other problems may be involved.

Your doctor may want to do tests and ask you questions to rule out other causes of your spine pain. Blood tests can be done to check for infection or arthritis. X-rays can rule out tumors or cancer. Your doctor may want to know whether you have had any recent weight loss or weight gain, whether your pain wakes you up at night, and whether your pain changes as you move or rest. Ruling out possibly serious conditions for your spine pain can increase your confidence and help you in the healing process.

Choosing a supportive mattress and pillow may help you get a better night's sleep. A soft mattress or un-baffled water bed might not give you the support you need for your spine. You can try these tips to give your spine some extra support while in bed.

Low Back Support - when lying on your side, slide a small pillow or rolled towel just above your waist, and put a pillow between your knees. When lying on your back, you can try putting a small pillow under your knees.

Neck Support - neck rolls, cushions, and pillows can be used to give your neck extra support while you rest. One option is to roll a mid-sized bath towel and slide it length-wise between your pillow and pillowcase. The roll can help support your neck as you lie on your back or on your side. If you lie on your stomach, arrange your pillow to keep your neck from turning all the way to one direction. Avoid foam pillows because the foam pushes against the pressure of your head and keeps your neck muscles from getting a good rest. Choose a feather or synthetic material for added comfort.

The pain you feel in your arm can be from a problem in your neck, much like leg pain can be from the low back. This type of pain is called referred pain. When there is injury or irritation in the tissues deep inside your body, your brain is not able to determine exactly where the pain is coming from. Instead, the pain is felt further away from the actual source of the problem. For example, pain in or around your heart may be felt in the jaw or down the left arm. In the same way, problems in your neck can "refer" pain down into your arm. When the source of pain is more toward the surface of your body, your brain has an easier time figuring out where the pain is coming from. A pinprick on your palm hurts right where the pin sticks your hand. Characteristics of referred pain include the following:

• The source of pain is usually deep and toward the center of your body.
• It is often felt as a vague, deep, burning, or aching pain.
• Intense pain radiates further.

Treatment for referred pain must address the source of pain. If your doctor determines that your arm pain is coming from your neck, you will need treatment for your neck, not your arm. Helping your neck problem should take away or reduce the pain in your arm.

It depends on the position you use to rest and how long it takes for your pain to go away. If your pain goes away slowly when you rest in a sitting position, you may have a problem in your low back called spinal stenosis. Spinal stenosis is a narrowing of your spinal canal, which can happen with disc problems, bone spurs, tumors, or infection. This problem is much more common in elderly people (over the age of 60) but can occur in younger people who have abnormally small spinal canals from birth. The narrowing usually causes back and leg pain that gets worse with activities like walking. This explains why people with spinal stenosis often get relief when they sit down. The sitting position opens the space around the painful nerve root. As the pressure is relieved, leg symptoms tend to go away.

If you simply stop walking and the pain goes away quickly, the problem may not be in your back. It may be from a lack of blood supply to your exercising muscles, a condition called intermittent claudication (claw-di-cay-shun). Leg symptoms of aching, cramping, or tiredness usually start soon after exercising, and they go away quickly with rest (usually in less than five minutes). Unlike spinal stenosis, people with intermittent claudication usually get relief if they stop the activity, even if they do not sit down. The lack of blood supply is usually from hardening in the blood vessels that supply the lower limbs, a condition called arteriosclerosis (are-teer-eyo-skler-oh-sis). Whether your pain is from spinal stenosis or intermittent claudication, you should see your doctor.

Not necessarily. Upper back pain has a variety of causes. Osteoarthritis (OA) is only one of many possibilities. Because OA has been linked to heredity, your symptoms may be the result of a cartilage problem that has been passed onto you through your family genes. Usually, people develop OA as they grow older. The joint changes that happen with OA are often described as "wear and tear," much like a machine that wears out over time. It is estimated that OA affects more than one-third of all people over the age of 60, and more than 80% of people over age 70. Your pain may have started from a strain to your upper back, poor posture, weakness in the muscles of your upper back, or even a problem in your neck. Your doctor can determine the cause of your upper back pain and help you find ways to ease the pain and prevent future problems.

It is estimated that 80% of people will have a significant episode of back pain. This is not a simple backache, but pain that limits your ability to participate in leisure, recreation, or work activities. After you have had a pain episode like this, there is a 90% chance that the pain will happen again. This is called recurring back pain. It can happen when you are starting a new or seasonal activity, when you lift incorrectly, or when you use awkward postures. If a weak disc has started to bulge, these types of activities can put extra pressure on the weakened disc, expanding the bulge. The bulge can bring on the pain by putting pressure on the joints, nerves, or ligaments of your low back. With time or treatment, the bulge may get smaller and the pain may go away.

Back pain that comes and goes can also happen when the muscles or ligaments are not able to control the movement of a spinal vertebra, leading to spinal instability. Ligaments connect bone to bone, helping to limit the amount of movement of a joint. If a ligament has been stretched, it loses its ability to hold the joint stable. Your abdominal and low-back muscles provide support for your lumbar spine much like guide-wires hold the mast of a ship. If your abdominal muscles are weak from postural changes or from not being exercised, the unstable vertebra can cause recurring pain. Daily activities can put extra strain on unstable joints, leading to extra wear and tear. It is like driving around with loose lug nuts on the wheel of your car. After a while you start to notice abnormal wear and tear. Whether the problem is from a weakened disc or from a spinal instability, you may benefit from physical therapy to strengthen and stabilize your lumbar spine.

Conservative spine care is most successful when a team of skilled professionals works together to help you gain control of your symptoms, improve your back function, and help you return to doing the things you enjoy. Other medical professionals who may help with your conservative treatment include:

• Dietician
• Chiropractic physician
• Physical or occupational therapist
• Naturopathic physician
• Psychologist
• Psychiatrist
• Counselor
• Ergonomic specialist

Popping sounds can sometimes be heard when a muscle or tendon slides over a bony bump. The sound you hear may also be the gliding of joints as you turn your neck. Articular cartilage forms a smooth covering over the surface of healthy joints. If your joint has been injured or becomes inflamed, the surface may thicken, creating a rubbing sound as you move. A courser grinding or crunching may indicate more advanced changes in the surfaces of one or more joints. Such changes can be caused by osteoarthritis (OA). OA can happen from normal wear and tear, especially when there has been a change in the alignment of your joint. Joint alignment can be changed following an injury, when your muscles are tense or in spasm, or from poor spine postures that have been used over the years. A physical therapy program to help with your posture and muscle balance can improve movement in your neck and may help stop the noise.

Identifying and getting treatment for the condition that is causing your pain is an important first step toward controlling spine pain. The treatment and reassurance from your doctor can help get you on the road to recovery. Sometimes these are all that are needed to help your pain go away completely. In fact, many people who experience mild back pain for the first time become pain-free within six to eight weeks without treatment. Yet spine pain is not predictable most of the time. Your doctor will have a better idea of your recovery time when your medical exam is completed. The goal of treatment will be to help you control your pain and get back your best possible function, even if your pain does not go away completely.

rounded shape or hump in your upper back is called a thoracic kyphosis (ky-fo-sis), a condition with several causes. Just like your size, height, and facial features are a result of your family genetics, your postural attributes including kyphosis can also be a result of genetics. A kyphotic posture can also be caused by using a slouched posture at work for many years. The slouched position can cause muscles of the upper back to weaken, making your rounded posture more noticeable.

The posture you have described is also commonly seen in people with osteoporosis. Osteoporosis occurs when bones lose minerals faster than they make them. This is more commonly seen in post-menopausal women, though other environmental and medical factors can cause changes in your bones.

As the vertebral bodies of your thoracic spine lose strength, they tend to slowly compress and become wedge-shaped. This causes your upper body to slouch into the characteristic kyphosis posture. Given your age, gender, and posture, it is advisable for you to check with your doctor. Tests are available to determine the health of your bones and whether this is influencing your posture. You may benefit from a supervised physical therapy program of postural training and exercise to help improve your posture.