Common Spinal Disorders that Attribute to Low Back Pain 

There are numerous spinal conditions/diagnoses that result in low back pain.  A thorough physical therapy evaluation may narrow down these diagnoses, which are often confirmed with diagnostic imaging such as an x-ray, MRI, or CT scan.  The most common causes of low back pain are described below. 

Spondylolisthesis: is the forward slippage of one vertebrae as compared to the vertebrae above and below that segment.  This slippage is due to instability, which may be attributed to worn discs or fractures.  When the vertebra slips forward, this tends to irritate nerves and may cause pain to travel down the leg.  This type of spinal condition may then lead to spinal stenosis if stabilization is not accomplished through exercise or surgery.

Spinal stenosis:  Spinal stenosis is described as the narrowing of the foramen (holes) that the nerves travel through by bony overgrowth.  Stenosis is noticed more with trunk extension, or bending backwards, as these foramen close with this motion.  As the foramen narrow even more, this may compress the nerve that travels out of that segment, which may result in pain shooting down into the buttock, hip, or down the leg with lumbar stenosis.

Herniated disc:  Herniated discs are common in the low back because of the size of the vertebrae and limited supportive structures as compared to other areas in the spine. The disc comprises the area between two vertebrae. You may think of the disc as a "jelly donut." The disc is made of a more rigid outer structure called the annulus fibrosis and an inner jelly-like fluid called the nucleus pulposus. A herniated disc is the bulging of the annulur or rigid portion of the disc either backwards, to the side, or a combination of the two. If the disc bulges backwards, which is made worse with forward bending and rotation, this can compress the nerves that travel down the leg, causing "sciatica" symptoms or radiculopathy.

Degenerative disc disease (DDD):  is the loss of disc height and shock-absorbing ability in the spine.  DDD is often a result of the aging process, which may be more advanced in some individuals at younger ages.  This spinal condition may also result in low back pain or shooting pain down the legs as the nerve roots may be compressed with the loss of disc height or bone spur formation, which often occurs in patients with DDD.

Benefits of physical therapy for low back pain:

• Recruit “core” muscles to stabilize the low back
• Restore spinal mobility
• Instruct in home exercises that may provide relief of symptoms
• Educate regarding proper body mechanics and positions to avoid to prevent flaring up symptoms

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