Surgery For Back Pain
If a herniated disk is causing relentless or chronic sciatica, weakness, loss of sensation, or loss of bladder and bowel control, surgical removal of the bulging part of the disk and sometimes part of the vertebra may be necessary.
For severe spinal stenosis, a large part of the back of the vertebra may be surgically removed to widen the spinal canal . A general anesthetic is usually required. The hospital stay is usually 4 or 5 days. People may need 3 to 4 months before they can resume all of their activities. About two thirds of people have a good or full recovery. For most of the rest, such surgery may prevent pain and keep other symptoms from worsening.
When the spine is unstable , surgery can be done to fuse vertebrae together . However, fusion decreases mobility and may put additional stress on the rest of the spine and cause further problems.
Diskectomy involves surgically removing the bulging part of the disk. This procedure may be done when a herniated disk is causing relentless or chronic sciatica, weakness, loss of sensation, or loss of bladder and bowel control. Sometimes part of the vertebra must also be removed. This procedure is called a laminectomy.
Osteonecrosis Of The Femoral Head
This issue, known as ONFH, causes the hip bone to deteriorate and collapse due to a lack of blood to the area. The cartilage that covers the hip bones also deteriorates, resulting in arthritis.
Hip pain is typically the first symptom, and it may accompany a throbbing pain or dull ache in the buttocks and groin. As the condition progresses, it may be difficult to put weight on the hip and any movement may be painful.
This may progression can take several months to a year, and getting an early diagnosis leads to a better outlook.
Internal causes of hip and groin pain may stem from underlying conditions or growths in other regions of the body. The issue may be:
When To See A Healthcare Provider
If your pain is caused by a muscle strain, minor joint sprain, or overuse, the pain should begin to resolve with rest and improve without medical help.
If you are experiencing chronic or unusual lower back and groin pain, your primary care healthcare provider or OB/GYN can help you determine the cause of your pain or refer you to a specialist. Lower back and groin pain in women is a symptom that may have many possible causes, so be sure to see your healthcare provider for a proper diagnosis.
Seek immediate medical attention at an emergency room or urgent care center if your pain is severe, sudden, or you have any of these symptoms:
- Rapid breathing or heart rate
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Complications Related To Sciatica
If you develop a loss of bladder or bowel control, contact your doctor right away. This can be a sign of a medical emergency that requires surgery to avoid permanent damage. Fortunately, this complication is rare. Most cases of sciatica go away within a few days or weeks and cause no lasting harm.
What Are Treatments For Groin Pain
Treatment for groin pain focuses on addressing the condition causing the pain. Depending on the underlying cause and the required treatment, groin pain can take anywhere from 4 to 12 weeks to heal.
Home treatment is often effective for groin pain caused by minor muscle strains or ligament sprains, through treatments including:
- Ice or cold packs, applied 10 to 20 minutes, 3 or more times a day, to help reduce pain and swelling
- Over-the-counter pain relievers, such as acetaminophen , aspirin , ibuprofen , and naproxen . Aspirin, ibuprofen and naproxen also have anti-inflammatory properties, which helps with healing.
- Rest, to minimize movement of the injured muscle and allow it to heal
- Snug-fitting clothing, such as spandex workout pants, to provide support to the groin muscles as they recover
- Stretches, to slowly bend and rotate your hip in a controlled way. Stretches improve range of motion and prevent muscles and tendons from becoming stiffand more susceptible to injury.
If your groin pain worsens or you have new pain, stop any at-home exercises and contact your doctor to discuss further treatment options.
When groin pain is caused by an underlying condition, it may require medical treatment, including:
- , to treat groin pain caused by infections, such as a or sexually transmitted disease
- and other cancer treatments, for referred groin pain caused by or lymphoma
- , to address referred groin pain from hip damage caused by or arthritis
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Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
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Why Back Pain Requires A Team Approach To Care
Whether back pain requires surgery or is manageable with conservative treatment, its important to see a spine specialist for diagnosis and care. The doctors at our Spine Center work as a team with experts in nerve, muscle, and bone conditions, as well as nurses and physical therapists who work closely with patients to manage symptoms and reduce the risk of recurrence.
Each week, our multidisciplinary team meets to discuss challenging cases and educate each other on the latest research and techniques. Together, we see a range of patients with complex medical needs. For example, if a patient with a spinal infection is taking a medication that suppresses the immune system, such as immunotherapy for cancer, we work together to find an effective treatment that is safe for their unique needs.
Some medications or medical conditions put patients at greater risk for low bone density, fractured vertebrae, or back pain. In these cases, we get referrals from and collaborate with oncologists, hematologists, rheumatologists, mineral metabolism doctors, and primary care doctors to reduce patients risks and manage their symptoms.
If you are worried about back pain, come see us for reassurance. The earlier you are diagnosed, the better your outcomes can be.
If you or a loved one might benefit from a back pain consultation, call or request an appointment online.
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Signs That Your Spine Is The Source Of Your Pain
Whereas groin pain is a telltale sign that the pain is linked to the hip, pain above the waistline that travels down the body typically indicates a low back issue. A low back problem may also be responsible for other types of lower body pain, including thigh, buttock, and below-the-knee pain.
Among the most common degenerative conditions that affect the lumbar spine are herniated discs, spinal stenosis, and spondylolisthesis. These conditions cause pain by irritating your low back nerves, resulting in pain that shoots down your legs , weakness, numbness, and reducing your range of motion.
The pattern of pain coming from the lumbar spine can be variable, depending of the specific issue causing the pain. Commonly, pain from arthritis of the spine occurs during transitions such as getting out of bed in the morning or raising up from sitting. It can often then improve after getting moving. In contrast, pain from spinal stenosis or nerve pressure is often worse with prolonged standing or walking and relieved with sitting.
For Your Convenience We’ve Divided These Causes Into Five Categories As Follows
- Low risk: This can be easily managed with over-the-counter medications or by avoiding the movement/stressor causing your pain.
- Low-medium risk: Usually managed as an outpatient by your doctor with prescription medication.
- Medium risk: May require a visit to your doctor or hospitalization. Prescription medication may be necessary.
- Medium-high risk: Hospitalization or urgent intervention. Although not life-threatening get help immediately of some kind.
- High risk: Serious and potentially lethal complications possible emergent intervention needed Intensive Care Unit care often needed.
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Overuse Injuries And Trauma
Frequent use and repetitive movement patterns can lead to overuse injuries to muscles, ligaments, and joints. They could include:
- Exercises and physical activities, like tennis or golf, that require repetitive twisting and bending in the same direction.
- Frequently lifting of heavy objects or any movements that are repeated regularly.
Trauma can also lead to lower back and groin pain. Trauma could result from car accidents, falls, or sports accidents. Such trauma can inflict both acute and chronic injuries to the body, like strained muscles or broken bones. Depending on the type of trauma, the healing time and treatment needed can vary.
Both overuse and trauma injuries to the lower back or groin area can lead to weakness in the legs, tingling, numbness, pain, stiffness, or popping sensations.
Physiological Changes During Pregnancy
The body undergoes a wide range of physiological and postural changes during pregnancy. Hormonal changes in particular influence the start and progression of a pregnancy. Certain hormones may also cause ligaments in the sacroiliac region to relax or loosen.
The loosening of ligaments is needed to accommodate the many changes that occur during pregnancy, but it also places stress on the sacroiliac joint, resulting in pain. The pain may be felt in the lower back, abdomen, and pelvis. This issue typically resolves after giving birth, but some women experience long-term discomfort due to sacroiliac joint changes.
Weight gain during pregnancy can also strain muscles in the lower back and hips, resulting in lower back pain that extends toward the front pelvic area. Then there are uterine contractionsthese may radiate through the back, pelvis, and lower abdomen, especially if they’re strong.
Its also true that pregnant people tend to experience abdominal, pelvic, and upper stomach discomfort, particularly during late stages of pregnancy when the uterus starts to compress different organs.
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What Complications Are Associated With Sciatica
Most people recover fully from sciatica. However, chronic pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a drop foot, might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time.
Twisted Ovary And One Sided Abdominal Pain
Twisted ovary can cause sudden sharp lower left abdominal pain or lower right abdominal pain. A twisted ovary can happen as a result of pregnancy, ovarian cysts, or hormone treatment.
According to Dr. Gene McNeeley, Clinical Professor at the Center for Advanced Gynecology and Pelvic Health, a twisted ovary will usually cause severe pain on just one side of your abdomen.20
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What Is Radiating Pain
Radiating pain is a term used to refer to pain that is showing up in more than one location but originating from a single source. These kinds of pain often occur with back injuries and hip problems due to the large concentration of joints, ligaments, and nerves contained in that area of the body.
An example of radiating pain could be a muscle strain in the back radiating into the groin area. Because the network of muscles are so interconnected, experiencing lower back inflammation would likely cause pain in this neighboring area of the body.
Treatments For Swelling In Legs And Feet
Swelling in the legs and feet can result from a variety of different causes so treatment will vary. Treating any underlying condition is necessary first before attempting other treatments, which include:
- Wearing compression stockings to help improve circulation from the legs back to the heart
- Elevating your feet above the level of your heart after prolonged sitting or standing
- Regular exercise involving the legs to promote improved blood flow
- Increasing fluid intake and decreasing sodium intake
- Diuretic medication to help get rid of excess fluid retention
Reflexes And Motor And Sensory Testing
Testing knee and ankle reflexes in patients with radicular symptoms often helps determine the level of spinal cord compromise. An altered knee or ankle reflex alone does not suggest the need for invasive management because this finding is generally transient and fully reversible.8
Weakness with dorsiflexion of the great toes and ankle may indicate L5 and some L4 root dysfunction. Sensory testing of the medial , dorsal and lateral aspects of the foot may also detect nerve root dysfunction.1
Pelvic Pain During Pregnancy
Some women experience pelvic pain during pregnancy. Pelvic pain can affect one or both sides of the lower back.
This pain may also affect the perineum or radiate to the thighs. It may worsen while walking, standing up, or rolling onto the side.
The following tips may help reduce pelvic pain during pregnancy:
- doing exercises that strengthen the pelvic floor
- avoiding standing for too long
- getting plenty of rest
Women can also try applying ice or heat packs to help ease the pain. OTC acetaminophen is generally safe to take during pregnancy. However, it is advisable to speak to a doctor before taking any medications while pregnant.
Testicular torsion can cause back pain on the lower right side in males.
Physical Therapy Guide To Groin Strain
A groin strain is an injury to the grointhe area of the body where the abdomen meets the leg and the inner thigh muscles attach to the pubic bone. Typically, groin strains occur in the muscles of the upper inner thigh near the pubic bone or in the front of the hip. This injury tends to be more common in athletes and men however, certain activities can increase the risk for anyone to experience a groin strain. Groin strains can occur during sprinting or any type of activity requiring forceful movement of the leg, such as jumping, kicking the leg up, or changing directions while running. Groin strains account for 10% of all hockey injuries and 5% of all soccer injuries. Physical therapists treat groin strains by reducing pain and helping patients improve muscle strength and leg motion and to increase the speed of recovery.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
Exercises To Prevent Low Back Pain
Lie on the back with the knees bent, the heels on the floor, and the weight on the heels. Press the small of the back against the floor, contract the buttocks , and contract the abdominal muscles. Hold this position for a count of 10. Repeat 20 times.
Lie on the back with the knees bent and feet on the floor. Place the hands across the chest. Contract the abdominal muscles, slowly raising the shoulders about 10 inches from the floor while keeping the head back . Then release the abdominal muscles, slowly lowering the shoulders. Do 3 sets of 10.
Lie flat on the back. Place both hands behind one knee and bring it to the chest. Hold for a count of 10. Slowly lower that leg and repeat with the other leg. Do this exercise 10 times.
If a specific cause can be diagnosed, that disorder is treated. For example, antibiotics are used to treat a prostate infection Prostatitis Prostatitis is pain and swelling, inflammation, or both of the prostate gland. The cause is sometimes a bacterial infection. Pain can occur in the area between the scrotum and anus or in the… read more . However, there is no specific treatment for musculoskeletal pain due to sprains or strains nor for many other musculoskeletal causes. But many general measures can help. Usually, these general measures are also used when a spinal nerve root is compressed.
What Are The Causes
The SI joint can become painful when the ligaments become too loose or too tight. This can occur as the result of a fall, work injury, car accident, pregnancy and childbirth, or hip/spine surgery .
Sacroiliac joint pain can occur when movement in the pelvis is not the same on both sides. Uneven movement may occur when one leg is longer or weaker than the other, or with arthritis in the hip or knee problems. Autoimmune diseases, such as axial spondyloarthritis, and biomechanical conditions, such as wearing a walking boot following foot/ankle surgery or non-supportive footwear, can lead to degenerative sacroiliitis.
Low Back Pain With Referred Pain
Low back pain with referred pain can vary widely with regards to severity and quality. It tends to be achy, dull and migratory . It tends to come and go and often varies in intensity. It can result from the identical injury or problem that causes simple axial back pain and is often no more serious.