Sometimes called a slipped or ruptured disk, a herniated disk is a common source of back or neck pain. Although a herniated disk can sometimes be very painful, most people feel much better with just a few months of simple, nonsurgical treatments. Only a small percentage of patients with disk herniations require surgery.
As we age, our spines change. These normal wear-and-tear effects of aging can lead to narrowing of the spinal canal, called spinal stenosis. Degenerative changes of the spine are seen in up to 95% of people by the age of 50. Spinal stenosis most often occurs in adults over 60 years old. People with spinal stenosis may or may not have back pain, depending on the degree of arthritis that has developed. Physical therapy, anti-inflamatory medications, steroid injections, acupuncture, and chiropractic manipulation can help manage symptoms. Surgery for lumbar spinal stenosis is generally reserved for patients who have poor quality of life due to pain and weakness. Patients may complain of difficulty walking for extended periods of time. This is often the reason that patients consider surgery.
One of the bones in your lower back can break and this can cause a vertebra to slip forward. In most cases of spondylolytic spondylolisthesis, the pars fracture occurs during adolescence and goes unnoticed until adulthood. The normal disk degeneration that occurs in adulthood can then stress the pars fracture and cause the vertebra to slip forward. Because a pars fracture causes the front and back parts of the spinal bone to disconnect, only the front part slips forward. Although nonsurgical treatments will not repair the slippage, many patients report that these methods do help relieve symptoms. Patients with symptoms that have not responded to nonsurgical treatment for at least 6 to12 months may be candidates for surgery. A laminectomy may be performed to remove the pressure and open the spinal canal. Spinal fusion may be used to weld together the painful vertebrae so that they heal into a single, solid bone.