Brief Outline of Stress Fracture to the Vertebrae

Stress fractures of the vertebrae (spondylolysisI) are a common spine injury, caused by overuse or hyperextension of the spine. Gymnastics, weight lifting, and football are among the sports prone to this injury. Stress fractures most often occue in the fifth lumbar vertebra and act to weaken the bone, sometimes to the point where the vertebrae shift out of place; this condition is known as spondylolisthesis.

lumbar spondylolysis

Anatomy and physiology

The upper and lower joints of the lumbar spine are joined by the pars interarticularis, the weakest bony portion of the vertebral neural arch, and the region between the superior and inferior articular facets. Overuse injuries can result in cracks or fractures in the pars interarticularis, a particularly common occurence in adolescent athletes during sudden growth spurts. The lowest lumbar vertebra (L5), where the spine meets the pelvis, is the most common site for vertebral fractures.

lumbar spondylolysis cause

Cause of Injury

Genetic predisposition. Mechanical stress caused by overuse, flexion, twsting, or hyperextension of the lumbar spine. Growth spurts, especially in adolescents.

Signs and symptoms

Pain spreading across the lower back. Spasms causing stiffening in the back. Tightening of hamstring muscles, causing changes in posture.

Complications if left unattended

If slippage due to vertebral fracturing is ignored, it will worsen and can become incapcitating. Bone that has developed cracks requires sufficient time to rebuild, a process known as remodeling. Surgery may ultimately be required should fractures further develop and become severe.

Treatment

  • Rest
  • Ice
  • Anti-inflammatories
  • Physiotherapy

Rehabilitation and prevention

Following a thorough healing period (which may last 6 weeks or longer depending on the severity of the injury), flexibility and strength training exercises should be undertaken, avoiding overuse. Exercising on hard, inflexible surfaces like concrete increases the forces causing stress to the lumbar spine, and should likewise be avoided.

Long-term prognosis

Unlike most stress fractures, spondylolysis (and spondylolisthesis) do not typically heal with time, although given adequate healing time, bone remodeling tends to repair lumbar fractures, particularly in less severe cases. Should rest and normal rehabilitation fail to restore mobility and should long-term pain persist, spinal surgery (in which the lumbar vertebrae are fused with the sacrum) may be necessary.

Call (+65) 64712 674 (24 Hour) to fix an appointment to treat Lumbar Stress Fracture today.

Brief Outline of Bulging Disc

Discs are segment of connective tissue that separate the vertebrae of the spine, providing absorption from shock and allowing for the smooth flexing of the neck and back without the vertebral bones rubbing against each other. A bulging disc is one that has extended outward beyond its normal boundary, due to various forms of degeneration. Should the disc impinge on the ligaments connecting the vertebrae or on nerves of the spine, pain results, though the affliction can also be painless in many cases.

Herniated Disc

Anatomy and physiology

The spine is made up of bones known as vertebrae, separated by fibrocartilaginous intervertebral discs. There is only slight movement between any two successive vertebrae, but there is considerable movement throughout the spinal column as a whole. The intervertebral discs are composed of a thick ring of fibrous cartilage, known as the annulus fibrosis which surrounds a jelly-like material known as the nucleus pulposus, and provide flexibility, cushioning, and protection to the spine. The spinal canal runs through the center of the vertebrae and discs and contains the spinal cord running from the brain stem to the first or second lumbar vertebrae. A bulging disc may result when the nucleus pulposus pushes outward.

Cause of Injury

Age-related wear and degeneration. Stretching of ligaments connecting vertebra. Successive strain from improper weight training.

Signs and symptoms

Back pain radiating to the legs (lumbar discs). Back pain radiating to the shoulders (cervical discs). Asymptomatic, only appearing on a magnetic resonance imaging (MRI) scan.

Complications if left unattended

  • Stop activity stressing the spinal discs
  • Rest
  • Medication
  • Injection
  • Physiotherapy

Rehabilitation and prevention

Bulging discs often occur as a natural consequence of the ageing process, though in some cases, they are a precursor to herniation or rupture of the disc, with the leakage of the disc’s gel-like center. Bulging discs are an example of contained injury while herniated discs are considered uncontained injury. Minimising undue stress on the back may help avoid this injury.

Long-term prognosis

More severely bulging discs may in time rupture, causing the inner material to extrude into the spinal canal. In less severe cases, rest and ice are generally sufficient to restore pain-free mobility to the athlete.

Call (+65) 64712 674 (24 Hour) to fix an appointment to treat Bulging Disc today.

Brief Outline of Slipped Disc

A slipped disc (also known as herniatedruptured, or prolapsed disc) results when the shock-absorbing pads or intervertebral discs filling the spaces between the bones of the spine, split or rupture. The discs contain a jelly-like substance that seeps out into the surrounding tissue, causing pressure and pain to the spinal cord or spinal nerves in the area of rupture. Slipped discs most frequently occur in the lower back although any disc of the spine is vulnerable to rupture.

Herniated Disc

Anatomy and physiology

The spine is made up of bones known as vertebrae, separated by fibrocartilaginous intervertebral discs. There is only slight movement between any two successive vertebrae, but there is considerable movement throughout the spinal column as a whole. The intervertebral discs are composed of a thick ring of fibrous cartilage, known as the annulus fibrosis which surrounds a jelly-like material known as the nucleus pulposus, and provide flexibility, cushioning, and protection to the spine. The spinal canal runs through the center of the vertebrae and discs and contains the spinal cord running from the brain stem to the first or second lumbar vertebrae.

Herniated Disc in Top VIew

Cause of Slipped Disc

Improper weight lifting technique. Excessive strain. Forceful trauma to the vertebral disc.

Signs and symptoms

Pain in the back or neck. Numbness, tingling, or pain in the buttocks, back, legs, or feet. Difficulty controlling bowel or bladder.

Complications if left unattended

Slipped or herniated discs require medical attention and evaluation. Symptoms of slipped disc may indicate other underlying ailments including fracture, tumours, infection or nerve damage, with serious – in certain cases, life-threatening – implications.

Treatment

  • Bed rest
  • Anti-inflammatory medication
  • Injection
  • Physiotherapy

Rehabilitation and prevention

Bed rest and limited activity for several days is usually indicated, though normal, non-athletic daily activity should be resumed soon thereafter, to prevent atrophy and restore mobility in the spine. Physical therapy may be combined with massage and gradually increasing exercise of the back, after the pain has subsided. Strengthening and flexibility exercises, proper warm-up, avoidance of excessive or sudden weight lifting and attention to good sports technique may help avoid the injury.

Long-term prognosis

Most disc injuries are resolved without surgery, given proper recovery time. Though full restoration of strength and mobility may generally be expected, discs are vulnerable to re-injury, particularly for weigh lifters and athletes placing significant demands on the back muscles, tendons, and ligaments and on the spine itself.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our doctor regarding slipped disc today.

Brief Outline of Ligament Sprain of the Back

Sudden, irregular motion, repetitive stress or excessive load on the ligaments associated with the back can cause a sprain, or tearing of the ligaments. The resulting injury, which affects athletes in a broad variety of sports, produces pain and varying degrees of immobility.

back pain

Anatomy and physiology

Ligaments are resilient bands made up of firbous tissue. They provide strong, flexible linkages between bones. A number of ligaments support the spine. The anterior and posterior longitudinal ligaments connect the vertebral bodies in the cervical, thoracic, and lumbar regions. The supraspinous processes, and is enlarged in the cervical region, where it is known as the ligamentum nuchae. The ligamenta flava attach to, and extend between the ventral portions of the laminae of two adjacent vertebrae, from C2/C3 to L5/S1. The ligaments, muscles, and tendons work together to manage external forces to the spine during movement, particularly, bending motions and lifting.

Cause of Ligament Sprain of the Back

Lifting beyond normal capacity. Sudden torsion of the spine, including a fall during skiing or other sport. Unprepared movement involving the back.

Complications if left unattended

A sprain to the ligaments will generally force the athlete to rest the injury and allow healing time due to pain and stiffness precluding normal activity. Should activity be continued before adequate healing, further tearing of the ligaments and lasting ligament injury may result. A mild ligament sprain can become acutely painful and incapacitating if ignored.

Treatment

  • Anti-inflammatories
  • Injection
  • Physiotherapy

Rehabilitation and prevention

In the case of mild to moderate ligament sprain, a few days rest should allow a return to most non-athletic daily activity. This should be undertaken re-establish flexibility in the spine and avoid atrophy. Strengthening exercises for the back should not be undertaken until full recovery. Warm-ups and stretching prior to sports, proper posture and attention to proper technique can help avoid this injury.

Long-term prognosis

Less than 5% of back injuries require surgery, and surgery is rarely warranted for ligament sprain, although 6-8 weeks of recovery are often required, sometimes longer, should the sprain be serious. Failure to allow complete healing will increase the risk of re-injury.

Call (+65) 64712 674 (24 Hour) to fix an appointment to see our doctor regarding Back Sprain today.