Back pain: intervertebral disc or spinal canal?

Back pain: intervertebral disc or spinal canal?

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Severe leg pain speaks for spinal stenosis

Back pain has long been one of the so-called "widespread diseases", from which about one in eight suffer across all social classes. The causes are lack of exercise, sitting for hours and one-sided stress. In 80 percent of those affected, symptoms disappear after a week or two at the latest. On the other hand, if they last longer than six months, experts speak of chronic conditions. Problems with the intervertebral discs as well as narrowing in the spinal canal, so-called spinal stenoses, are among the most common causes of chronic back pain. The type of symptoms provides information about which illness sufferers suffer from.

"Spinal stenosis is a narrowing of the spinal canal," explains Dr. Thomas Bierstedt, spinal surgeon and specialist in neurosurgery from the Orthopedic-Neurosurgical Center in Datteln and Recklinghausen. "These constrictions are caused, among other things, by bulging of the intervertebral discs, widened vertebral joints or thickened ligaments." In the event of an intervertebral disc, the fiber ring of the intervertebral disc tears and the gelatinous content bulges out into the vertebral canal. In the case of particularly large herniated discs, compression of the spinal cord and thus spinal stenosis can also occur. However, they are very rare. If the herniated disc occurs in the area of ​​the lumbar spine and presses on nerves, severe back pain sets in. They usually appear suddenly and movement aggravates the pain. With spinal stenosis, on the other hand, severe back pain occurs primarily in addition to back pain. "Patients often complain of neurological deficits such as sensitivity disorders and motor failures according to the segment concerned," explains Dr. Bierstedt. "The clearest difference in the symptoms, however, is that sufferers with spinal stenosis complain of temporary symptoms of numbness and weakness of the legs even with short walking distances and extreme leg pain. This improves when they stop and bend over at the front. ”With such a forward torso inclination, the spinal canal widens and the permanent pressure on nerves and vessels eases. This is also why patients are often almost free of symptoms when they ride a bicycle.

The good news for people with chronic pain: Regardless of whether they involve a herniated disc or spinal stenosis - the complaints can usually be treated with conservative treatments using targeted movement therapies, heat treatments, electrotherapy and other physical applications, as well as acupuncture and neurostimulation. Only in the case of severe herniated discs or severe narrowing in the spinal canal, surgery is required. "In the case of spinal stenosis, we surgically remove constrictions in the spinal canal and stabilize the spine with a dynamic TOPS implant," explains Dr. "This flexible spine stabilization ensures that the patient remains flexible in all directions after the operation and is permanently free of pain." There are also modern procedures for operations on the intervertebral discs. (pm)

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  1. Hovsep

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  2. Krocka

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