Neck Pain, Back Pain, and Sciatica: Understanding and Dealing With Failed Back Surgery Syndrome

Spine surgeries are performed for a myriad of conditions and complaints every year here in the United States and around the world. Of the spine surgeries performed, an incredibly high number result in what is known as failed back surgery syndrome.

When referring to the terms spine surgery and back surgery, I will be applying them in their broadest sense, meaning neck, upper, middle, and lower back surgery.

Back surgery is generally the result of a number of complaints and conditions, usually all related in some way to acute and/or chronic neck pain, back pain, and/or sciatica. Failed back surgery syndrome is generally a continuation of pain, known as chronic pain, and other symptoms affecting the patient.

The medical names for the various back pain expressions are as follows:

1) Back pain, also known as dorsalgia, is a generalized pain experienced, mild to acute, isolated to chronic, in the back and originating as the result of a number of conditions, affecting a variety of structures (e.g., nerves, vertebrae, joints, intervertebral discs, etc). Back pain is said to affect as many as 95% of all adults at some time in their lives.

2) Neck pain, also known as cervicalgia, affects as many as 66% of all adults at some time in their lives. Neck pain may also express as pain in the shoulder, arm, and hand, with associated numbness and tingling into the hands and fingers.

3) Upper back pain, also referred to as thoracic pain or middle back pain, is expressed along the spine from C7 to L1, or from the base of the neck to the base of the thoracic region of the spine. Upper or middle back pain is often but not always isolated to a specific location and has a lower incidence than neck or lower back pain.

4) Lower or low back pain, also known as lumbago, is pain in the lumbar region and may be localized or may radiate laterally. In its worst form, lower back pain will be accompanied by sciatica or leg pain radiating into one or both legs.

5) Sciatic nerve pain or sciatica, also referred to as sciatic neuritis, often associated with lumbar radiculopathy, and commonly referred to as “leg pain,” generally arises as a result of an irritation or compression of one of the five nerve roots that ultimately make up the sciatic nerve. The leg pain may extend into the feet and often ranges from acute to chronic and sensation from tingling to numbness of the legs, feet, and even the toes.

Stress and Trauma Induced Neck Pain, Back Pain, and Sciatica

The pain expressions listed above, neck pain, upper and middle back pain, lower back pain, and sciatica, are complex and often arise as the result of stress placed on the spine and the reaction of the spine and the supporting musculoskeletal system to a specific stressor or constellation of stressors, whether generalized or specific. The spine may also be traumatized as the result of an isolated event, thus resulting in pain to a specific location and ranging once again from acute to chronic, depending on a myriad of factors.

Failed Back Surgery Syndrome: Failure of Expectations

Often, particularly when the reason for the back pain is the result of a number of factors, back surgery may not yield the anticipated result. The failure of the back surgery thus leading to a continuation and, in many instances, increasing levels of neck pain, back pain, and/or sciatica, and failed back surgery syndrome.

Failed Back Surgery Syndrome: Odds of Success and Behaviors

It is estimated that several million individuals see a medical practitioner daily for neck, back, and sciatic nerve pain and that between four hundred thousand and five hundred thousand individuals in the United States alone undergo back surgery in one form or another every year. Of the half a million neck pain, back pain, and/or sciatica sufferers who submit to back surgery every year, between 20% and 40% continue to have significant issues, to include similar or increased levels of pain, overall muscle weakness, excess weight and/or obesity, sleep disorders, depression, numbness and tingling of the extremities, and disability…to list just a few.

Failed Backs and Frustration Across the Board!

There is a general sense of frustration, not only on the part of the surgical patients and their families, but also within the medical community, as failed back surgery syndrome is one of the most perplexing issues facing orthopedic medicine today. The condition is not an isolated syndrome, and in fact to call failed back surgery syndrome a “syndrome” is a misnomer, it is a condition resulting from a constellation of issues and a myriad of factors, many completely unrelated to the surgical procedure itself.

Failed Back Surgery Syndrome: Reinforcing Results and Behavior

Individuals with failed back surgery syndrome, also referred to as post-laminectomy syndrome and failed spine surgery, or simply failed backs, generally have chronic to chronically acute pain affecting the original area of concern. Neck pain, back pain, and sciatica may grow worse with time and the pain may become debilitating and disabling. The resulting pain often leads to guarding, decreased activity, loss of muscle tone and sensation, over all malaise, and often addiction to pain medication.

A Mixed Bag: Why FBBS?

Failed back surgery syndrome may result from an ill-advised surgery, an ill-prepared surgical patient, an improperly executed surgical procedure, an incomplete surgical procedure, an incomplete or inadequate post-operative experience to include under prescribed physical therapy or incomplete physical therapy regimen, and a myriad of other reasons and consequences. Failed back surgery syndrome may also be the result of a number of psycho-social and socio-economic factors, as has been suggested in the medical literature lately as orthopedic medicine attempts to come to grips with this complex and frustrating issue.

The Reality of Failed Back Surgery Syndrome: Get a Second Opinion!

The reality of the matter is, regardless of cause, failed back surgery syndrome is a fact of life for tens of thousands of neck pain, back pain, and sciatica sufferers every year…and there is little hope in sight that this complex issue will be resolved any time soon. Ultimately, before agreeing to any sort of surgical intervention for neck, back or sciatic nerve pain, an individual should get a second opinion and explore every avenue of relief possible first…because the risk of a failed back surgery is real.

More in the next article: How to Deal With Failed back Surgery Syndrome

You can also see several videos dealing with failed back surgery syndrome and neck pain, back pain, and sciatica at my blog covering The 30 Day Neck Pain, Back Pain, and Sciatica!

John

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

PS, If you want to win back your life and live neck pain, back pain, and sciatica free? If you want to find real and lasting pain relief in a program of self-treatment with great individualized support? A free trial that is 100% guaranteed? Just click this link and begin your new life today!

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The 5 Ds – Degenerative Disc Disease, Diet, and Dehydration
Degenerative Disc Disease Part III

As stated in the previous two articles in this series, degenerative disc disease is not a disease but a process, a condition. Or, better still, degenerative disc disease is an age-progressive phenomenon or set of phenomena working in concert, and against musculoskeletal health generally, and spine health in particular. Degenerative disc disease affects millions worldwide, one of the principal causes of neck, back, and the sciatic nerve pain as we age.

There are a number of reasons why musculoskeletal health generally, and spine health in particular, degenerates as we grow older. There are a myriad of factors and processes that come into play and affect the overall health of the spine as we age, to include:

• Many begin to carry excess weight, some becoming medically obese.

• Our muscles weaken as we age, particularly when living a sedentary lifestyle.

• Muscle imbalances are common and widely misunderstood.

• Inadequate diet and nutrition is a fact of life for many reasons, around the world.

• Inadequate hydration and/or dehydration is a reality for many of us.

We have touched upon the first three of the above factors contributing to degenerative disc disease in the first two parts in this series. In this article, we will deal with the fourth and fifth factors on this list:

• Inadequate diet and nutrition

• Inadequate hydration and/or dehydration

In many ways, the final two factors are the most important for reasons we will discuss below (note: the number of factors affecting spine health is by no means restricted to the five mentioned previously and above but they are the most important).

Degenerative disc disease generally leads to neck pain, back pain, and sciatica at one point or another in our lives, particularly as we age.

Degeneration of the intervertebral disc (IVDs or discs) may lead to a bulging or herniated (ruptured) disc. When the disc bulges or ruptures posteriorly (to the back), the disc material may affect (i.e., irritate or impinge) the nerve root and lead to neck pain, back pain, and/or sciatica…depending on the level affected. Disc degeneration, depending on how severe and at what level, may lead to a cascading or ripple effect. Whereby, discs above and below the affected IVD begin to come under increasing levels of stress and may bulge or rupture, particularly if they have started to degenerate, as well. This sort of ripple effect can be very difficult to treat and neck or back surgery is generally ill advised, the likelihood of failed back surgery syndrome is a reality.

In an individual with advanced degenerative disc disease, the prognosis is generally not good and neck pain, back pain, and sciatica may be chronic and pervasive throughout the spine.

While the above scenario sounds dire, there is a way out!

We have discussed excess weight and/or obesity, muscle weakness, and muscle imbalance in the previous two parts in this series. Diet and nutrition and hydration are crucial to tying it all together and, without attention to these final two factors, the likelihood of a good outcome when dealing with degenerative disc disease is almost nonexistent.

Diet, Nutrition, and Dehydration

Without proper diet and nutrition, and without adequate hydration, meaning an adequate intake of water on a daily basis, our body cannot ward off the effects of age nor can it replenish and rebuild itself, as is required for overall spine health. There are a number of reasons why diet and nutrition, or rather inadequate diet and inadequate nutrition come into play, particularly as we age. Many of the reasons for inadequate diet and nutrition are cultural, some are biological, and many more are economic. For many throughout the world, it is a combination of all three. However, for the majority of us in the western world it is a matter of lifestyle. In very much the same way a sedentary lifestyle often affects disc degeneration, leading to degenerative disc disease and neck pain, back pain, and sciatica, a busy lifestyle, one where meals a gulped down and little attention is paid to nutrition and balanced meals, the outcome may be the same.

Rebuild and Replenish: The Consequences of Aging

When little attention is paid to diet and nutrition, the body simply cannot ward off the effects of aging and cannot repair and rebuild itself. As we live our lives, the body generally, and spine in particular is placed under severe stress and often must deal with traumatic events on a daily basis. If the spine is healthy and has plenty of material to rebuild itself, the stress and even isolated trauma is generally handled quite nicely. However, as spine health begins to deteriorate and the process of disc degeneration is initiated, combined with an inadequate diet lacking the proper nutrients, the breakdown in overall spine health is exponential and neck pain, back pain, and sciatica becomes a reality. This is easily offset, if caught early enough, and may be arrested even in more advanced cases, provided proper attention is paid to nutrition and diet…meaning what and when we eat.

Dehydration: A Fact of Life for Millions

The final component to be dealt with in this article, the last of the five factors contributing to degenerative disc disease; and, neck pain, back pain, and sciatica is dehydration or simply inadequate hydration. The intervertebral discs are made up of approximately 85% water. During the course of the day we lose a great deal of water through a variety of processes and functions. By the end of the day, providing we do not take in adequate amounts of water, we go into water debt. The debt is difficult to repay and the damage done, if this debt is ongoing, is substantial. Water is crucial to bodily function and is necessary for cell health, for rebuilding and repairing various anatomical structures, and for overall physiology. Meaning, without water the structure and the function of the body is negatively affected.

When it comes to spine health, dehydration leads to intervertebral disc degeneration because the main component of the IVDs, water, is lacking.

In today’s world, we take in large amounts:

• Soft drinks, many with caffeine and sodium.

• Coffee and tea, both with high levels of caffeine and/or related substances.

• Alcohol, more destructive and in more ways than we can address here.

• Sports drinks, perhaps the worst when it comes to sodium.

• Energy Drinks, perhaps the worst of all for sodium, caffeine, and a number of other substances (chemicals)!

In every instance, in every drink listed above, there is one common factor, they are all diuretic. Consequently, they all negatively impact the body’s overall ability to hold water. As a result, and because they are the staff of life for millions of people around the world, almost all of us drink them, many of us are in a constant state of dehydration…and don’t even know it.

The constant state of dehydration leads to inadequate amounts of the necessary component for proper spine health, water.

Dehydration also leads to significant problems at the cellular level. If there is not enough water for the body to properly conduct the business of life, it will rob the resources it needs from other areas, in this case the body will find the water necessary for day-to-day existence and the overall health of the spine will suffer. The constellation of behaviors and consequences above leads to disc degeneration.

The IVD degeneration leading to degenerative disc disease and, you guessed it:

• Neck Pain

• Back Pain

• Sciatic Nerve Pain or Sciatica

So, what is the answer?

Actually, the solution is not as complex or as overwhelming as it may appear. In order to offset the consequences of aging, particularly the consequences with a behavioral component, we need to adjust our behavior. If we adjust our behavior by addressing the negative impact of the 5 factors on the body generally, and the musculoskeletal system and spine specifically, we may be well on the way to our very own Fountain of Youth.

By addressing the factors leading to a breakdown at the cellular level (i.e., diet and nutrition, dehydration), addressing the behaviors affecting the musculoskeletal system (i.e., the 5 factors), and integrating a plan to focus on the body as a whole (i.e., diet, exercise, and education), we will insure proper spine health and may be able to alleviate and/or eliminate the consequences of degenerative disc disease and neck pain, back pain, and sciatica.

John

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

PS, If you are ready to begin the process of changing your behavior and dealing with your neck pain, back pain, and sciatica, as well as your degenerative disc disease, simply click here and take the next step! If you make the decision and take the first step, you will never regret it. And, you may discover your very own Fountain of Youth!

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Degenerative Disc Disease and Neck Pain, Back Pain, and Sciatica Treatment and Relief: Part II

Contrary to what many in the medical community would have you believe, degenerative disc disease is not a disease at all, it is a condition. In fact, degenerative disc disease is a symptom of a breakdown in the overall health of the musculoskeletal system, generally. And, it is a symptom of deterioration in the health of the spine, specifically. Significantly, degenerative disc disease is an age-progressive phenomenon affecting millions worldwide, one of the primary causes of neck pain, back pain, and sciatica, primarily as we age.

Let me restate my main points:

• Degenerative disc disease is not a disease, it is a condition!

• Degenerative disc disease is an age-progressive phenomenon. Or, more accurately, it is an age-progressive constellation of phenomena.

• Degenerative disc disease is actually several phenomena, meaning there are several age-related factors working against us, and our spines, in concert as we age.

• Degenerative disc disease is age-progressive, behavioral, and preventable!

There are many factors that come into play, affecting the musculoskeletal system generally, and the spine specifically. Consequently, some of the factors affecting spine health contribute to degeneration of the spine generally and the intervertebral discs (IVDs or discs), specifically; and, there is a ripple effect as the breakdown in one system impacts and affects the next, and so on.

The degeneration of the spine leads to specific and often serious consequences. Some of the consequences associated with spinal degeneration include structural changes, as in the case of degenerative disc disease.

Some of the structural changes include:

• Bony spurs, also known as osteophytes. Osteophytes generally appear in direct response to stress or a traumatic event. The overall appearance of osteophytes,
and the associated bridging (a fusion or near-fusion of osteophytes across the intervertebral space), mimics the curvatures of the spine in frequency, with the secondary curvatures being more commonly affected. The secondary curvatures being those of the cervical (neck) and lumbar (lower back) regions. The presence of osteophytes may be asymptomatic, meaning no pain or other symptoms are apparent, or they may lead to neck pain, back pain, and/or sciatica, depending on the level and severity.

• Stenosis. Stenosis is a narrowing of various spinal openings, known as foramen, by the deposition of bone. Bony deposition may also be a consequence of ossification and/or calcification of connective tissue adjacent to the foramen. The intervertebral foramen allow the spinal nerve roots to exit the spinal canal. Pressure, stress and/or trauma on and of the nerve roots, either as a consequence of stenosis or as a result of bulging or herniated discs, will often lead to neck pain, back pain, and/or sciatica, depending on the severity and the level of the spine affected.

• Osteoarthritis. Osteoarthritis may cause abnormal bone deposition, often leading to stenosis, osteophytosis (the creation of osteophytes), and neck pain, back pain, and sciatica. Osteoarthritis generally affects the secondary curvatures with greater frequency and intensity, particularly as we age. In our 60s, 70s, and 80s osteoarthritis may be every bit as common a factor in neck pain, back pain, and sciatica as degenerative disc disease. In fact, the often co-present in the same individual and are interrelated.

• Changes to the intervertebral discs. Changes to the IVDs occur as a consequence of the five factors mentioned above, all five contributing to degenerative disc disease, and other age-progressive phenomena, such as osteoarthritis and osteophytosis, also affected by the five factors. Changes in the intervertebral discs is one of the primary causes of neck pain, back pain, and sciatica.

• Connective tissue damage, including ossification and calcification. The reasons for a breakdown in the connective tissue associated with the spine can in large measure be traced back to the five factors. However, factors such as ankylosing spondylitis, rheumatoid arthritis, and several other conditions, diseases, and traumatic events may contribute to a breakdown of the connective tissue, particularly the spinal ligaments. The breakdown of the spinal ligaments is one of the principle factors contributing to degenerative disc disease and neck pain, back pain, and sciatica.

• The vertebrae (vertebral bodies). As stress transfers from the muscles to the connective tissue and on to the intervertebral discs, the stress and associated trauma adversely affects and impacts the vertebrae. When the vertebrae are adversely affected by stress and trauma meant to be handled by other components of the musculoskeletal system generally, and the spine specifically, the vertebrae undergo structural changes. Often when the vertebrae are stressed, osteophytes and osteophyte bridges occur. The osteophytes may be an adaptive response on the part of the spine to stress normally handled by the musculature, connective tissue, and intervertebral discs.

The structural changes listed above, incomplete as the list may be, provides a window into how interconnected and interrelated the spine is as a living system and how one component’s health directly affects the overall spine health.

As noted above and in part one, some of the factors contributing to a breakdown of spine health include:

• Excess weight and/or obesity

• Muscle weakness

• Muscle imbalance

• Inadequate diet and nutrition

• Dehydration

The five principle factors listed above, along with other contributory factors, negatively impact the musculoskeletal system and place stress on the spine generally, and its components individually. Consequently, stress on the spine often creates a breakdown in the overall health of the system and degeneration of the individual components, including the intervertebral discs or IVDs (or more simply, the discs), thus leading to a myriad of consequences…including degenerative disc disease and neck pain, back pain, and/or sciatica.

As stated in part one, stress placed on the spine as we age may be traced, in part, back to excess weight and/or obesity. Excess weight sets in place a ripple effect throughout the spine. The excess weight often leads to exaggerated spinal curvatures. The exaggerated curvatures of the spine stress the musculature, particularly the core muscles of the lower back and abdomen. Muscle weakness leads to back strain and back sprains. Muscle weakness may also lead to muscle imbalance, although muscle imbalances may also occur in otherwise healthy individuals, something we will address in an upcoming article. Muscle weakness and muscle imbalance may also exacerbate neck pain, back pain, and sciatica.

Interestingly, muscle weakness and muscle imbalance may lead to exaggerated spinal curvatures. Exaggerated spinal curvatures may lead to muscle weakness and muscle imbalance. All four factors, excess weight and/or obesity, exaggerated spinal curvatures, muscle weakness, and muscle imbalance will lead to a breakdown in the connective tissue, particularly the spinal ligaments, and the intervertebral discs (IVDs), thus leading to degenerative disc disease. The vertebrae themselves are affected by the stress being transferred from muscle, to ligament, to IVD, to vertebral body, leading to osteophytosis and other bony changes.

All of the above related factors will result in neck pain, back pain, and/or sciatica, depending on the level of the spine affected. In later life, the health of the spine becomes adversely affected and debilitating pain and disability may result. The entire process is often accelerated by decades when the five factors work in concert and against the musculoskeletal system and the spine, leading to early onset degenerative disc disease and neck pain, back pain, and/or sciatica.

As the spinal system begins to break down, as demonstrated above, the impact is often across the board, meaning as one component breaks down they all do, one affecting the next. Degeneration of the intervertebral discs may and often does occur, thus leading to degenerative disc disease and neck pain, back pain, and sciatica.

In part three we will examine the final two factors, inadequate diet and nutrition, and inadequate hydration or dehydration. The final two factors to be examined are as important, if not more-so, depending on the individual. Diet, nutrition, and hydration may affect and impact not only the overall spine health but the body’s ability to heal and rebuild itself when stressed and during and after a traumatic event.

Ultimately, the five factors contribute to degenerative disc disease and neck pain, back pain, and/or sciatica, they must be dealt with in the context of an entire system and not as singular entities if neck pain, back pain, and sciatica treatment is to be effective and pain relief lasting.

To your health!

John

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

PS, Do you want to start right away? Are you ready to be rid of your neck pain, back pain or sciatica? Do you want to find real and lasting neck pain, back pain, and sciatica relief? Just click this link and start today!

PPS, Or go to my other neck pain, back pain, and sciatica blog and follow us, join us, as we create a new future in time for the New year…one without pain, one with real and lasting pain relief!

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Contrary to popular belief, while one of the primary causes of neck pain, back pain, and sciatica, primarily as we age, degenerative disc disease is not a disease, it is a condition. Degenerative disc disease is an age-progressive phenomenon. It’s actually several phenomena, meaning there are several age-related factors working against us, and our spines, all at once as we age!

Degenerative Disc Disease is Age-Progressive, Behavioral, and Preventable!

Degenerative Disc Disease: Excess Weight and/or Obesity

In fact, degenerative disc disease is a natural, albeit somewhat preventable, age-progressive phenomenon that occurs as we age and our muscles, connective tissue, intervertebral discs (IVDs), and vertebrae weaken. As we age, we tend to put on and carry excess weight, some people becoming obese. The added weight places additional stress on the curvatures of the spine, particularly in the cervical (neck pain) and lumbar (lower back pain) regions. However, the thoracic and sacral regions will also experience stress, creating the related upper and middle back pain, as well as lower back pain and even sacroiliac joint dysfunction (a somewhat related condition). Overall, excess weight is the biggest single contributor to back pain of any kind, and particularly lower back pain and sciatica. As we gain weight, and as the various curvatures experience greater stress, the muscles, connective tissue (especially the ligaments), the intervertebral discs, and the vertebrae have to do more work and the once healthy back will begin to become stressed, its balance no longer sustainable, and as a result we experience neck pain, back pain, and/or sciatica…depending on the level most affected.

Degenerative Disc Disease: Muscle Weakness

As we gain weight, and as the curvatures of the spine are adversely affected as a result of additional weight, the muscles weaken, particularly the core muscles of the spine and abdomen. The abdominal and back muscles weaken as a result of the additional strain placed upon them and because of the sedentary lifestyle usually associated with weight gain…and aging. The weakened musculature, associated with inactivity, lack of exercise, and weight gain, will create a shift in the stress handling mechanisms of the spine, thus transferring much of the work usually done by the muscles of the spine and abdomen to the ligaments, intervertebral discs (IVDs), and the vertebrae. Consequently, as a result of the added weight and/or obesity, combined with the loss of muscle tone and strength, the stress transfers and the spine is more vulnerable to insult and injury, as well as “normal” age-progressive phenomena, such as degenerative disc disease.

Degenerative Disc Disease: The Spinal System and Neck Pain, Back Pain, and Sciatica

As you can no doubt see by now, the entire system in interconnected, one component dependent upon the next and the overall health of the spine affected by a breakdown at any one level (curvature) or by one component (muscles, connective tissue, IVDs or vertebrae). A breakdown at any point makes the entire system more vulnerable to injury or degeneration…with the resulting neck pain, back pain, and/or sciatica.

Degenerative Disc Disease and Connective Tissue: The Ligaments

The next spinal component at risk is the connective tissue, the tendons and ligaments, and particularly the ligaments of the spine. The two major ligaments, and there are far too many to cover all of them in this article (e.g., the anterior costotransverse ligaments and the interarticular ligaments, to name just two more of many), are the anterior and posterior longitudinal ligaments. The anterior and posterior longitudinal ligaments are very important and are central to the overall health of the spine for a number of reasons. The ligaments provide stabilization and strength along the entire length of the spine. As their name implies, they run longitudinally from the cervical region down the entire length of the spine to the sacrum and connect one vertebral body to the next via the intevertebral discs. The makeup of the anterior and posterior ligaments are somewhat different; and, they have a complex structure and a variety of functions. However, they are crucial to the overall health of the back and, when they are stressed, either as a result of a single event or as the result of excess weight, muscle weakness or muscle imbalance, the entire system is at risk. A loss of strength and/or stabilization may have an immediate and far reaching impact on the spine, resulting in neck pain, back pain, and/or sciatica.

Degenerative Disc Disease and Intervertebral Discs: IVDs and Neck Pain, Back Pain, and Sciatica

The intervertebral discs, IVDs, or simply discs are the next major component in the spinal system affecting and affected by a breakdown in the system, either as a consequence of aging generally or excess weight, muscle weakness, muscle imbalance, connective tissue issues and stress (including various stress-related injuries, trauma, ossification and calcification), specifically. The intervertebral discs are made up of approximately 80 to 85 percent water. The IVDs are also the spine’s shock absorbers, also responsible, along with the anterior and posterior longitudinal ligaments mentioned above, for stabilization and strength. The IVDs are made up of two parts, the annulous fibrosus and the nucleus pulposus, a cartilaginous outer ring system and a center gel-like substance. The IVDs have been referred to as a kind of jelly donut, with the gel in the middle being held in place by the outer cartilage and responsible for much of the impact absorption. They are also responsible for the height of the spine, maintaining a set distance between vertebrae, which allows the spinal nerves to leave the spinal canal without injury or stress. It is the intervertebral disc, its height, resilience, and strength, all related to disc health, that directly impacts and affects the presence and level of neck pain, back pain, and/or sciatica.

Degenerative Disc Disease: A Constellation of Behavioral Factors

Significantly, as the system begins to break down, as described above, or as the result of a single stress-related injury, the disc may undergo significant change. The changes in the disc over time, as a result of aging combined with excess weight, muscle weakness, muscle imbalance, loss of connective tissue strength and stability, and two additional factors, inadequate diet and nutrition, and inadequate hydration or dehydration may cause the intervertebral discs to break down, resulting in neck pain, back pain, and/or sciatica. The combination of aging and the constellation of other contributory factors leads to what is commonly called a disease, in this case degenerative disc disease. Interestingly, degenerative disc disease is not a disease but a combination of consequences, all but one traced back to behavior.

The age-progressive nature of degenerative disc disease is related to the following:

1. As we age, we generally gain weight, some of us becoming obese.
2. As we age, and we generally gain weight, some of us becoming obese, and our muscles weaken due to inactivity and/or a sedentary lifestyle.
3. As we age, and we generally gain weight…and our muscles weaken due to inactivity…the connective tissue breaks down as our muscles can no longer do the job alone and thus the stress is transferred to the connective tissue.
4. As we age, and we generally gain weight…and our muscles weaken due to inactivity…the connective tissue breaks down as our muscles can no longer do the job alone…stress is transferred to the connective tissue…the stress is then transferred to the intervertebral discs which break down due to the stress from the above mentioned factors and due to muscle imbalance, inadequate diet and nutrition, and inadequate hydration and/or dehydration.

Interestingly, I am certain I could probably stretch the above 4 points out to between 10 and 12, perhaps even more, before even starting to stretch things. But I hope you get the overall message here, that degenerative disc disease, while associated with aging, is actually linked to a constellation of behaviors; and, it is the behaviors over time that lead to the degeneration of the IVDs and not a disease process. The degeneration of the discs over time results in the entire system being more susceptible to insult and injury…and not a disease process but a behavioral constellation of factors.

Does degenerative disc disease lead to neck pain, back pain, and/or sciatica?

Certainly!

Degenerative Disc Disease and Neck Pain, Back Pain, and Sciatica: The Prognosis?

Neck Pain, Back Pain, and Sciatica Treatment and Relief!

However, the impact of the process we call a disease can be overcome to a great extent, depending of course on how much damage has been done prior to starting the right sort of treatment strategy; and, it can certainly be slowed down, if not halted entirely, through behavior modification combined with an intelligent, overall program of diet, exercise, and treatment. If applied properly, a neck pain, back pain, and/or sciatica relief and treatment strategy can offset, alleviate, and in many cases even eliminate many of the consequences of degenerative disc disease.

In the second part of this article we will explore the other factors responsible for degenerative disc disease and some of the neck pain, back pain, and sciatica relief and treatment strategies many have used to find real and lasting pain relief.

Do you want to start right away? Are you ready to be rid of your neck pain, back pain or sciatica? Do you want to find real and lasting neck pain, back pain, and sciatica relief? Just click this link and start today!

Or go to my other neck pain, back pain, and sciatica blog and follow us, join us, as we create a new future in time for the New year…one without pain, one with real and lasting pain relief!

Have questions, comments, feedback? Leave it here or contact me directly!

John

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526 (Home/Business)
866-835-2913 (Toll Free)
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

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The Archives of Physical Medicine and Rehabilitation recently reported, and John’s Hopkins Medical Center concurred, that a supervised program of exercise, particularly for chronic lower back pain sufferers who had experienced chronic lower back pain for 3 months or more, and as part of a total program, received greater back pain relief, faster, than a control group who just received exercise advice, without a supervised, long-term, and lasting exercise program to follow.

The results validate what I have been saying for the last few months, and what other researchers around the world have also discovered, that neck pain, back pain, and sciatica respond faster and the pain relief is far greater, for individuals in exercise programs, particularly supervised exercise programs.

For many years, it was considered gospel that the best way to treat neck pain, back pain, and sciatica was with bed rest. We have since demonstrated through research instituted, and followed up on, by some of the finest medical institutions in the world, among the authorities and institutions of note are the Cleveland Clinic, the Mayo Clinic, Duke University, and Johns Hopkins Medical Center, these institutions, and a myriad of others, have demonstrated that the worst bad back strategy, the way to increase neck pain, back pain, and sciatic nerve pain levels, is bed rest…the most effective pain relief strategy is exercise! Not just exercise, but low impact exercise conducted in a supervised environment and/or as part of a total neck pain, back pain, and sciatic nerve pain relief strategy.

Once again, the data is conclusive! If you want to reclaim your life, a neck pain, back pain, and/or sciatica free life, exercise must be an integral component of a supervised, and if possible individualized, program of pain relief…a bad back strategy that works!

For the best individualized program available today, one that can be integrated into a supervised program (call me for details), go to:

TheBadBackGuy.net will change your life!

Wishing you a pain free life!

Professor John P. J. Zajaros, Sr., The Bad Back Guy
Skype: johnzajaros1
216-712-6526
johnz@ultimatebadbackstrategies.com

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Sciatica affects millions of people worldwide ever year, yet little is understood about the etiology, the cause or causes, of sciatic nerve pain and what the best ways are to get immediate and lasting relief from sciatica. This article offers the reader five tested methods for dealing with sciatica, methods used for years, pain relief strategies that work. The methods of sciatica relief are in some instances counter-intuitive and in other cases buck current “wisdom,” yet they have been tried and found to work over many years and after many surgeries. It is my hope someone else will benefit from them as well.

The Sciatic Nerve

The sciatic nerve is the largest and longest nerve in the body. The sciatic nerve begins in the lumbo-sacral region (L-4 through S-3) of the spine, as five nerve roots from L-4 through S-3 leave the spine and merge into one large nerve that travels across the buttocks (the gluteal muscles) and down the back of the thigh and then into the lower leg, branching off just above the knee, at the back of the lower thigh, into the peroneal and tibial nerves, and finally giving rise to nerves traveling down into the ankle, feet, and toes. Consequently, sciatic nerve pain or sciatica may be felt at any point along the nerve route, expressing as lower back pain, pain in and/or across the buttocks, leg pain, particularly pain at the back of the leg, pain behind the knee, and even pain, tingling, and/or numbness into the feet and toes. Interestingly, sciatica is not a specific condition but a symptom of a problem at some point along the nerve route, usually but not always at the nerve root itself.

Sciatica and Ice

The ultimate sciatica pain relief strategy is ice. Ice is by far the most effective method for immediate and lasting sciatic nerve pain relief. Unfortunately, many people, including many medical experts advise heat for sciatica, in fact for almost all back pain, and that is generally the worst thing you can do. Inflammation and swelling is exacerbated by heat and reduced with ice. Most nerve irritation is the result of inflammation and/or swelling at some point along the nerve route, ice is the recommended treatment. Ice, using an ice compression brace is best but a plain old ice pack will also do just fine. Keep the ice on for as long as you can stand it, providing you have a sheet or thin towel between the ice and your skin to avoid frostbite. This is, of course, anecdotal and based on my experience over 15 major surgeries, 14 on my back…ice works best!
I am not going to get into why people recommend heat, beyond mentioning that proponents argue that heat helps with blood flow to the affected area, specifically nutrition and oxygen, and healing is enhanced, as a result. As you know too well if you experience sciatic nerve pain, when you are in pain the most important thing is relieving the pain! The healing will come later, let’s deal with the sciatica first!

Sciatica and Stretching

The second sciatic nerve pain relief strategy is stretching. The piriformis muscle, and in particular what is called piriformis syndrome, may be the culprit when it comes to sciatica, or it may be at least partially to blame. The anatomy, where the sciatic nerve is located, along with a muscle imbalance, as the sciatic nerve is located in close proximity to the piriformis, may create the piriformis syndrome. A muscle imbalance may create pressure on the sciatic nerve, creating sciatica. A simple and easy to do stretch can help alleviate discomfort almost immediately.
The sciatica stretch is easy to do while seated in any chair. While seated in a chair, cross your left leg over your right leg so that your left ankle is resting on your right knee, bend forward at the waist pulling the left leg to the chest while continuing to bend forward. You will feel stretching outside of the left leg, as well as in the buttocks, stretching and leaning forward as much as any pain will allow. This stretch may be done to both sides, both legs, but the emphasis should be on the side where you are experiencing the sciatica. If the sciatic nerve pain is due to a muscle imbalance or piriformis syndrome you will feel immediate pain relief, if the pain is the result of a bulging or herniated disc, you may need to rely on other treatment strategies.

Sciatica and the Proper Footwear

The third method is to change your footwear. Often people suffering from back pain in general, and sciatic nerve pain specifically, are wearing the wrong shoes. The importance of proper shoes cannot be overstated! Fashion? Forget about fashion! The only thing that matters when it comes to footwear is pain relief when you are in pain; and, when experiencing sciatica in particular. I recommend New Balance walking shoes because they are rated very high when it comes to heel cushioning; and, because they allow for varying degrees of width and a greater array of sizing alternatives, thus improving fit which translates into a better walking experience. The better fit and cushioning means less impact on the spine and that means less back pain generally and less sciatica specifically.

New Balance shoes are also rated very high for dealing with pronation, another factor to consider when it comes to sciatica. For more information, Runner’s World Magazine has a great website that deals extensively with the proper shoes, as well as pronation and supination. Keep in mind their target audience is a bit different but they still have excellent explanations for both of these conditions and they make recommendations concerning walking shoes, as well as what shoes are ranked highly and for what. The only other shoe worth considering is the Asics Gel-Nimbus 11. This is a runner’s shoe but took the editor’s award for Runner’s World, a huge accomplishment. The shoe mainly won for the “fit and feel” of the shoe. It has memory foam throughout for a great overall fit. I have just ordered a pair, I so will let you know what I think. They are comparably priced to the best New Balance walking shoes.

Sciatica and Water Walking

The fourth sciatic nerve pain relief strategy is water walking. No, I don’t mean swimming, I mean getting into a pool and walking and moving with slow and deliberate movements. I have used this strategy and it is one of the best I have ever found. Not only is the water soothing, even if the water temperature is on the cold side (so much the better, actually!), but the motion itself is therapeutic. I realize not everyone has access to a pool but most communities in the states have a YMCAs or YWCAs. And price shouldn’t be an issue because they have membership rates tailored for any socio-economic bracket. So, there is no reason not to get in the pool at least a couple of times a week. If you use this strategy for a month or two, you will never do without it again, it is that good.

Sciatica and The Four Letter Word – R…E…S…T

Finally, the fifth sciatic nerve pain relief strategy is rest. This is a short-term pain relief strategy and should not become a permanent method of dealing with sciatica or any other form of back pain…or pain of any sort for that matter. In fact, the reason I left it until last is because it is usually the worst thing you can do as a regular method of dealing with pain. While being active and even exercising may seem counter-intuitive, it is usually the best back pain and sciatic nerve pain relief strategy, period! The more you sit around, the less you do, the more pain you will have, guaranteed! However, there are times when you may need to put your knees up, put the ice pack on your back, and rest. As long as it is short-term and incident specific, fine, rest. But please, do not become a couch-potato as a means of treating sciatica or any other form of back pain, it is the absolutely kiss of death when it comes to overcoming your back pain and/or sciatica.

The Five Ultimate Sciatica Strategies!

So there you have them, my five ultimate bad back strategies…or in this case, my five sciatica relief strategies. The best for immediate relief from sciatica is ice. The next-best treatment strategy for sciatic nerve pain relief is stretching, particularly the piriformis/sciatica stretch. The third technique is to switch your shoes, slip into something more comfortable, so to speak. The fourth pain relief strategy is to start walking, water walking that is. By the way, walking, as a rule, is also one of the best long-term strategies and will be dealt with extensively in an upcoming article series. Finally, number five is last for a reason, it should not be abused…rest. Rest, while at times necessary, is not a long-term treatment strategy. In fact, rest is a terrible long-term strategy leading to muscle weakness, muscle atrophy, weight gain, and other negative effects that actually contribute to, instead of alleviating, back pain and sciatica. So, get off the couch or out of the recliner, and certainly out of bed, and start walking…more to follow!

To start on the right path, get this FREE book:

The 7 Day Back Pain Cure, it is a marvelous resource and it will get you pointed in the right direction immediately!

For an excellent program, one that deal effectively with every issue you may face as a neck pain, back pain, and/or sciatica sufferer, one I own myself and still use daily…after 14 back surgeries:

http://TheBadBackGuy.net This will change your life! And it is 100% guaranteed!

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

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Neck pain, back pain, and sciatica or sciatic nerve pain (also known as lumbar radiculopathy) affect millions every year. It is estimated that between 80% and 95% of adults will experience back pain and/or sciatica at some point in their lives. This is the third article in a series on sciatica, its symptoms, its causes, and the treatment strategies for dealing with the underlying causes. I hope you find it useful.

Sciatica: Symptom or Condition

In the previous two articles in this series we’ve discussed some of the reasons why we experience sciatic nerve pain or sciatica. In this article I would like to jump back just a bit and discuss the symptoms associated with sciatica, explain just why we experience this type of pain, and some of the other basic issues often faced when we experience it. Naturally, as you know by now if you’ve read my previous articles and watched my videos on sciatica, sciatic nerve pain is an expression of a condition and not the problem in and of itself. An example of this might be the pain you feel when you burn yourself. The burning sensation is a signal that your skin has been exposed to heat, the pain is not the problem, although it may be at that particular moment, it is a signal that your skin is too close to the flame. The same is true of sciatica. Sciatic nerve pain is a signal that something is wrong at some point along the sciatic nerve, usually but not always at the nerve root, where the nerve exits the spinal canal, and it is that condition which needs to be addressed. In the previous two articles, we discussed several of the reasons why a back, leg, and at times ankle and foot pain sufferer may experience sciatic nerve pain. We will now discuss the symptoms associated with the condition and where they emanate from.

Sciatica: Getting to the Root of the Pain

The sciatic nerve is the source of the pain signal we refer to as sciatica, usually the result of what is called a lumbar radiculopathy. The radiculopathy is primarily an irritation or compression of a lumbar nerve root at L4-5 or L5-S1, affecting the nerve just as it exits the spine either to the left or the right. However, sciatica may be experienced as the result of aggravation or damage to the spine and/or spinal nerve roots as high up as the second lumbar vertebrae and as low as the third sacral nerve (remember the sacrum is a primary curvature and fused). The location of the pain, weakness, and/or numbness associated with sciatica will depend in large measure on exactly where the irritation, compression, and/or damage is located on the spine.

Sciatica: The Sciatic Nerve

The sciatic nerve is the longest and largest nerve in the body. The nerve may be as big around as your big toe or thumb at its broadest point and is actually a combination of five nerves. The nerve roots, exiting the spine on both the left and right sides, generally between the fourth lumbar and third sacral vertebrae, come together and form the sciatic nerve on the anterior (front) surface of the piriformis muscle (at the rear), and fuse to become the sciatic nerve, one large nerve that travels from the piriformis down the back of the leg, branching into two separate nerves behind the knee, becoming the peroneal and tibial nerves. We will discuss the piriformis muscle and the piriformis syndrome in a future article. Interestingly, many sciatica sufferers experience pain behind the knee, particularly after driving for extended periods. We will discuss ways of dealing with this condition while driving in a future article, as well. The peroneal and tibial nerves continue to radiate down the leg, into the ankle, heel, and toes; and, this is why many sciatica sufferers have pain, numbness, and tingling radiating into the feet and toes.

The Sciatica Nerve: Function and Effect

The sciatic nerve is responsible for strength, sensation, and reflex action in the hips, thighs, lower legs, feet, and toes. When irritated or compressed, the sciatic nerve will cause pain, tingling, numbness, burning, loss of strength, and a loss of reflexes In the worst cases, sciatica will create a debilitating and disabling level of pain and loss of sensation. In its mildest forms, the pain expressed may seem like nothing more than a pulled muscle or an ache behind the knee. However, in any of the above manifestations or pain expressions, it is important to get to the “root” of the problem before more permanent and/or intractable pain and disability becomes a reality. While there are distinctions between radicular pain, meaning true sciatica, and other types of leg pain, whatever the ultimate diagnosis may be, any sort of pain of the lower limbs, particularly pain radiating down the back of one of both legs and causing numbness, tingling, and a loss of sensation should be examined right away to make sure nothing serious is going on.

Sciatica: Treatment and Prognosis

There are exercises and stretches sciatica sufferers can do to ease and in many cases eliminate the pain completely, but if the pain is ongoing and acute, a medical practitioner should be consulted. In the next article we will discuss degenerative disc disease and how it may express itself as sciatica; and, how it may be avoided. Ultimately, regardless of the etiology or cause of the pain (e.g., degenerative disc disease, herniated disc, etc.) sciatic nerve pain may be a signal of a serious condition. A medical specialist, preferably a neurologist or an orthopedic surgeon should be consulted to rule out a more serious issue before embarking on any sort of exercise regimen or treatment program. The prognosis for most sciatica sufferers is quite good, provided action is taken to eliminate the chance of a more serious condition being to blame for the pain, and an intelligent program of treatment, to include stretching and exercise, is initiated early…and the 5 contributory factors are addressed (see previous videos and articles for the “5 factors”).

To start on the right path, get this FREE book:

The 7 Day Back Pain Cure, it is a marvelous resource and it will get you pointed in the right direction immediately!

For an excellent program, one that deal effectively with every issue you may face as a neck pain, back pain, and/or sciatica sufferer, one I own myself and still use daily…after 14 back surgeries:

http://TheBadBackGuy.net This will change your life! And it is 100% guaranteed!

Professor John P. J. Zajaros, Sr., The Bad Back Guy
216-712-6526
Skype: johnzajaros1
johnz@ultimatebadbackstrategies.com

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