As a result of the natural wear and tear that occurs with aging, certain parts of the
spine start to degenerate and wear out, as we grow older. This process makes some of the
anatomic structures of the spine, the bones, intervertebral discs, ligaments, and muscles
less flexible and less resistant to injury.
Spondylolysis is a defect in the lamina of the vertebrae in the pars interarticularis,
usually the fourth or the fifth lumbar vertebrae in the lower (lumbar) spine.
Spondylolysis may occur as a congenital defect or be the result of repetitive trauma. Some
physicians believe spondylolysis may be caused by genetics, and that someone could be born
with thin vertebral bones causing them to be vulnerable to the condition. Spondylolysis is
common in teenage gymnasts and football players, and presents with lower back pain that is
worse with strenuous exercise or activity. Radiographic findings are subtle, but bone
scans or CT scans will usually detect the lesion. Activity modification, bracing, or
surgical treatment may be indicated for persistent symptoms.
Spondylolysis is a prerequisite for spondylolisthesis. Spondylolisthesis occurs when
spondylolysis weakens one of the vertebrae so much that the bone slips out of place.
The condition can also be caused by degenerative disc disease. If the vertebrae slip
too much and begin to press on nerves, surgery may become necessary. Spondylolisthesis may
also be caused by degenerative conditions that affect the vertebral joints, such as
Early treatment usually involves rest and medication. Progressive spondylolisthesis
usually requires surgical treatment.
Sprains and Strains
Most acute pain in the back results from sustaining a mild strain in the back or back
musculature. Sprains and strains in your lower back usually happen during a sudden and
stressful injury, causing stretching or tearing of the muscles, tendons, or ligaments in
your lower back. When you strain or sprain your lower back it causes a lot of stress on
your spine, irritating it. If you have this condition you may also suffer from painful
muscle spasms which can occur during your daily activities or at night while you're
sleeping. The pain is usually limited to five or ten days.
Sciatica is the descriptive term for when pain runs from your back or buttocks down your
leg and into your foot
It is a condition caused by either compression or trauma of the sciatic nerve. Sciatica is
made worse when you cough or if someone lifts your leg up while you are laying down.
Symptoms may begin abruptly or gradually, are usually irritated by movement, and often
grow worse at night. Sciatica implies that there is an irritation of your nerve root in
the lower part of your spine. In some instances, this could be due to a ruptured or
herniated disc in your lower back.
Herniated / Ruptured Discs
A herniated ("slipped") or ruptured disc in your back can cause each of these
pain patterns. The ways in which a slipped disc causes different pain patterns and
problems with your back is related to the location of the slipped disc along your spine,
and also to the anatomy of your spinal column.
The spinal column, or backbone, consists of 33 bones (vertebrae) and can be divided into
five segments, called the cervical, thoracic, lumbar, sacral, and coccygeal sections of
the spine. Each of these sections corresponds to a particular part of your body. The
cervical spine is that part of the spine in your neck, the thoracic spine supports your
trunk, the lumbar spine supports your lower back and abdomen, the sacrum supports your
pelvis, and the coccyx is your tailbone.
Stenosis produces a dull, aching pain in the lower back when standing or walking. The
pain usually radiates down into the buttocks and thighs, and can be relieved by stopping
to rest, or by using a walker or a shopping cart in the grocery store. These symptoms
usually slowly get worse over time, and people who suffer from spinal stenosis will notice
a slow decrease in their ability to walk shorter and shorter distances.
Lumbar stenosis is a natural product of aging, and the wear and tear on the spine
throughout our lives. As our bodies grow older, the ligaments and bones that make up the
spine grow thicker and become stiffer. The spinal canal gradually narrows, and the spinal
cord is slowly compressed. The lack of space interferes with the normal function of the
spinal cord and the body becomes less able to function normally.
1171 East Putnam Avenue - Greenwich, CT 06830 Yale Spine Center - 1 Long Wharf Drive, 6th Floor - New Haven, CT (203) 785-2807
Dr. Debra Petrucci
Please call for an appointment.
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