The condition is cauda equina syndrome. It involves “acute loss of function of the neurologic elements (nerve roots) of the spinal canal below the termination (conus) of the spinal cord,” where the nerves spread out like a horse (equina) tail. Again, this condition causes symptoms in the “saddle” of the body: butt, groin, inner thighs. BACK TO TEXT
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• Rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disease of the joints that occurs when the body’s immune system – which normally protects us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. Although rheumatoid arthritis most commonly affects the hips, knees, hands, wrists, feet, elbows and ankles, it can also affect the facet joints in the spine, causing pain and, in severe cases, destruction of the joints. This may allow the upper vertebra to slide forward on top of the lower vertebra, a condition called spondylolisthesis. The slipped vertebra may put pressure on the spinal cord and/or the nerve roots where they exit the spine.
• Juvenile Spondylarthropathy. Also called juvenile-onset spondyloarthritis (spinal arthritis), this term is used to describe spondylarthropathies that begin before age 16. In addition to affecting the spine, they may cause pain and inflammation in the joints of the pelvis, hips, ankles and knees. They may also affect other body organs such as the eyes, skin and bowels.
Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray… which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT
But moving is important for hip and knee OA. It causes your joints to compress and release, bringing blood flow, nutrients, and oxygen into the cartilage. “This can help prolong the function and longevity of your joints,” says Eric Robertson, DPT, a physical therapist and associate professor of clinical physical therapy at the University of Southern California.
Squats. Using a squat machine will strengthen your quadriceps muscles on the front of your thigh and the hamstring muscles on the back of your thigh, both of which attach to your hip and give it support. The squat machine may be vertical, in which case you’ll start in a standing position and bend your knees until your thighs are parallel to the floor, or it may be on a sliding incline board.
How to: Lie on your back with your right knee bent and foot flat on the floor (a). With your left leg fully extended, press into your right foot to shift onto your left hip. This is your starting position (b). Then, squeeze your right glutes to press your left hip open until you feel a stretch, pause, then return to start. That’s one rep (c). Perform six to eight reps, then repeat on the opposite side.
Back pain can suck the joy out of your days for week, months, even years. It can definitely be “serious” even when it’s not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
Avulsion fractures of the apophyses of the pelvis are rare injuries. This injury occurs mainly in young persons, between the ages of 8 and 14, before they've fully grown. That is because fusion of these bones does not occur until between the ages of 15 and 17 years. The cause is typically a contraction of muscles during extreme sports activity. Treatment includes rest and physical therapy as well as pain medications.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
Or anything else. Pain is a poor indicator, period! The human nervous system is really terrible about this: it routinely produces false alarms, and alarms that are much too loud. See Pain is Weird: Pain science reveals a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it. BACK TO TEXT
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.9) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.
If your sciatica is due to a herniated disk, and it's still causing severe pain after four to six weeks, surgery may be an option. The surgeon will remove a portion of the herniated disk to relieve the pressure on the sciatic nerve. About 90% of patients get relief from this type of surgery. Other surgical procedures can relieve sciatica caused by spinal stenosis.