A friend just had back surgery and that reminded me about spinal problems. Back pain is one of the commonest orthopedic problems, and the often used terms such as lumbago, sciatica and slipped disc get bandied about at the dinner table. These conditions can be crippling and come on suddenly.

However, first thing – discs do not “slip”. They do not shoot out of the spaces between the vertebrae (the tower of cotton reels that makes up your spine) and produce pain that way. The disc actually stays exactly where it is, but the center of the disc (called the nucleus) pops out through the edge of the disc and hits the nerve root. When this happens you have a very painful condition, as anyone who has had a disc prolapse (our fancy name for the “popping out” bit) will tell you. Think of the pain when the dentist starts drilling close to the tiny nerve in your tooth. Well, the sciatic nerve is a large nerve! When the nucleus of the disc hits the sciatic nerve, this produces the condition known as Sciatica - an acute searing pain which can run from the buttocks, down the legs, even all the way through to the toes.

Unfortunately, just to make diagnosis a little difficult (if it were all so easy why did we go to Medical School for six years?) you can get sciatica from other reasons as well. It may just be soft tissue swelling from strain of the ligaments between the discs, or it could even be a form of arthritis. Another complicating fact is that a strain may only produce enough tissue swelling in around 12 hours after the heavy lifting, so you go to bed OK and wake the next morning incapacitated.

So what do you do when you get a painful back? Rest and paracetamol is a safe way to begin. If it settles quickly, then just be a little careful with lifting and twisting for a couple of weeks and get on with your life as normal. If, however, you are still in trouble after a couple of days rest, then it is time to see our doctor and get that definitive diagnosis. Ask to see a specialist from our spine clinic.

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