Lumbar disc disease is the leading cause of disability in America low back pain is the number one cause of work loss from pain in the U.S. This is a combined effect of poor work habits in the workplace, unsafe lifting techniques and vehicle trauma. The fact that insurers and Workmen’s Compensation will allow surgery and physical therapy and little other care causes patients to wax and wane trying to avoid operation.
The principle problem with low back pain management is failure to make an accurate diagnosis. There are more than a dozen different causes of low back pain. Most patients suffer from at least two or three causes confounding the therapy. The fact is that ligament instability is a common factor to each every cause and it is the only therapy that stands any chance to correct enough of the problems to get the patient working with a permanently repaired back.
Intervertebral Disc Bulging and disc herniation is the best-recognized and most feared cause of back pain by patients. This is so because it is the one disorder visible on MRI and myelogram. This does not mean that it is the cause of the back pain. Pain below the knee associated with back pain is almost always nerve root pressure from a herniated disc.
Associated numbness below the knee strongly supports the diagnosis. The cause of leg pain is not simply herniated disc material pressing on the nerve. The narrowed disc leaves the Intervertebral ligaments to long allowing abnormal movement that causes the nerve to rub or chafe.
Correcting the ligaments can improve range of motion, reduce leg pain and protect the disc against further degeneration. Disc degeneration is a separate disorder. Many older patients have dried brittle discs that have not bulged or herniated. These discs may also lose their blood supply and undergo tissue death with deterioration, fermentation and gas formation causing diskitis. This is visible on plain x-ray as air inside the disc.