Certain low back conditions can give rise to more than just lower back pain.
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves: front and back. The structures in the front half include the larger, heavier bones called vertebral bodies. The shock-absorbing cushions that lie between the vertebral bodies are intervertebral disks. The disk is like a jelly donut and the center is liquid-like. The outer portion is tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back of the spine includes the spinal cord, nerve roots, and facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the movement of surrounding ligaments. The larger, heavier vertebral bodies and shock-absorbing disks carry the majority of the weight approximately 80%. The smaller facet joints carry much less weight only 20% but are responsible for guiding the movements of our back. When leg pain is present, it can occur from either a pinched nerve or an inflamed facet joint.
Leg Pain with Pinched Nerve
When a nerve is pinched, the cause is usually from the intervertebral disk. The jelly-like center leaks out and presses on the nerve that goes down the leg. This is commonly referred to as a herniated disk with sciatica. This type of pain is quite specific and often extends below the knee to the ankle or foot. It can include muscle weakness and numbness in certain areas of the leg. Bending forward increases low back and leg pain while bending backward reduces the leg pain.
When a facet joint capsule tears, the pain goes down the leg in a generalized, non-specific manner. This is usually described as a “deep ache,” and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backward. Disk-related leg pain carries a potential for surgery if all non-surgical approaches fail. Facet joint referred leg pain rarely requires invasive treatments or surgery.
Both of these sources of low back and leg pain are very treatable with chiropractic care! The important point to remember is that obtaining prompt treatment when symptoms first appear is best. Hoping it will subside on its own often results in a longer treatment course and less satisfying.
