What Does It Mean If Lower Back Pain Is Shooting Into Legs
Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.
If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.
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Costochondritis Is Not The Same As Tietze Syndrome
Costochondritis is often confused with Tietze syndrome, a similar but less common disorder that typically involves swelling of the second or third rib that can last for months. According to the American Family Physican review, Tietze syndrome typically affects people who are younger than 40 and is considered rare, while costochondritis is more common and can affect children, teens, and adults, says Gewanter. In fact, he says, the rib cages of kids are extra flexible, so that increases the opportunity to irritate the costochondral junctions. Local swelling is typically present with Tietzes, while it is not with costochondritis, though the RA advocate ONeill notes inconspicuous swelling with her costochondritis. In reality, whatever you want to call it, both conditions are treated in essentially the same way, says Gewanter. Tietze syndrome can subside without treatment, but over-the-counter pain medication may be used.
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Tylenol And Heat Therapy
Doctors frequently prescribe nonsteroidal anti-inflammatory drugs such as ibuprofen or aspirin to help manage back pain. However, NSAIDs arent typically a viable solution for people with UC, as the medication can cause symptoms to flare.
Those with ulcerative colitis can generally take the pain reliever Tylenol which is not an NSAID for minor aches and pains without side effects. Applying moist heat to affected areas may also reduce pain.
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How Is Neck Pain Treated
Treatments could include medications called muscle relaxants, physical therapy, a padded neck collar, or traction.
In rare situations, you may need shots of cortisone or even surgery.
With treatment, your neck will usually stop hurting in a few days. Use medicines like acetaminophen, aspirin, or ibuprofen to ease pain. Put an ice pack on your neck for the first 2 to 3 days to help lower swelling. After that, use moist heat, like a hot shower or a heating pad, to help it heal. There are also exercises you can do at home to gently stretch your neck muscles.
When The Fingers Are Abnormally Bent
Some disorders, such as rheumatoid arthritis, and injuries can cause the fingers to bend abnormally. In swan-neck deformity, the joint at the base of the finger bends in , the middle joint straightens out , and the outermost joint bends in . In boutonniÃ¨re deformity, the middle finger joint is bent inward , and the outermost finger joint is bent outward .
Cysts, which may develop behind affected knees, can rupture, causing pain and swelling in the lower legs. Up to 30% of people with rheumatoid arthritis have hard bumps just under the skin , usually near sites of pressure .
Examination of joint fluid
In addition to the important characteristic pattern of symptoms, doctors follow established criteria when evaluating a person for rheumatoid arthritis. Doctors suspect people have rheumatoid arthritis if they have more than one joint with definite swelling of the jointâs lining that is not caused by another disorder. Doctors diagnose people with rheumatoid arthritis if they have certain combinations of the following criteria:
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Effects Of Ra On The Back
RA causes inflammation in joints. The cervical spine has seven vertebrae, or bones. RA inflammation typically affects C1, also called the atlas, and C2, also called the axis.
C1 and C2 are the uppermost vertebrae and they have synovial-lined joints like those of the peripheral joints.
When the immune system attacks the tissue that lines these joints it can lead to an excess of synovial fluid. This causes swelling and pain and joint erosion over time.
Once C1 and C2 are affected, the inflammation can also cause pain in surrounding areas, including the upper back, shoulders, and head.
RA can also affect the facet joints of the spine. You have a pair of facet joints that run along the spine on both sides at the back of the spine. They connect to the bony bumps you feel down your back. The facet joints support the movement and flexibility of your spine.
RA can cause the facet joints to become inflamed resulting in neck and/or back pain. Sometimes, chronic inflammation can cause damage to the facet joints and make the spine less stable.
Instability in the spine causes a vertebra to slip out of their place where an upper vertebra slide over the lower one. This is called spondylolisthesis.
Spondylolisthesis is different from a slipped disc, or correctly named, a herniated disc. A herniated disc is usually the result of injury. C1 and C2 also are unique vertebrae that do not have discs between them.
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What Are The Long
Middle or lower back pain is most often a mechanical issue, and does not occur because of RA. However, in some cases the disease can indirectly cause pain in the mid or low back. For example, severe pain in other joints could alter the mechanics of your gait, which could result in back pain over time.
My neck has been affected the most by my RA, but my lower back also hurts, and I think thats caused by the pain in my hips and knees, says CreakyJoints member Mary Eldreth Pearson. If I have to stand for longer than 30 minutes my lower back hurts more.
RA may also indirectly affect the back because it increases a persons risk of developing osteoporosis, Dr. Bolster says. While osteoporosis itself isnt painful, it can result in insufficiency fractures of the vertebral bodies in the thoracic and lumbar spine.
If someone with RA came to me with sudden onset of back pain, that could indicate a compression fracture of the spine, which occurs in people with osteoporosis, she explains.
Rheumatoid Arthritis And Sciatica
The term sciatica describes the symptoms that occur when the sciatic nerve is pinched or irritated . These symptoms may include pain, tingling, numbness, and weakness that radiate along the sciatic nerve, affecting the buttocks, the back of the leg, and the foot.
Sciatica is not a medical diagnosis. It can be caused by a variety of conditions, including those associated with RA, such as spondylolisthesis.
Read about Spondylolisthesis on Spine-health.com
To relieve sciatica, the underlying cause must be treated.
Learn more about Sciatica on Spine-health.com
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Causes Of Chronic Inflammation
However in some cases, inflammation does not decrease. This could be due to re-injuring your body while it is healing, or repeatedly injuring the same body part . Over time, the affected joint, muscle, or organ can experience a buildup of white blood cells and swelling in their protective membranes leading to chronic inflammation and pain. Common ailments involving chronic inflammation include:
- Muscular pain in the lower back or neck
In severe cases or in the case of chronic diseases, medical or surgical treatments are required to reduce inflammation or manage symptoms. For situations involving the musculoskeletal system, chiropractic care is one non-surgical treatment available for pain management. Individuals who suffer from inflammation-linked pain as a result of chronic ailments can also consider chiropractic care as an option for long-term pain management.
What Are The Symptoms Of Neck Pain
If your neck hurts, you may notice other symptoms including:
- Pain that gets worse when you hold your head a certain way while working on a computer, driving, or doing other tasks
- Muscle tightness or spasms
- Do you have numbness or weakness in your arms or hands?
- Does moving your neck in a certain way make things better or worse?
- Does coughing or sneezing make the pain worse?
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When To See A Healthcare Provider
If you have RA and develop new symptoms in the spine, talk to your healthcare provider as soon as possible about what treatment changes or additions may help control symptoms and slow the advancement of your disease.
If you aren’t diagnosed with rheumatoid arthritis but develop symptoms consistent with RA in the spine, you should make an appointment with your healthcare provider to begin the diagnostic process. Either way, the earlier you get treatment, the better off you are likely to be down the road.
To prepare for your appointment, download our printable Doctor Discussion Guide below. It’ll help you learn relevant terminology and questions to bring up the next time you speak with your healthcare provider.
Rheumatoid Arthritis Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
How Can A Physical Therapist Help
Your physical therapist will help you set goals to reduce your symptoms and slow the progression of the disease. Youll learn how to safely exercise and continue to participate in your normal daily activities.
Your physical therapist can help with a variety of treatment options, including:
Exercise. Exercise is the most important treatment to lessen your pain and improve your mobility. Your physical therapist will prescribe specific low-impact activities that will strengthen your spine, abdomen, and hip musclesÃ¢to improve your ability to stand, walk, and balance, and lower your risk of falling.
Caution: Please consult your physical therapist or doctor before starting any exercise program.
Stretching. Your physical therapist will prescribe specific stretching exercises for your spine, arms, or legs based on the results of your initial evaluation. Obese individuals are in special need of stretching and exercises. Combined with strengthening, stretching may help slow the progression of the disease.
Symptom management. Symptom management means learning to feel better and remain active. Sometimes people are fearful that increased activity will worsen their symptoms or increase their pain. Your physical therapist will help you learn how to be more active without worsening your symptoms. The therapist will help you find your appropriate activity levels, and develop a unique program to keep you moving.
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What Are The Risk Factors For Ra
Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.
Characteristics that increase risk
- Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
- Sex. New cases of RA are typically two-to-three times higher in women than men.
- Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
- Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
- History of live births. Women who have never given birth may be at greater risk of developing RA.
- Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
- Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.
Characteristics that can decrease risk
What Are The Signs And Symptoms Of Ra
With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Signs and symptoms of RA include:
- Pain or aching in more than one joint
- Stiffness in more than one joint
- Tenderness and swelling in more than one joint
- The same symptoms on both sides of the body
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What It Feels Like
Neck pain is a primary symptom of RA in the neck. The severity of neck pain varies from person-to-person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can also make it difficult to move your head from side to side.
The difference between RA neck pain and a neck injury is that stiffness and pain from an injury may gradually improve over days or weeks. If left untreated, RA in the neck may not get better it can actually worsen. Even if symptoms do improve, inflammation, swelling, and stiffness can return.
RA in the neck also differs from osteoarthritis. RA pain is due to inflammation in the joints, whereas osteoarthritis involves the natural wear and tear of joints.
Osteoarthritis can also affect the neck. However, pain and stiffness with RA can be worse in the mornings or after periods of inactivity. Osteoarthritis neck pain tends to worsen with activity.
Are There Any Complications
Some people who have osteoarthritis in their neck might have problems swallowing or when they speak, but this is not very common. This can be caused by bony spurs affecting blood supply to the spinal cord.
If you have osteoarthritis of the spine, you may have other problems that may need treating. Let your doctor know urgently if you:
- have trouble going for a wee, or feel like you need a wee when you dont
- lose control of your bladder or bowel the organs that control wee and poo
- have feelings of numbness or tingling around your genitals or bottom
- lose power in your legs
- feel unwell like having a fever or sweating.
Spinal stenosis is a condition that happens when the spinal canal, which contains the spinal cord, gets narrower. The most common symptoms are pain and weakness or numbness in the area linked to the affected part of the spine such as the legs, arms, neck, back or shoulders.
Spinal stenosis is often caused by osteoarthritis, as the bony spurs that form on the edge of the vertebrae can irritate the nerves in your spine. It can usually be treated with exercise, over-the-counter drugs and steroid injections.
Sometimes surgery will be needed to remove the spurs and make space in the vertebral column.
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When To Get Medical Advice
See a GP if you think you have symptoms of rheumatoid arthritis, so they can try to identify the underlying cause.
Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage.
- Sit in a firm chair with armrests to relieve pressure in your back and shoulders.
- Keep your upper back straight and shoulders relaxed. Keep stomach muscles pulled in, and maintain the proper curve in your lower back. You can do this by tightening your stomach and buttocks. Some people are more comfortable sitting with the back of the chair at a 15- to 20-degree angle. A small cushion behind the lower back to maintain the natural curve of the back also can be quite helpful.
- Keep your knees slightly higher than your hips.
- Use a footstool or book under your feet if necessary.
- Keep your feet flat on the floor or other surface.
- Dont sit for a long period of time. Stand up every now and then to stretch tight muscles and give them a chance to relax.
Lie on your side with your knees bent.
- If more comfortable, place a pillow between your knees while sleeping on your side.
- If you sleep on your back, ask your doctor or physical therapist if placing pillows under your knees would help your lower back pain or make it worse.
- Use a firm mattress.
What Are The Symptoms
Low back pain can be felt as a sharp pain, ache or spasm. It can be felt in the midline of the back or on either side. Your back may feel stiff, making it difficult to turn or bend in certain directions. Sometimes pain can be felt in one or both of the legs. Along with pain, you may also experience a range of feelings and emotions, such as anxiety, worry, fear or distress.
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What Kind Of Physical Therapist Do I Need
All physical therapists are prepared through education and clinical experience to treat OA of the spine. However, you may want to consider:
- A physical therapist who has treated people with OA of the spine. Some physical therapists have a practice with an orthopedic or geriatric focus.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or geriatric physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when youre looking for a physical therapist :
- Get recommendations from family and friends or from other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists experience in helping people with OA of the spine.
- Be prepared to describe your symptoms in as much detail as possible, and report activities that make your symptoms worse.
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