They say 40 is the new 30, which is great news for all us ladies-of-a-certain-age who are just hitting our prime. But while we are getting into our new groove, our spines may be finding a new groove also — one that can cause unwelcome pain.
Common Spinal Complaints for Women
One of the most common spine problems he sees in women in their 40s is called sacroilitis, or a dysfunction of the sacroiliac joint. Usually marked by lower back pain that’s worsened with sitting, this condition is aggravated by laxity in the pelvis, which is a necessity for childbirth, but can cause back problems later in life. Men generally don’t have to deal with this issue because their pelvises don’t have that laxity, Dr. Milam said.
With sacroilitis, leg pain may also go down the leg and may act like a pinched nerve, even though it’s not (the nerve can, however, be irritated and inflamed causing the pain).
Treatment includes taking anti-inflammatories like an NSAID or steroids, or doctors will administer injections into the joint. He also said some patients find relief via physical therapy once the inflammation is under control.
Another issue that’s much more common in women (lucky us) is called Degenerative Spondylolisthesis, a condition that causes our vertebrae to slip and slide over each other because of arthritis. This can affect ladies in their 40s, but it’s more common in the older set. Symptoms include back pain and pain going down the leg that is aggravated by standing and walking and is relieved when you sit down.
Dr. Milam said treatments are similar to sacroilitis, in addition to an epidural steroid injection that would actually apply a steroid to the inflamed nerve. Lots of patients get instant relief from the epidural injection, and typically one injection will do the trick unless you’re much older. If your symptoms aren’t responding to treatment, the next step is surgery.
The final common issue Dr. Milam sees affects both men and women: herniated nucleus pulposus or disk herniation. Our invertebral disks, like our faces, dry out as we get older. When a “wrinkle” or crack happens, the disk can push out through the crack and into the space where our nerves are, causing pinched nerves and a lot of pain.
Dr. Milam said lots of patients with herniated disks find themselves in fairly continuous pain that isn’t relieved by sitting, standing, walking or lying down.
The good news is that the human body is extremely capable of healing herniated disks. Dr. Milam said in some cases, the disk is reabsorbed on its own. Again, your spine specialist will likely treat it with NSAIDs, injections and physical therapy, but if those approaches aren’t working and your symptoms are severe and activity-limiting, you may need surgery.
When to see a professional
If you’re experiencing back pain, should you pop an Aleve and lay on an ice pack for a few days? Dr. Milam said possibly, but there are a few cases when you should definitely call a pro.
• If you have motor weakness. If your foot isn’t working or your knee feels like it’s giving out, you need to make an appointment sooner rather than later. Dr. Milam said a “foot drop” is the most common type of muscle weakness — patients can’t bend their foot upward and may have to bend their knee extremely high to not trip over their toe. This could be a sign of a serious spinal issue.
• If you’ve tried “RICE” therapy (Rest, Ice, Compression and Elevation) for a week or two and aren’t seeing any relief. The “compress” portion of RICE can be achieved with a corset or waist binder, but Dr. Milam concedes that it’s tough to elevate your spine.
When you get to the specialist’s office, be prepared to tell him or her not only what hurts, but also what causes, aggravates and relieves the pain. Many spinal problems have similar symptoms but would be treated in completely opposite ways (especially regarding physical therapy), and it’s up to you to give your doctor all the relevant information.
Tips for prevention
Dr. Milam said good flexibility in your legs and back as well as core-strengthening exercises for your abs and back are often preventative for lots of spinal conditions. But don’t ever do strengthening exercises without working on flexibility as well. Dr. Milam said when we train and strengthen muscles, they tend to tighten up, which can cause pain and problems over the long haul.
He also has special advice for runners: stretch as much as possible. If not, your leg muscles will start to get tighter and tighter and as they do, they start to affect the muscles in your back, potentially causing big problems.
For more information, contact a professional at OrthoCarolina.