| One of the most common mistakes of patients with low back and/or leg pain is that they immediately attribute their complaints to herniated disc. However, herniated disc is only one of the many reasons that cause this kind of pain. We will briefly touch on the others to give you an idea. Trauma is an important cause of back and/or leg pain. Depending on the severity of the trauma, the injury may remain in the superficial tissues or may progress to the deep, vertebral bones and nerve elements. Most of these are mild traumas such as strains, sprains and injuries, or pain due to excessive exercise, and the complaints usually resolve within a week with medication and rest treatment. However, the treatment of more serious traumas that cause fractures and/or slippage of the vertebrae is naturally different. Some congenital structural defects and deformities in the spine may also cause similar complaints. Some of them show symptoms on the skin, while others do not show any abnormality when viewed from the outside. In such cases, where the examination can be completely normal, the diagnosis is made by imaging methods. While degenerative changes in the spine usually occur due to aging, occupation and genetics also play an important role in some people. Wear, tear and deformation of the disc and ligaments as a result of aging can cause pain. Being obese is a disadvantage. Sometimes thickening of the joints, calcification and degeneration of the disc progress, narrowing the channels and holes through which the nerve elements pass. This can cause serious complaints. Spondylolisthesis, which our people call “slipped back”, can also cause similar complaints. Degenerative diseases that concern the nerve tissue itself should not be overlooked. Various rheumatic disorders form an important group. It is instructive to take the patient’s story in detail and to have the necessary tests done. Inflammatory diseases should not be forgotten either. Inflammation of the lower back bones may be present, or the lesion may be found in the disc space, membranes, or other soft tissues. Sometimes the inflammation has involved both bone and soft tissues, as seen in tuberculosis of the vertebral bones. Infectious diseases such as brucella can also cause similar complaints. Very rarely, fungi and parasitic diseases can be found in this region. Similar pain can be found in some diseases involving the veins. Ballooning of the part of the aorta, which is the largest artery in the body, in the abdominal cavity or the other vessels leaving the aorta, and the structure and deformities of other vessels may cause this. Internal diseases should also be taken into account. Inflammation of the pancreas, liver, gallbladder, inner lining of the heart, intestines and kidneys; diseases of the bladder, prostate, ovaries, uterus and other organs of the lower abdominal cavity; Kidney stones and ulcers should be considered in the differential diagnosis.
When it comes to low back and/or leg pain, tumors come first among the diseases that people fear most. Some of them are benign and some are malignant. Tumors may originate from the bones or soft tissues in the lower back, or they may have spread from neighboring or distant organs. If it is thought to spread from distant organs, breast, prostate and lungs should be especially investigated. Pancreatic, kidney and flat-intestinal tumors should not be forgotten. For this reason, low back and/or leg pain should be taken seriously, and further investigations should be performed at the slightest suspicion. Various cysts found in the lumbar region may also cause similar complaints. Osteoporosis, which our people call osteoporosis, is a very common cause of low back and back pain in the population over a certain age. Plain X-ray films and bone density studies are guiding for this disease, which mostly affects women. Another metabolic disease that seriously affects the spine is osteomalacia, that is, bone softening, which develops due to calcium and phosphorus deficiency in the body. Paget’s disease also falls into this group. In addition to all these, chronic radium poisoning, hemorrhages, inflammation of nerves, fiber-muscle pain, AIDS, diseases of the spine and various gynecological diseases should not be ignored. Injury, compression, entrapment, inability to feed, tumors of the sciatic nerve while injecting the hip or for other reasons should be considered. Diabetes, bad posture and sitting habits, obesity, pregnancy and various psychological disorders can also cause back or leg pain. In the differential diagnosis, it is always necessary to consider the pain and other diseases arising from the leg veins, spreading due to hip joint and other joint disorders, and reflected from the lesions in the back and neck region. It should also be noted that there may be people who try to attract the attention and affection of those around them and aim for indirect gains such as compensation or early retirement. |
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Magnetic resonance photo shows a benign tumor located in the spinal canal |
