Doc, about causalgia in the lower back.

[daodejing]

If one is experiencing mild, intermittant, burning back pain in the lower thoracic, upper lumber area (sometimes midline, sometimes in the paraspinal muscles) which is dependent on posture and alleviated by stretching, is this indicative of a pinched nerve in western medicine?

I vaguely remember you talking about one of the monks in your charge having a pinched nerve around L4, how's he doing these days?

[doc]

Xingwei had a slipped disc, brought upon by "slipping" while hiking with Kevin. He sprained his ankle, and then, when trying to do one of those spinning kicks, he landed wrong, twisting his lower back. I treated him with steroids, bed rest, and exercise, and now he's back to normal again.

A "pinched nerve", or, more specifically, a herniated nucleus pulposus, occurs when stress is applied to the spine, usually lumbar or cervical, causing the usually watery gel like nucleus to expel out of the disk and protrude against a nerve root, causing irritation and neurlogical sypmtomatology.

Compare that, with lumbosacral strain, which is a muscle strain, ie, tear or over stretching, of the muscles of the lower back.

It is common for those with herniated discs to experience lumbosacral strain; not only because the injury that causes the lumbosacral strain MAY have also caused herniated disc, but, because, a herniated disc can generate lumbosacral strain as a protective mechanism.

Yes, damage to an area of the spine usually triggers some sort of surrounding muscle spasm, which keeps the damaged spine area immobile, preventing further slippage of the disc.

Now, one has to be careful about back pain, as there are other reasons for it. Abdominal aortic aneurysm; pancreatic cancer; renal cancer, infection and stones; cardiovascular disease, dissecting thoracic aneurysm; some intraabdominal pathologies; and some of your "weird" cancers, such as multiple myeloma, sarcoma, neuroendocrine cancers, etc, need to be considered and ruled out.

One day, if you want, I'll do a diatribe on low back pain. I can put it on the list, with shoulder injuries, which I haven't finished, and plumflower's thingie. Just been busy trying to get russboasia off the ground. And, this sudden influx of emails.