Back Pain.

Back pain is not a disease. It is a symptom or a complaint of the patient. Back pain or backache, usually is  the lower back pain. Among the back pains,  lower back pain is the most common. If you have read the Back Bone, you will know  that  this is the area of the lumbar and sacral vertebrae. Reading the anatomy of the back bone will give you a better insight into your back pain problem and will help you to tackle it better when your doctor explains it to you.

Back Pain|Lower Back Pain.

Back pain can be either neck pain, or upper back pain or lower back pain. Back pain and lower back pain are being taken together because pain in the back is normally situated at the lower side of the back in 90% of the cases. 9 out 10 people experience acute back pain at some point of their lives.

It is the 2nd most common reason  for absentees from work  (next only to common cold). Acute back pain may last for a few days to a few weeks. It is termed chronic back pain when its duration is of more than 3 months. Acute back pain becomes chronic back pain when the cause of acute back pain is left untreated.

Facts about Back Pain.

• Back pain may be acute or chronic.
• Back pain may be dull, or piercing or a burning sensation.
• Back pain may be constant or intermittent.
• It may be localized or may radiate to other parts of the body.
• Back pain may be associated with other symptoms such tingling and numbness.
• In 98% of back bone cases, no specific or serious cause can be found even after a thorough medical investigation.  It is the 2% which can present with a serious pathology and require aggressive treatment.

Back Pain Risk Factors.

• Obesity. The excess weight that the back has to bear causes strain and weakness of the back muscles resulting in back pain.
• Mental stress causes muscular tightness and spasm which results in back pain.
• Smoking does cause malnutrition which reflects on the back muscles and the intervertebral discs.
• Pregnancy results in tightening of the back ligaments which results in back pain.
• Certain medications such as corticosteroids, when taken over a period of time cause weakness of the bones.

Cause of Back Pain.

In 98% of back pain or lower back pain cases, the cause of back pain is muscular. Wrong posture for a prolonged period or a sudden awkward movement may cause fibers of the back muscle to tear or the muscle may go into spasm. The back pain caused as a result of this usually recedes after a few days when the muscle recovers. Low back pain is experienced due to wrong posture habits.

Other Causes of Back Pain.

1. Age and Back pain: As Age advances, there is muscular weakness, osteoporosis of the bones and degenerative changes. When these changes affect the muscles and the bones of the back, back pain sets in. Age also causes degenerative changes in the intervertebral disc which loses its moiture and causes back pain. This is called spondylosis.
2. Back Muscle Strain/Sprain: Back muscle pain  is the most common cause of back pain. This normally settles down within a few weeks. It is caused by the tearing of a muscle or ligament due to its abnormal stretching, as a result of some strenuous physical activity.
3. Ruptured herniated disc: As explained in Back Bone, there is a disc, made of fibrous cartilage, between two adjacent vertebrae. It acts as a cushion  to absorb shock and facilitates movements of the back. In case of herniated disc, the inter vertebral   disc herniates out of its usual space and presses on the spine and/or a nerve producing symptoms of back pain. Here severe back pain is felt.

Causes of Herniated Disc.

• Result of an injury  to the spine.
• Repeated strain to the spine.
• Age:  With age, the inter vertebral disc loses its elasticity and ruptures with back movements. As a result, it herniates out its space. Usually, after the age of 30 years,  herniated disc is present, but only 3% of these present symptoms.

4. Spinal Stenosis is a result of the arthritis of the vertebral joints. Due to swelling of  the joints, the spinal canal gets narrowed at the place of the arthritic joint. Spinal stenosis causes severe back pain.

5. Arthritis of the vertebral joints without spinal stenosis can also give rise to pain in the back.

6. Osteoporosis of the vertebral bones causes them to become weak and prone to fracture.

7. Metastasis is spread of cancer to the back bone from a primary which is situated somewhere else in the body. Most commonly breast, lung and prostate cancer spread to the back bone.

8. Formation of an epidural abscess. This formation of pus due infection.

9. Osteomyelitis of the spine. This refers to infection in the vertebra and is a rare condition. The lumbar vertebra is the most commonly affected.

10.Referred Pain. At times due to some pathology in the abdomen, pain gets referred to the back. Such conditions are appendicitis, kidney diseases and kidney stones, urinary bladder stones, infection in the pelvis region and diseases affecting the uterus and ovaries.

11.  Lower Back Pain during Pregnancy. Lower back pain during pegnancy is common and occurs due to a number of reasons.

• Increase in weight due to the growing fetus.
• Change in posture due to the change in the center of gravity of the body as a result of the increasing abdomen.
• Increase in hormone levels during pregnancy so as to soften the muscles and ligaments to facilitate delivery of the baby. During pregnancy, the hormone relaxin increases 10 times its normal concentration which causes the changes described above.

12. Spondylitis is a non infective inflammation of the vertebrae.

13. Cervical Spondylosis causes pain at the back of the neck.

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