Back Pain
Your back is the workhorse of your body. You rely on it in almost every move you make. So even though your back is a well-designed structure of bone, muscles, nerves, and other soft tissues, it is vulnerable to injury and back pain, either of which can be disabling.
Back pain is a common condition, occurring in four out of five adults. While back pain is most likely to occur at one time in your life, there are steps you can take to prevent it from happening to you or keep the pain from becoming worse.
Causes Of Back Pain
Most back pain occurs in the lower back, where most of your body weight is supported. It is often a result of strained back muscles and ligaments due to any of the following activities:
- Improper posture
- Heavy lifting
- Sudden awkward movement
- Muscle spasm
- Stress
- Accidents or injuries leaving muscle pain
- Osteoarthritis with deteriorating cartilage
- Osteoporosis with bone loss / fracture
- Fibromyalgia
- Major conditions like cancer
In some cases, however, back pain can be traced back to specific conditions, such as:
Degenerative Disk Disease
The degeneration of vertebral disks is a natural part of the aging process. What often happens though, is that when the narrowing of the disk space combines with the nociceptors, sensory receptors that respond to pain, in the outer annulus (in the disk space outside the nucleus) or dorsal root ganglion (spinal nerves) that become heightened, the result can be pain, although not always.
Sometimes pain can be felt by some people, and other times not. For example a minor accident like missing a step and landing a little harder than usual on your feet might cause back pain.
And certain activities can aggravate degenerative disks, like yard work or house cleaning movements. But overall, pain associated with degenerative disk disease generally heals within a few days at most.
Preventative measures like strengthening muscle groups to lessen future traumas are usually recommended along with an analgesic or medication that helps relieve pain. Only in some cases are epidurals or injections, blocks or surgery needed.
Psychological Issues
If acute back pain turns into chronic stages, factors of depression, fear and anxiety could increase discomfort and pain. And the longer the chronic pain persists, the more these factors tend to play a role, an increased role over time.
So treatment strategies may need to include learning coping skills and alternative lifestyle enhancements to deal with the psychological factors present.
Systemic Disease
This disease is the cause for up to 10% of back pain and largely among the elderly. Causes could be cancer-related or related to reduced bone mass or simply the aging process. Increasing or decreasing activities as well as switching positions all may have no affect on pain relief. Alternative therapies may be in need.
Facet Syndrome
Similar to pinched nerves symptoms, this is believed to be associated with pain in the back’s side joints and the main cause of up to 20 percent of back pain cases, with buttocks and upper leg pain increasing with long-term standing, and when switching sitting / standing / lying positions.
An injection of local anesthetic into the facet joint helps determine the diagnosis. However, since the anesthetic relieves the pain at the same time and is used as a short-term solution, an x-ray doesn’t help with imaging the pain results.
Recommended treatment includes rigorous lumbar activities and body mechanics exercises to learn proper or more beneficial posture and movement techniques.
Herniated Disk
Also known as a ruptured or protruding disk, a herniated disk extends beyond its own area into a surrounding region. Compression of the nerve root can cause pain. And pressure on the fibers in surrounding ligaments can cause pain.
Although an accident involving lifting could be the cause of a herniated disk, it’s not necessarily so. For many, the cause is unknown; pain can occur suddenly or gradually over time.
Relief for the pain can come from walking instead of sitting or standing, and surgery is rarely required right away, if at all in the event relief from pain happens within a limited amount of time.
During this time (up to several weeks) any of the following might be effective to use, depending upon your healthcare provider: medication, physical therapy or non-frequently, steroid spinal injections.
Spondylolisthesis
Spondylolisthesis, or the forward displacement, or slippage of one of the lower lumbar vertebrae (generally the fourth or fifth) over the vertebra below it or on the sacrum is another cause of back pain. This state of health is diagnosed by x-ray.
Pain is believed to occur where the displacement is, at or below the displacement, or from spinal stenosis, discussed next. Depending upon the patient, strengthening exercises or a back support may be all that’s required. In others, surgery may be an option.
Spinal Stenosis
SPINAL STENOSIS is the constriction or narrowing of the vertebral canal. Mainly due to aging, as the gradual lessening of disk space and changes in ligaments advance upon the nerve roots below the lumbar vertebra or L2, pain can result.
It’s often accompanied by numbness in the legs and is not aided any by walking. Different vertebra and varied physical activities can affect the pain’s location, intensity, recurring and duration.
To help diagnose this condition, healthcare providers can use myelography, or an x-ray of the spinal cord after injection of air or a radiopaque substance into the subarachnoid space, with a post-CAT scan.
And depending upon the patient, treatments can vary and be minor with medication if the pain gradually disappears, to epidural corticosteroid injections in the epidural, to blocks or surgery.
Spondyloarthropathy
This term refers to a variety of diseases affecting spinal joints; arthritis variations- psoriatic arthritis and ankylosing spondylitis, the more common of the two and in males more often than women; and sacroiliitis, accompanies inflammatory bowels.
Diagnosis consists of a physical exam, history and testing including x-rays, CAT or MRI, as the disease progresses slowly long-term fusing sacroiliac joints together and joints between vertebrae together.
To relieve pain, there is treatment with exercises and physical therapy to promote better enhanced posture and mobility and some arthritic medications.
Since back pain in any of these instances is premised on a definable cause, the treatment procedure is also easily identified. Back pain may also be caused by other specific conditions, not mentioned here because they occur only rarely.
Back Pain Treatment
Home treatment and self-care are often the best method to take care of back pain. However, there are rare instances where back pain could signal a more serious medical problem, in which case, medical advice is needed.
Take heed of the following symptoms of back pain:
- Constant or intense back pain, especially when lying down at night
- Back pain spreads down one or both legs
- Weakness, numbness, or tingling in one or both legs
- New bowel or bladder problems
- Abdominal pain or pulsation, fever
- Follows a fall, blow to your back or other injury
- Accompanied by unexplained weight loss
If you experience any of the above, then be sure to see your doctor immediately. Additionally, if you are older than 50, seek doctor’s advice about your back pain even when you do not experience any of the abovementioned symptoms.
People with a history of osteoporosis, cancer, steroid use, or drug or alcohol abuse should also see the doctor if they experience back pain.
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