Common Causes of Back Pain

This is one of the most common complaints in pain management, with 1 in 3 people experiencing back pain at some point in their lives. Anyone who has suffered from back pain, will know that it can be extremely debilitating as well as having a negative impact on the quality of life. Daily routines such as getting ready for work, driving or gentle exercise can become a challenge.

Back pain can develop over an extended period of time or symptoms can develop quickly as the result of an accident or strain. It is categorised as being either acute; a pain that develops suddenly and doesn't continue for lengthy periods of time, or chronic; pain that generally lasts longer than 3 months.

What Is The Spine?

spinal region diagramThe spinal column or vertebral column as it is sometimes referred to, is formed of 33 individual bones or vertebrae, stacked upon each other. Between the vertebrae are discs, which allow your spine to bend as well as acting as shock absorbers. The spinal column not only gives the body support and structure, enabling us to stand and move, it also protects the spinal cord. Forming part of the central nervous system, the spinal cord consists of nerves that carry information to and from the brain to the rest of the body.

The adult spine has a natural curvature, forming the 'S' shape when viewed from the side.

The spinal column is divided into 4 regions, see diagram

The cervical region (neck) – made up of 7 vertebrae, this region supports the weight of the head and has the greatest range of flexible movement.

Thoracic region (chest) – consists of 12 vertebrae, with one rib attached to each side, forming the thoracic cage, this protects the internal chest organs. This region is less flexible because of the thoracic cage.

Lumbar region (lower back) – the 5 lumbar vertebrae are the largest of the unfused vertebrae, able to bear the weight of the entire upper torso.

Sacral (pelvic) – The lowest part of the spine, consisting of 5 sacral vertebrae and a further 4 vertebrae in the coccygeal region. These fused vertebrae connect the lower part of the spine to the pelvis, transmitting the weight of the body to the pelvic girdle.

What Causes Back Pain?

Numerous factors can contribute to, or cause back pain, a large majority can be triggered by everyday routines and activities, some of these include the following:

  • Poor posture; slouching while either standing or sitting regularly
  • Moving or lifting heavy objects; this includes pushing, pulling, lifting or carrying heavy objects, can occur during housework for example
  • Staying in the same position for a long time; sitting for hours at a desk without moving can cause back pain
  • Repetitive strain injury; overusing a particular group of muscles from a repetitive movement or sport
  • Bad sleeping habits; poor posture whilst sleeping
  • Unsuitable footwear
  • Being overweight; bearing an excess burden puts pressure on the spine
  • Pregnancy; additional weight of the baby puts pressure on the spine
  • Long term use of certain corticosteroids
  • Psychological factors; stress, depression or any other kind of emotional distress

Medical Conditions That Cause Back Pain

  • Fractures
  • Herniated disc; more commonly known as a slipped disc, occurs when one of the discs between the vertebrae is damaged and presses on the nerve
  • Spinal Stenosis; the space around the spinal cord narrows and compresses a section of nerves, a rare and severe type of this condition is Cauda Equina, where all the nerves in the lower back become suddenly compressed
  • Sciatica; compression of the sciatic nerve, resulting in shooting pains down the legs
  • Osteoporosis; fractures and damage to the vertebrae are more likely to occur due to weakened bones
  • Whiplash; neck injury caused by sudden movement of the head, damaging the tendons and ligaments in the neck
  • Shoulder contracture or frozen shoulder; the area surrounding the shoulder joint, also known as the capsule (containing flexible tissue) thickens and becomes and inflamed
  • Spondylosis; the degeneration of the discs
  • Scoliosis; abnormal curvature of the spine
  • Cancer or infection; In some rare cases, back pain denotes a more serious underlying condition such as a tumour or spinal infection

Diagnosis

A GP, physiotherapist, back or pain management specialist should be able to diagnose the cause of a back condition. Some tests may be required to determine the diagnosis, these may include:

Treating Back Pain

common causes of back painThis subject area is vast, and clearly depends on the cause of the pain. Specific treatments are available for the treatment of the above medical conditions. However, for non specific back pain, a change in habits and routines can be extremely beneficial.

Prevention

Looking after your back will reduce the risk of experiencing back pain. Good posture in general, is extremely important, especially so when bending or lifting heavy objects. Not staying in the same position for a long time is also important in the prevention of back pain. A healthy life style is beneficial to everyone, this includes maintaining a healthy weight through a balanced diet and regular exercise. Not smoking, not consuming excessive amounts of caffeine or alcohol. Certain types of exercise with stretches and back strengthening exercises like yoga and Pilates, can also be very helpful in the right patient.

Medication

Over the counter medicines, such as paracetamol or an anti-inflammatory such as ibuprofen can relieve back pain and help the patient stay active. These are not recommended as a long term solution.

Physical Therapies

Physiotherapists and other health professionals that specialise in mobility, often combined with specific back strengthening exercises can significantly improve certain problems. Other types of treatment include "hands on" practitioners such as Chiropractors, Osteopaths, massage or spine manipulation, some patients also find acupuncture effective.

Psychological therapies

Coping with pain can lead patients to feel stressed, worried, upset or depressed. Psychological well being is intrinsically linked to physical well being, stress may contribute to a range of health problems. A psychologist or other mental health professional may be able to help the patient cope with their pain and the stress it causes in their everyday routines.

Surgery

In some cases when a specific cause has been found and other treatments don't work, surgery is required, in these cases the patient will be referred by a specialist.

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