Back Pain: The bane of the modern world.

In today’s world, increased sedentary workstyle, gaming and technology has reduced activity level causing back pain to become a common occurrence in the young adults as well as the older population. Given the various potential underlying factors that lead to back pain, it makes sense to delve deeper into understanding them to help ourselves heal better from this modern age curse.

Pain is an unpleasant stimulus and the response to this stimulus varies from person to person. A mild strain might cause excruciating back pain while there might be no pain in another individual with disc extrusion. There might also be potential underlying factors that might cause intermittent flare-ups of pain. Since the pain is subjective, and varies in the type and intensity, it is always advisable for a person to actively participate in the treatment protocol to ensure the most successful outcome.

Understanding the causes of back pain

The back is a complex structure and the issues with pain might be related to orthopedic or neurologic causes. The spine undergoes a lot of stress through activities like twisting, turning, bending, sudden jerky movements etc. If the mechanics used during these activities are not ideal, it might result in back pain.

The orthopedic factors associated with back pain can be:

  • Injury to joints, ligaments, muscles and bones of back.
  • Strain to the larger muscles of the back.

The manifestations, however, are interconnected and predisposition to one may lead to another.

Orthopedic Factors

  • Injury to bones, joints, ligaments or muscles of the back
  • Strain of the large muscles at the back

Neurologic factors

  • Spinal cord injury
  • Disc protrusion/herniation
  • Nerve impingement/irritation

Degenerative changes in the orthopedic structures might eventually lead to neurologic signs and symptoms with accompanying back pain depending upon the structures involved.

Identifying the causes of back pain

The right diagnosis of the cause of back pain is paramount to fixing the issue so that the pain resolution can occur. However, the complexity of the back with the several structures involved and them sharing common nerve supply adds to the complexity of making the right diagnosis.

The following steps are a good plan to move in the right direction regarding the diagnosis:

  • The individual needs to be interviewed to attain their medical history and the present history as it pertains to the present issue of back pain with details obtained about the onset of pain, the type of pain, and the intensity of pain experienced.
  • An objective examination needs to be conducted with detailed physical examination and special tests that would help rule out and rule in structures that might be the issue.
  • Further diagnostic tests in the form of X-rays and MRI might be advised depending upon the structures suspected to be involved.
  • Sometimes when a definite etiology is not found, symptomatic treatment and conservative care are provided to help manage the back pain.

The most common types of back pain experienced are:

  • Mechanical pain: Usually precipitated by muscle strains and can be sharp or dull, intermittent or constant.
  • Referred pain: Dull and achy pain that is experienced at a location away from the actual region of issue. For eg. Degenerative disc disease may produce referred pain along the course of the nerve impinged or irritated without actually causing back pain.
  • Radicular pain: Deep pain along the course of nerve with possible weakness and loss of sensation. It is caused by injury to a spinal nerve root, irritation or compression by the surrounding structures. Some common underlying conditions causing radicular pain include sciatica, spondylolisthesis, disc degeneration and spinal stenosis.

Managing back pain

The first line of treatment in self-management of back pain usually includes:

  • Pain medications as required
  • Anti-inflammatory and analgesic ointments
  • Heat therapy
  • Correction of faulty posture and maintaining good posture
  • Using relaxation techniques to relax the muscles that might be tight and causing the pain
  • Strengthening the weak structures and muscles
  • Stretching the tight structures and muscles
  • Modifying the activities to ensure they are being completed without eliciting pain
  • If the pain lingers even after the above self-management, consult a specialist to rule out issues that might have the potential to cause long term disability due to their severity

In conclusion, managing back pain is easier and the healing process faster if the action is taken earlier rather than later. The later you push this matter of pain resolution, more structures might get involved and prolong the healing process.

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