Back pain is no stranger to anyone. Whether in the early or late period of life, it appears in some form. In fact, statistics show that this problem is second only to the common cold as a reason to visit the doctor’s office.
The good news is that about 85% of the victims recover in three to six days. However, by reading this material, you will learn about more serious conditions, other than the familiar pain of benign origin, which threaten our health inexorably.
Anatomy of the back
The peculiarities of the topography of the back are a major prerequisite for local symptoms. Like other areas, there are bones, muscles, fascia, joints, ligaments, blood vessels, and nerves.
Affecting them creates conditions most often for pain with varying degrees of strength and disposition. In contrast, the skin covering all these structures is one of the least affected in the whole body. Therefore, it is rarely the core of pain.
Examining the back in layers, we find the deepest bone elements. These include the ribs of the chest, the shoulder blade (although it is functionally connected to the shoulder), and the spine. The latter is a rosary of vertebrae connected by small joints, ligaments, and intervertebral disks.
The vertebrae vary in shape and size. Their size increases gradually in the upper-lower direction. This is physically logical since each one takes on a bigger load. The presence of several main types of vertebrae divides the spine into areas – cervical, thoracic and lumbar.
A total of three curves correspond to them. They give an S-shape to the spine, which makes it the spring of the body and especially the head.
The disks we have already mentioned are very often the focus of our well-known back pain. They contain a fluffy substance surrounded by harder fibrous tissue (ring).
This structure helps them to absorb shocks.
Apart from being a passive base for the body, the spinal column plays another very important role – it encloses and protects the spinal cord from damage. From it comes a rich network of nerves that have a variety of functions.
In order to separate from the solid bone sheath of the spinal cord, they pass through the narrow spaces between the individual vertebrae. In other words, the nerves around the spine are in close proximity to a hard pad, which can be a potential danger to them in certain conditions.
More superficially, a large set of muscles is concentrated, located in several layers. This is because they are burdened with the difficult task of keeping the whole body upright and tilting it in different directions. Those of them that largely determine the surface relief of the back are m. trapezius and m. latissimus dorsi.
Origin of back pain
Muscle or ligament strain
This is the number one reason for back pain, especially in the lower third. Muscle stretching is excessive tension when jumping, falling, lifting heavy objects, and more. In ligaments, this type of trauma is similar.
In extreme cases, rupture can occur. It is difficult to differentiate these conditions separately in muscles and ligaments. It can even be said that in practice most clinicians usually put them under a common denominator. This is because most often the symptoms, prognosis, and treatment are the same.
One of the features of the intervertebral disks is their high water content. Over the years, this amount gradually decreases. The result is a reduction in the size of the disks and the spaces between the individual vertebrae. In addition, the disk itself loses its elasticity. For the development of these phenomena, there are other factors:
- overload and wear of the spine
- incorrect posture
- abrupt application of pressure
- poor technique when performing exercises
As a result, the outer ring may break. From this place comes a certain amount of disk matter, affecting the roots of the nerves and thus leading to pain. Sometimes it is possible to separate whole pieces of the fluffy substance. This often leads to impaired control of the intestines and urinary tract.
Spinal stenosis (narrowing)
This condition most often affects the lumbar region. It results in a reduction in the space allotted to the spinal cord and the nerves emanating from it. In this situation, even without disk herniation, there is a constant and long-lasting pain in the back, buttocks, legs, lameness, numbness, and severely reduced performance.
Elderly people are at risk, as the most common cause of spinal stenosis is the natural degeneration of the spine with age.
The cauda equina syndrome (from the Latin “horse’s tail”)
Lower back pain is a common symptom that usually goes away over time. However, horse’s tail syndrome is a diagnosis that requires urgent surgery. It is rare and is expressed in the compression of the end nerves of the spine, which form something like a tail.
These nerve pathways control the organs in the pelvis and lower extremities. Affecting them often leads to difficulty controlling the bladder and intestines, and in more severe cases to paralysis.
There are serious conditions of the abdominal organs in which, in addition to locally manifested, the pain can become encircling and reach the back. Such diseases require immediate medical attention.
There are other conditions that should also be considered when pain occurs: muscle spasm, spondylosis, spondylolisthesis, fracture, influenza or other infection, osteomyelitis, cancer, etc. Recently, attention has been paid to depression, stress, and repressed anger as socially significant factors.
Knowing the basics of anatomy and the origin of back pain, we can move on to determining a kind of diagnosis (of course, it must be confirmed by a clinician), as well as dealing with it.
Specifically for the treatment, I note that in these articles we offer you possible options. This does not mean that they are all suitable for your condition. Rather, this information should serve as an incentive for you to seek additional information from relevant professionals.
Symptoms of back pain
The main symptom is a pain in the lower back. Neck and chest are less common. This is a result of their stability and the limited movements they perform.
In most sufferers, the symptoms are transient and disappear quickly. To make sure that nothing more seriously endangers our health, we need to answer a few questions:
- Does the pain go to one of the lower limbs?
This speaks to conditions such as herniated disks. It may be accompanied by tingling.
- Do you have pain that appears and passes spontaneously since your childhood?
Spondylosis and spondylolisthesis are diagnoses with similar manifestations.
- Do you feel pain on one side of the lower 1/3 of your back, accompanied by burning when urinating and possibly blood in the urine?
This pain is a common symptom of kidney diseases such as kidney stones, pyelonephritis, and others.
Back pain during pregnancy
During this period there is significant tension in the lower back, ie. this is a completely physiological finding.
- Very severe pain in almost every position and movement?
This is most often a symptom of a broken spine.
- Is the pain accompanied by fever, runny nose, cough?
In this case, back pain accompanies an infectious disease.
- Do you have pain accompanied by impaired bowel and bladder control?
It occurs in various conditions affecting the spine, some of which we discussed in the first part of the topic.
- Do you get, along with the pain, a feeling of numbness and weakness in the lower extremities?
These are common symptoms of spinal stenosis.
Treatment of back pain
For the pain of muscular or skeletal origin, drugs from the group of NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, ketoprofen can be used. They are widely used in the fight against pain symptoms, especially acute forms.
In addition, they reduce the inflammatory process. Their disadvantages are the frequent side effects observed especially with prolonged use – gastrointestinal disorders, high blood pressure, fluid retention, etc.
Other options include opioids, steroidal anti-inflammatory drugs, and muscle relaxants. However, their use should be under strict medical supervision.
Alternative forms of treatment
Hot and cold
The main principle of this type of hydrotherapy is to improve blood circulation, which accelerates the healing process. It is utilized for pain from muscle tension and sciatica.
To do this, you must place a towel on the affected area, pre-immersed in hot water, which is then well squeezed. It should sit for 2 minutes, then replace with a towel dipped in cold water for 1 minute. Alternate them this way for 15 minutes.
Today’s medicine has denied long bed rest. It is believed that this can be used for severe pain for no more than two days. A better option is to move and, after consulting a doctor, start light exercise for a few minutes a day.
These should aim at stretching and tightening the back and abdominal muscles, thus relieving sprains and sometimes helping with sciatica. You should stop them if you feel an increase in pain.
Most experts believe that massage is an effective adjunct to the treatment of back pain. The benefits of its implementation are the following:
- improves blood circulation
- relaxes muscles and increases range of motion
- increases the levels of endorphins, which are proven natural analgesic mediators of the body
Herbal medicine and homeopathy
There are many different natural remedies, although most have not been studied and there is no proven scientific evidence. Such are St. John’s wort oil, valerian, ginger, guelder rose, and others. It is advisable to consult your doctor before using them.
There are other methods of alternative medicine such as manual therapy and acupuncture, for which you should seek the appropriate specialists.
Surgery is rarely performed for back pain unless a disease such as sciatica or horse’s tail syndrome is present. Intervention occurs mainly when the intervertebral disks and nearby nerves are affected.
It should be noted, however, that surgery is not a guarantee of cure and even a return of pain symptoms has been proven in about 72% of cases after such manipulation.
Today, many of the classic tips for preventing back pain have proved contradictory. One of the surest ways to prevent pain symptoms is to maintain strength and flexibility through exercise. However, they must be measured and properly executed. Here are some of the other more important steps you can take:
- do not carry heavy objects in one hand only, distribute the weight evenly
- while you carry weight and you have to turn around, do not bend your waist, but turn your whole body
- warming up is key to preventing injuries during exercise
- lifting weights should not be done by bending the waist, but by squatting, keeping your back straight
- your back should be straight when you are sitting
- workplace perception can be prevented by getting up from the desk every half hour and moving around
- wearing uncomfortable shoes and those with high heels can cause back and lower back pain. Orthopedic insoles can help with such conditions
- the most suitable sleeping position is the side one, with slightly bent legs and a pillow suitable for you. If you prefer the back, place a pillow under the knees and a smaller one under the lower back
- sleeping on a firm mattress often relieves pain. However, very hard surfaces pose risks
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