5 Keys to Understanding Back Pain

Back pain is one of the leading causes for people to seek medical treatment and is also a leading cause for patients missing work. One question may be, what exactly causes back pain?

In this article, we’ll review the 5 keys to understanding back pain.

#1 – Structures Related to the Spine

In order to understand the causes of back pain, we need to look at the different structures related to the spine.

Essentially, the spine is a column surrounded by muscle and ligament tissue. The spine itself is composed of bones which are called vertebra and are stacked upon each other. Between each vertebra there are discs. The vertebra themselves are connected to each other through joints called facet joints. Spaces are created between the vertebra with a central canal where the nerve and spinal cord descend from the brain and out holes on the side which are called foramen.

The spinal cord descends down this central canal and individual nerves, and out of the foramen and then descend into the lower extremities. This entire structure is surrounded by large muscles in the back and front which stabilize the spine and allow the individual to move back and forward, turn and twist. All of these structures are interrelated and depend upon each other to maintain normal activity.

If any 1 or more of the structures in the spine is injured or damaged, they can cause pain or inhibit normal function.

#2 – Vertebral Compression Fracture

A common cause for pain related to the vertebra or bony structure of the spine is a vertebral compression fracture.

This occurs frequently in older patients who have osteoporosis. From weight or stress, the vertebra collapses like a house on itself. This can be excruciatingly painful.

In the past, one had to wait until this heals on it’s on before it could be treated. New techniques include vertebroplasty and kyphoplasty which utilize placing cement into the collapsed vertebra to treat the fracture and restore normal anatomy.

#3 – Damaged Disc

One of the most frequent causes for back and leg pain is related to a damaged disc.

These discs are essentially shock absorbers between the vertebras which allow movement. Simplistically, they are like a jelly doughnut. They have a central gel-like substance which is surrounded by a capsule of tissue. The gel helps distribute weight when standing or moving. With wear or tear or an injury, the pressure can be too much and the gel tears through the capsule.

When healing occurs and new inflammatory tissue and nerves move into the tear and become painful. When moving, the disc hurts which then causes the back muscles to tense up and also hurt. If the gel breaks through the back of the disc and goes into the spinal canal, it can cause pain in one of two ways:

1. The gel itself can cause an inflammatory response, almost like a burn irritating the nerves. This then causes sciatica or burning pain down the leg into the foot.
2. The other way that it can cause pain is when the disc itself is large and puts pressure on the nerve. This will cause pain down the leg but also numbness, tingling and possibly loss of muscle strength or sensation.

Again, if there is inflammation in the spinal canal irritating the nerves, this will also cause the muscles in the back to tense up and hurt.

#4 – Facet Joints

The joints in the back, which are called facet joints, are just like any other joint such as your finger joints, elbow or knee. They can be injured or develop arthritis.

Small fractures, bleeding in the joint or inflammation are all sources of pain. When moving the joint, this makes the pain worse. Again, this will cause the muscles in the back to tense up and contribute to the back pain.

These joints can cause pain in the back or what we call referred pain into the buttocks or even into the leg similar to sciatica.

#5 – Muscle Pain

A common factor in back pain is muscle pain as can be seen from above. The muscles are an integral structure allowing movement and support. Whenever the disc, the nerves, the facet joints are painful, there will almost always be some degree of muscle pain associated with these problems.

There can also be primary muscle pain which means the muscle is the major source of back pain. This occurs when lifting improperly and the muscle is torn or stretched beyond normal limits. The muscle tissue is injured; there is inflammation and perhaps even bleeding into the muscle.

All of this can cause severe back pain, muscle spasms and significant difficulty with normal activities such as bending, turning, and sitting.

Treating Back Pain Without Surgery

When trying to treat back pain, one needs to address all of these factors which may be causing the patient’s symptoms. That is why we often combine one or more minimally invasive techniques with other treatment modalities such as physical therapy, medication, creams, and adjunctive modalities such as a brace or a TENS unit.

If you’re experiencing acute or chronic back pain and need a pain management physician to accurately diagnose and treat your pain, we invite you to reach out to us below to get started…we’d love to hear from you and have one of our board-certified doctors help you.

National Spine & Pain Centers has over 30 convenient office locations for you to choose from and is a leading provider of non-surgical pain management solutions.