Sheppard Spine And Sports Clinic can provide you with relief for your back pain symptoms. Our practitioner will perform a complete history and physical examination to determine what may be causing your back pain. Our practitioners can often reduce back pain significantly with the N.U.C.C.A. technique. Below is more information about back pain and what typically causes the problem.
What Is Back Pain?
In the US, 85% to 90% of Americans experience some form of back pain in their lives. Back pain is the 2nd most common reason people go to their doctor in a given year. On a given day, close to 2% of the US workforce has a serious bout of back pain. In those who are under 40, back pain is the most frequent reason for being unable to do basic life and work tasks. Some of the symptoms of back pain include the following.
- Regular aching and stiffness in any part of the back – from the base of your neck to the tailbone.
- Any localized and sharp pain in the upper back or lower back. This is especially the case when you have just lifted a heavy object or done any type of strenuous activity. Note that pain in your upper back also may be a sign of a serious heart problem.
- Chronic aching in the middle and/or lower back, particularly after you have sat or stood for a long time.
- Back pain that goes from the lower back to the buttocks, down the thigh and even into the toes or calves.
- You cannot stand straight up without pain or spasming in your lower back.
- Pain may improve when position is changed. Some types of back pain will improve if you sit or stand or engage in a different activity; how your symptoms change can make it easier for your practitioner to identify the problem.
- Pain may be worse after you wake and better after the day progresses. Many people who have lower back pain say that it is worse in the morning.
It also is important to differentiate between the onset and duration of different types of back pain:
- Acute: This back pain comes on in a sudden fashion and may last days or weeks. It is generally a normal body response to some type of injury or damage. The pain goes away as your body heals.
- Subacute low back pain: This type of back pain may last six weeks to three months. It is often a problem with a muscle or joint, but lasts longer than acute pain. If you are experiencing subacute back pain, you should be examined by a medical professional as soon as you can. This type of pain will usually affect your ability to live, sleep and/or work.
- Chronic back pain: This is pain in the lower back that normally is for more than three months. It is usually more severe and is more difficult to treat.
Common Causes of Back Pain
Back pain often occurs because there is something wrong with how the spinal joints, discs, muscles and nerves are coming together and moving. Your practitioner at Sheppard Spine and Sports Clinic can perform a full physical evaluation to determine if you have one or more of the following problems:
- Herniated and/or slipped discs: This condition is where the spongy material between the vertebrae is coming out. It is often caused by wear and tear over your life, but it can also be caused by a serious accident. A herniated disc can cause significant lower back pain as well as hip pain.
- Bulging discs: This is where the disc bulges but not to the degree as with a herniated disc. Some people will not have major symptoms when there is a bulging of the disc. But if it presses on a nerve root, the pain can be quite severe.
- Degenerative disc disease: This condition is caused by the discs between the vertebrae either tearing or shrinking. This will cause bones to rub against each other, leading to pain.
- Inflammation/wear of sacroiliac joint: This is the area where the pelvis and spine meet. It does not have a lot of movement, but it is a vital area because it handles the load of your upper body and joins it to the lower body. Swelling or tearing of the cartilage of this joint can happen from injury, arthritis or infection.
- Spinal stenosis: This is a narrowing of the spinal canal, which can cause more pressure on the nerves and spine. You may experience numbness in your legs or shoulders. It is a common problem for people over 60.
- Osteoarthritis: this is due to long term wear and tear of your disc and facet joints. It will cause pain, inflammation and possibly stenosis. This is associated with aging and progresses over time.
- Cervical radiculopathy: Also referred to as a pinched nerve. It is usually caused by bone spurs or a herniation of a disc in the back.
- Spondylolisthesis: This is where a bone in the spine slips out of place. It is common in the lower back.
- Accident: Injuries from car accidents, slip and fall incidents and other accidents are common reasons for back pain.
- Spinal fracture: A break in one or more of the vertebrae can be due to a fall, a car accident or even osteoporosis.
- Strain or sprain: It is very common for injuries to the ligaments, muscles and tendons of the middle and lower back to occur. It is commonplace when you try to lift and twist. Strains and sprains also can be due to strenuous exercise, such as running or weight lifting.
- Spasms: These can occur when you have muscles and tendons damaged in the lower back. It is common with playing sports and lifting weights.
Risk Factors For Back Pain
Patients who have one or more of the following factors could be at enhanced risk for back pain:
- Age: Over the years, wear and tear on the back and spine can result in conditions that may cause back pain, such as disc degeneration and spinal stenosis. This means that people who are over 30 or 40 years old are at higher risk for back pain than those in their teens and 20s. People from ages 30 to 60 are more likely to have problems with their discs, and those over 60 are more likely to suffer from osteoarthritis in the back.
- Smoking: People who smoke have a higher chance of suffering from back pain.
- Sedentary: People who do not regularly exercise may have a higher risk for lower back pain.
- Obese: Being overweight puts more stress on your lower back and your other joints.
- Genetics: There is research that suggests some spinal problems have a genetic connection, such as degenerative disc disease.
- Occupation: Any job that requires you to bend, twist and lift has a higher chance of back injury. For example, construction workers and nurses have a higher chance of having back problems.
Types of Low Back Pain
There are several ways to categorize pain in the lower back:
- Mechanical pain: This is the most frequent cause of lower back pain. It is mostly pain from ligaments, muscles, joints and bones in the spine. This pain is most often localized in your lower back, buttocks and the top of the legs. It is influenced by the load the spine has, and may have different pain levels based upon what you are doing.
- Radicular pain: This is back pain often caused by a nerve root becoming pinched or inflamed. Radicular pain may radiate down into the legs. It is a specific type of pain in that it is sharp and burning pain. It often comes with weakness and numbness to the affected body part.
Diagnosing Back Pain
Your Sheppard Spine And Sports Clinic practitioner will do the following to determine what may be causing your back pain:
Before the physical examination, you will be asked to offer information about your back pain symptoms and medical history, such as:
- Current symptoms: Do you have back pain at certain times of the day, such as after you get up or right after work? How far does the pain go? Do you have any numbness or weakness?
- Level of activity: Do you have an active or sedentary lifestyle? Does your work require you to sit or stand? How much do you exercise and what type?
- Sleeping habits: What is your preferred sleeping position and how much sleep do you get?
- Posture: What is a comfortable or uncomfortable posture for you?
Your practitioner will conduct a physical examination to further narrow down what may be causing your back pain. He may do tests such as testing your nerve function and muscle strength is certain areas of the body. In most cases, the series of tests will give your practitioner a better idea of the cause of your back pain and how to treat it.
After your practitioner has a better idea of the source of pain, diagnostic tests such as an MR or CT scan can be recommended.
- Low Back Pain Fact Sheet. (n.d.). Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
- Back Pain Basics. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/9516-back-pain-basics