Back Pain

Back Pain: Symptoms, Causes, Diagnosis, Treatment, and Prevention

What is Back Pain?

Back pain is one of the most frequent complaints encountered in our day-to-day life. Out of every ten individuals, 9 people experience backache at some point in their life.

We are today, living in corporate age. It is both a bane and boon. Rapid development and progress is the boon and the high rate of occurrences of people with backache, is one of the side-effects of this age with predominant sedentary lifestyle. People over the world suffer from backache- a highly painful and annoying condition. The number has increased over the few years, as the living habits have undergone a drastic change. It’s a tech savvy world and work is mostly done on computers- be it desktops or laptops. This decreases our physical movements and increases our chances of having backaches.

Before going further let’s understand the vertebral column-

The vertebral column, the spine or the backbone consists of 33 small bones and a network of complex nerves, muscles, tendons and ligaments extending from the skull to the pelvis. The intervertebral disc is a cartilaginous structure, present between each vertebra, functioning like a shock absorber or a cushion.
 
Types of Vertebrae: There are Five different types of Vertebrae in the Vertabral olumn (spine).

1) Cervical Vertebrae (7) : C1-C7
2) Thoracic Vertebrae (12) : T1-T12
3) Lumbar Vertebrae (5) : L1-L5
4) Sacral Vertebrae or Fused Vertebrae (5) : S1-S5
5) Coccygeal Vertebrae  usually 4, rarely (3-5) fused vertebrae or (Tailbone)

The more information:

  • Cervical vertebrae forms the upper part of the spine
  • Thoracic are present between the neck and the lower back
  • Lumbar vertebrae are the largest and strongest vertebrae lying in lower back between the chest and hips
  • The sacrum and the coccyx are the bones situated at the base of the spine.

What Is Backache

Dorsalgia  lumbago or backache can be neck pain, upper backache,  lower backache and tailbone pain, originating from the muscles, nerves or bones of the spine.

Types:

It can be both acute and chronic type

  • Intensity: Can be a dull ache or a sharp and piercing one.
  • In the United States, lumbago or lower back pain is the fifth most common cause for seeking physician’s advice.

What Causes Backache?

The main causes of backache include the following:

  • Lumbar Strain: It is the most common condition characterized by the stretch injury of the muscles, tendons and ligaments of the back. The stretch injury can be due to excessive use or trauma.
  • Ruptured Intervertebral Disc: Another common cause of backache is presence of ruptured intervertebral disc, which is also known as herniated disc. Discogenic backache is a condition where disc sustains some damage, but without the herniation.
  • Stenosis of Spine: This condition is quite common in elderly. With advancing age the spine becomes tight and constricted, causing backache.
  • Spondylolisthesis: A condition seen when one segment of spine slips away from the other. It is generally common in elderly, where degenerative changes occur in the spine.
  • Spondolysis: In this situation the vertebra may slip backwards, forward or below a bone as a result of injury or fracture (stress fracture) sustained by one or both wing-shaped parts of the veretebra.
  • Osteoporosis: Backache occurring from osteoporosis is chiefly due to vertebral compression fracture. Osteoporosis weakens the bones and lead to fractures due to compression.
  • Paget’s Disease: It is characterized by softening, enlargement and bowing of bones.
  • Osteod Osteoma: It is a benign tumour arisisng from osteoblasts, similar to osteoblastoma.
  • Trauma
  • Myeloma
  • Metastases
  • DISH ( Diffused Idiopathic Skeletal Hyperostosis)

Types of  Back Injury 

Back injuries differ in intensity, ranging from mild short affair to agonizing long term ailments.

The two main types of back injuries are:

1.   Spondylolithesis –  It is a condition characterized by slipping of one vertebra over the other, commonly occurring at the base of spine. Congenitally defective vertebra and trauma are the chief accountable factors for spondylolithesis.

2.  Cervical Radiculopathy – Nerve function damage or disturbances caused as result of compression of one or more nerve roots near the cervical vertebra causes cervical radiculopathy. This results in pain and loss of sensation to the upper extremities, depending upon the site of damaged nerve. [-pagebreak-] 

Causes Of Spondylolithesis 

The condition is commonly seen in children and adolescents who are active in sports. The main causes are:

  • Trauma to vertebra
  • Congenital defective vertebra
  • Stress fracture
  • Infection or diseased vertebra

Cervical Radiculopathy

Cervical radiculopathy is a condition resulting from compression of the sensory nerves near the cervical vertebrae, by the protruding intervertebral disc. Other synonymous terms used are herniated nucleus pulposus and herniated intervertebral disc.          

Causes of Cervical Radiculopathy

The important  known causes include:

  • In young individuals– the condition occurs as a consequence of pressure from the contents of ruptured disc or herniated disc.
  • In older individuals– It is primarily caused due to the normal degenerative changes of bones and intervertebral disc, which irritates nerves and causes pain. Common degenerative diseases like arthritis are mainly responsible for cervical radiculopathy.
  • Any trauma to spinal column.
Symptoms of Back Pain

Back Pain: Symptoms

Symptoms of Spondylolithesis

Some of the important symptoms of spondylolisthesis are as under:

  • Low back pain
  • Discomfort in movement or rising from bed
  • Muscular tightness and stiffness
  • Pain in buttocks
  • Radiating pain down the legs (resulting from pressure on nerve roots)              


Symptoms of Cervical Radiculopathy

The important symptoms include

1. Pain radiating to arms, shoulders and neck or chest.
2. Tingling sensation or numbness in hands and fingers.
3. Weakness and lack of coordination in hands.

How Is Back Pain Diagnosed?

Apart from the complete medical history and the general physical examination, there are certain diagnostic tests required by your doctor, to facilitate him/her to treat your backache. The investigative studies can be:

  • Blood and Urine tests: They are done to rule out any underlying infections. or pathology.
  • Radiographic films: X-rays are useful in pinpointing any bone deformity, fracture or tumors.
  • Computerized Tomography Scanning (CT scan): Are helpful in diagnosing the conditions like herniated disc, disc ruptures or spinal stenosis.
  • Magnetic Resonance Imaging (MRI): It is a sophisticated technique used to find out intricate spinal pathology involving spinal nerves, disc, etc.
  • Discography: It involves injecting contrast dye in spinal disc for diagnostic purposes.