What is “Back Pain?” Why your experience is probably different from mine.

Posted: July 29, 2011 in Basic Info, History, Pain
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This is a rewrite from a Newslettter I wrote back in 2006. It was not even meant to be all inclusive or to even touch on every cause of back pain. I just wanted to give people the knowledge that there is more than one cause of back pain. -Lori

I realize that I am talking to people with back pain of many different origins. With back pain second only to headaches as the most frequent cause of pain, I find that it is important to try and understand WHY the pain exists, not just settle with the knowledge that it does, in fact, exist.

The Basics: The backbone is connected to the…well, almost everything else in your body. Tendons connect muscles of the torso to the 33 vertebrae (backbones). Ligaments, which are similar to very tough rubber bands, hold these vertebrae in place. The spinal cord – the body’s “power line” so to speak, is connected to 31 pairs of spinal nerves, which protrude out through the vertebral column. Tendons, ligaments, and muscles connect pelvic bones to the spinal column. This lumbo-sacral area, has an eloquent network of muscles, tendons, bones and nerves, and carries most of the body’s weight load. Not surprisingly, this is the most frequent site of back pain.

Why does back pain hurt so badly? Well…to be honest, excess weight and lack of abdominal muscle tone are the most common reasons why the back hurts. Poor posture (probably related to the aforementioned reasons) and our computer-oriented lifestyle (as I type I sit here hunched over my laptop on the couch…) encourage further imbalance. Imbalance and stress in/on these areas lead to muscle fatigue, and injury.

What are the most common reasons people have back pain? Strains and overuse top the list, which causes inflammation, and of course, pain. These are also the causes of stiffness. This is just your body telling you to chill out to prevent further damage.

Osteoarthritis affects almost everyone as they approach middle age. A natural part of aging is the deterioration of cartilage that protects the joints in the spine. Discs between the vertebrae wear out, and the vertebrae get closer together and rub in places where they now meet. This process causes the area around the spine to get inflamed – and painful. (your may have heard of the term “degenerative spondylolysthesis?”  If so, just a fancy way of sayng, your old bones are breaking down and not supporting you how they used to. Now is NOT the time to take up that weight-bearing exercise you have been told you should have been doing since your 20’s though. It is a bit late to undo what has already happened if this is your diagnosis.

And then there is “sciatica”…a small word to describe what is probably the most common cause of back complaints. That stabbing, shooting pain that seems to come from the middle of your butt cheek and travel all the way down your leg into your foot – sound familiar? The path of pain is so well defined; you could take a pen and trace the outline of it on your skin. This pain is caused by the compression of the sciatic nerve, which can happen any number of ways (including placing objects, such as a wallet, in your back pocket). The most common cause is actually muscular, the tightening of a funny little muscle in the buttocks called the “piriformis”. It is situated just in the right place – around the sciatic nerve – where it can spasm, and make your life miserable. Quite often, stretches that target this area, done regularly, can help alleviate the pain. Massage therapy, by a trained and certified muscular therapist, is also quite helpful. Other muscles can impinge (or pinch) the nerve, again causing the all-to-familiar shooting pain down the leg. Closer to the spine, there are nerve roots – the beginning of the nerves that travel to our extremities.If something happens to the structures near the spinal nerve roots (damaged discs, damaged vertebral structures, degeneration….) then this sciatic pain will become a well known companion.  So don’t forget to carry a thinner wallet – if any – in that back pocket. And remember, everyone’s sciatic pain is NOT caused by the same process, even though it the same nerve, the sciatic nerve – is being angered.

Milk does a body good, right? Well, any calcium source actually does help you body prevent osteoporosis – literally translated as “hole in bones.” This disease creeps up on you in your early 50’s, so early prevention is recommended over the course of the lifetime, by consuming enough calcium from a variety of sources to keep your bones strong. Contrary to majority belief, this is not a woman’s disease. Men are also susceptible. Loss of calcium in your bones weakens the structure, resulting in degradation and easy fracture. Frequently, the site of the weakness manifests in the part of the body that takes the most stress – the low back – and can result in fractures and compressed discs.

Slipped a disc, anyone? Although a metaphor since the discs between the spinal vertebrae do not slip…they ooze, tear, and rupture. Saying “slipped” does sound much more, well, less severe. No wonder we like to say it that way! The most common way a disc becomes herniated is through falling injuries and automobile accidents. (I can personally vouch for the auto injury cause.) If you do suspect a “slipped” disc as the result of an accident, fall, or years of wear and tear, PLEASE (I cannot emphasize this enough) see an orthopedic doctor for a CT / CAT Scan (Computerized Axial Tomography). I initially saw a chiropractor, who had a practice of treating mostly minor car accident cases, and likewise, treated my injury as minor, and caused further tearing and damage to my already torn disc. Please, learn from my experiences. (NOTE: I see a chiropractor now for routine maintenance – I do not have anything against them or the profession of chiropractic.)

This was just a brief overview. There are MANY more reasons for back pain – these are just the most common.

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