If you have ever visited a doctor because of your back pain, you will remember the three essential questions that the doctor would ask you:
- How long have you had this pain?
- Where exactly is the pain located?
- How much does it hurt?
This is simply because there are different types of back pain and the answers to these questions will help the doctor better diagnose your pain. Here is how.
Overview of Back Pain:
Depending on whether your pain appears and disappears on your back or persists despite medications and exercises, you may define your pain as acute or chronic.
The pain, if it is acute, can last between a month and three. He could leave on his own and return at random. It’s called acute because even in its most casual form, back aches can cause you not to go to work. WHO even has a term for this: years lost due to disability.
If it lasts more than three months after an injury, or even after receiving treatment for acute pain, you may label it as chronic.
Your spine can be divided into three parts – upper or cervical (with bones c1 to c7), middle or thoracic (with bones th1 to th12), and lower or lumbar (with bones l1 to l5). The structure of the spine consists mainly of bones called vertebrae separated from each other by rubber discs made of cartilage. In addition, there are several muscles, ligaments, tendons and associated nerves. A deformity, injury or degeneration of any of these could be a cause of your back aches. But it is also possible that a more serious condition does not cause any pain until there are complications.
Upper Back Pain:
Let’s say you have pain in your upper back, or cervical pain, or to be more specific, pain on either side or between your shoulder blades. Based on its structure, history of injuries and daily activities, if the doctor can rule out deformities such as scoliosis (the spine curves sideways) and kyphosis (where the spine curves to give a hump). You can also rule out fractures. The two remaining causes are: muscle irritation and muscle tension. If you are middle-aged, the doctor may request a diagnostic test for spinal osteoarthritis and spinal stenosis. Although it is rare, you may also be asked to be careful with herniated discs and cervical radiculopathy.
If you have been feeling a feeling of tightness and tenderness for a few weeks and the pain worsens when you are in stationary positions such as driving or sitting or when pressing on the spine, the cause could be muscle irritation. Muscle irritation or inflammation occurs when the tendons that connect the back muscles with the spine become inflamed due to excessive use, poor posture, poor muscle or bone strength.
Muscle Sprain and Sprain:
What if your reason for visiting the doctor is a sharp and sharp stabbing pain, and that your onset can be related to a sudden violent movement? Most likely it is a muscle strain.
“The sudden movement must have put too much pressure on your muscles, causing your fibers to break”.
It is painful, but it does not require going to the emergency room unless the distension is total and the entire muscle, not just a few fibers in it, has broken. On the other hand, the sprain is when the ligament that joins two bones tears apart.
If you are diagnosed with arthritis of the facet joints, also known as spinal osteoarthritis and degenerative joint disease, the doctor will tell you that it is a more serious condition. Spinal osteoarthritis also makes you prone to have herniated discs and spinal stenosis. This condition is more likely when you are at an advanced age. With age, the discs between the vertebrae that help you twist, flex and bend your back disappear. They lose their ability to dampen friction between the bones of the spine during movements. As a result, the facet joints that join the vertebrae wear out, causing inflammation and chronic pain. To compensate for joint wear, the body stimulates bone growth, forming bone projections in the spine, which are known as osteophytes. This leads to greater friction and pain. You may curse for the pain, but you will be lucky if the symptoms are experienced in the early stages; some people feel nothing unless arthritis has reached a very advanced stage.
Eventually, osteophytes narrow the spinal canal, putting pressure on the nerves and causing pain. The narrowing occurs mainly in the cervical and lumbar region, where space is more restricted. In the cervical region, you are more likely to exert pressure on the spinal cord, leading to severe spinal cord dysfunction, known as myelopathy. You may have stabbing pain in your arms and legs and difficulty walking. Check if your calligraphy is getting worse or if you have problems with the buttons on your shirt. If it pinches the nerve roots, it causes cervical radiculopathy. Even herniated discs can cause this. You may feel the pain along the pinched nerve. You may even feel a tingling or numbness in your fingers and pain in your upper back.
Herniation, rupture or sliding of the discs is what happens when the gelatinous nucleus of a disc spills over a nearby nerve, pinches it and causes pain. In such a case, you will experience pain and even numbness mainly in the shoulders and arms. However, if the rupture occurs in the thoracic region, the upper back will hurt, especially when you cough or sneeze. Usually, herniated discs occur during years of poor posture, but even inadequate sudden lifting or torsion can cause them. Because not all cases of herniated discs hurt, a regular checkup is always recommended.
Middle Back Pain:
Now, if your pain is in the middle or thoracic part, the doctor is likely to rule out degenerative diseases. This is because the vertebrae in this part do not move much, so friction-related degeneration is uncommon. The function of the vertebrae is to protect the vital organs of the thoracic region, such as the heart, lungs and liver.
Bloating and Sprain:
If there is swelling, bruising, tenderness and pain that get worse with movement, the most likely causes are muscle strain and sprain. Unless there is numbness, tingling or irradiated pain, you do not need to worry about herniated discs or any other disc problems.
A thoracic disc herniation is uncommon, but it can occur due to an injury or osteoporosis. It can start chronic pain and affect nerve functions too. But in many cases, it may not present any symptoms and the diagnosis can be a stroke of luck.
Pain in the Back Side of the Back:
Your doctor would probably take you more seriously if you feel the pain down to your lower back, even if you label it as acute pain. This is because apparently, 20 percent of people with acute low back pain graduate to chronic type. Even the WHO Global Burden of Disease 2010 showed that it exceeds the other two types, upper and middle pain, as the leading cause of disability worldwide. Only Americans spend a whopping $ 50 billion, at least, every year on pain at back. Most of these cannot be attributed to serious conditions such as inflammatory arthritis, infection, fracture or even cancer. So if your doctor says that you have a nonspecific back ache, it means that the pain is mainly caused by mechanical factors. You will be asked about your history of injuries, daily activities or inactivity, and your lifestyle.
The mechanical factors are more or less the same as in the upper and middle back, but the risks of those who damage the lower back are greater. This is because the angles of the flexion or torsion movements in the lower back are much greater and withstand more pressure.
Spondylolysis and Spondylolisthesis:
Do you participate in sports activities such as weightlifting, soccer or gymnastics, or in any activity in which you stretch your spine too much? Then, a possible cause of your lower pain could be spondylolisthesis. It usually occurs when you have already had an overload fracture in the fifth lumbar bone due to the activities mentioned, leading to a condition known as spondylolysis. When the fracture causes the bone to be so weak that it cannot maintain its position, it slides over the bone under it, leading to spondylolisthesis.
The spondylolysis itself may not present any symptoms, but when the spondylolisthesis is aggravated, you would experience pain that radiates from the lower back to the buttocks and one or both legs, which could make walking or bending difficult.
If the doctor can relate pain in the lower back and stiffness of the spine with ankylosing spondylitis, it means that the condition is still in its early stages. Pain and movement restriction proceed to the neck in its final stages. This inflammatory arthritis affects the spine where it joins the pelvis, eventually causing the vertebrae to fuse together. It affects men more and can start as early as 17. Once it reaches the cervical area, it can narrow the spine and pinch the spinal cord.
Underlying Medical Conditions:
Certain underlying medical conditions can also cause back pain. It is known that osteoporosis, more common among women, leads to compression fractures of the spine and can cause acute and sharp pain in the middle and lower back. But its adverse effects can be felt throughout the spine.
Sometimes, the pain you feel in your back may not even originate there. In that case, it is a referred pain.
- For a pain in the upper back, try to twist the spine to see if the pain increases. If it does, it is more likely to have been caused by a mechanical factor. If you don’t, and if it hurts especially when you breathe deeply or cough, it could indicate a lung infection or something more severe.
- An intense and sudden back pain with chest discomfort, arm pain, nausea or cold sweat may indicate a heart attack, especially if you are a woman.
- Both liver and gallbladder problems can cause pain in the right side of the body, in the right shoulder, in the upper back and in the middle of the back.
- Kidney stones cause constant pain in the lower back.
Infections and Other Factors:
Although they are not common, infections of the vertebrae, a condition called osteomyelitis, or of the discs, called discitis, can cause back pain. Tumors are not common either. In most cases, if a back tumor is causing the pain, it is because it has spread from a cancer in some other part of the body. Other factors such as age, genetic tendency and race – yes, believe it or not, black women have a risk of spondylolisthesis two to three times greater than their white counterparts – are difficult to counteract.
But regardless of the location, duration and intensity of your back pain, your doctor will ask for sure:
- Get rid of a diet high in calories and fat that leads to obesity. Obese people, especially women, have a high risk of back aches, since excess weight around the stomach puts pressure on the lower back.
- Eat foods rich in omega-3 fatty acids such as salmon, Atlantic mackerel, sardines or trout, cherries, coffee and red grapes to reduce pain in your back. And load your food with turmeric, which stops the inflammation of the joints caused by arthritis by inhibiting the inflammation-inducing protein called NF-kB.
- Stop smoking because it reduces blood flow to the lower part of the spine, which contributes to the degeneration of the spinal disc and the slow healing of back injuries.
- Change your sedentary lifestyle with one that involves moderate but regular stretching exercises and specific yoga postures for the back, which will keep the spine and back muscles healthy and flexible.
- Avoid heavy lifting and running on hard surfaces.
- Control your stress and anxiety problems.
Pain intensity is not always a reliable measure because people have different pain thresholds. In addition, some of the most severe conditions of the spine, such as herniated disc, may not cause pain. But your doctor needs to know before prescribing any medication. So, you will be asked about the nature, frequency and intensity of pain.
When to See a Doctor?
If you tend to visit the doctor for every small complaint, it’s really not a bad thing when it comes to back ache. Because if you believe that time will cure pain, it may be completely out of place since degenerative conditions only get worse over time. Because many of the symptoms of these conditions do not manifest until an advanced stage, you should consider regular checkups. In any case, if your pain comes with fever, numbness, loss of reflexes, loss of bowel control, or weight loss, it is imperative that you visit a doctor.