Back pain is as common as a headache, in fact up to 80% of us will suffer from back pain at some time in our lives. It can stem from a number of different injuries to intervertebral discs, spinal joints or nerves and the symptoms differ with each. Moreover, if injury to one of these areas is not dealt with effectively within six weeks, compensations in the spine can cause pain in another of the related structures, making it very difficult to diagnose and treat. A recent study also showed that if you see a GP with back pain, who then refers you to a specialist, who in turn sends you for X-rays and MRI scans, the accuracy of diagnosis is still only 15-20%, this is a frightening fact. Unfortunately, the principles of modern medicine mean that the medical profession cannot treat an injury without an accurate diagnosis, so there is little wonder that the incidence of back pain has doubled every decade for the last 30 years. As you can imagine, the problem is made even worse when you have suffered for some time and more spinal compensations set in.
How it happens
There are many causes of back pain and, as usual, there are two different categories: extrinsic and intrinsic. Extrinsic causes include factors like incorrect lifting technique, poor posture, adopting prolonged static postures, performing movements at higher speeds than normal, and working at extreme ranges of movement, such as overreaching for something.
Intrinsic causes consist of abnormal inherent factors that affect the injured structure. For example, if the pelvis isn’t performing properly, it can increase pressure on the spine. That’s because the pelvis has three joints within it and each should move; if they do not move or are abnormally positioned, this can cause put huge pressure on the spine. Moreover, an abnormally-positioned pelvis can cause one leg to appear longer than the other, which further increases spinal pressure. Yet another intrinsic factor to be aware of is stiff joints around the lower back, since when the hip joints or upper back are stiff, this means the lower back has to move more to compensate, increasing the amount of work it has to perform and increasing the risk of injury.
Should you have a stiff sciatic nerve, you are more at risk of lower back pain. Of course, lower back pain can actually cause a stiff sciatic nerve, but it can operate the other way round too. Very tight hamstrings may also be a sign that the sciatic nerve is tight; in fact, a tight sciatic nerve can cause the hamstrings to be tighter, as tension increases to protect the nerve. So, those with a history of hamstring injuries should be aware that this injury is commonly associated with intrinsic lower back causes, irrespective of which came first.
How back pain feels
Pain is the main factor with back injuries. This will vary depending upon the structure involved and how much nerve pain there is arising from the injury. Pain can be local to the spine, found on either side, in the lower back or buttocks, or even referred down into the legs. Any combination of injured structures can combine to create a plethora of different symptoms, some of which can be ‘red herrings’ to anyone attempting to diagnose the injury. There can be a variety of symptoms too: from a dull ache, sharp pain or radiating ‘heat’, to stiffness, tingling, pins and needles and stabbing pains. Movement usually aggravates the situation, but so can being static for too long. The type of movement that aggravates pain is usually from faster and uncontrolled movements, like bending, reaching or turning. Lifting and carrying can also cause pain, as can adopting a static position for too long. In effect, when you suffer from back pain, as doubtless you will have already discovered, almost everything hurts!
How to treat back pain
Treating back pain is difficult; as you can imagine, if back injuries cannot be diagnosed easily, they are harder to treat. With an acute injury that is less than six weeks old, it is often easier to diagnose and treat, since there is less compensation to confuse matters. So, the key is to see an expert in back pain management as soon as possible, who will identify the best way of managing the injury and ideally provide a list of bespoke exercises to help its treatment, then re-educate the injured area to move properly again. If the injury is more than six weeks old, the task is much harder and, in such cases, it is critical to identify the intrinsic causes and manage them as soon as possible, in conjunction with remedial therapy.
How to prevent back pain
The best way of preventing back pain is to check through the possible extrinsic and intrinsic causes and work towards either eradicating or minimising them. Should you have a ‘vulnerable’ back, for instance, make sure that you move rather slower than normal, that you do not adopt fixed positions for prolonged periods, such as when driving, and do not overreach for items. At the same time, find someone who can examine your biomechanics and check that the pelvis is working properly and the nerves are mobile, and then prescribe some exercises to ensure the trunk muscles are working effectively.
