Types of
Back Pain
There
are many structures
in the lower back
that can cause severe
pain. These include
muscles, ligaments,
tendons, bones,
joints and discs. The
outer rim of the disc
can be a source of
significant back pain
due to its rich nerve
supply and tendency
towards injury.
During our
development, there is
a great deal of
overlap of nerve
supply to all of
these structures.
This makes it nearly
impossible for the
brain to distinguish
between injury to one
structure versus
another. For example,
a torn or herniated
disc can feel
identical to a
bruised muscle or
ligament injury. This
is where an
examination into the
cause of the pain is
important; each of
these different
structures may need a
different type of
treatment to resolve
your pain.
Back pain can be
divided into three
large
classifications. The
most common condition
is known as axial, or
mechanical back pain.
This pain can run the
gamut from a very
sharp to a dull ache.
It may occur all the
time, or it may come
and go. It also
varies in intensity
from very mild to
extremely severe. For
some you may report
that his/ her lower
back is only sore
when having been
seated for a long
time, or after
working in the
garden. Or you may
report severe,
debilitating pain and
need assistance to
walk or stand, or
even to get up from a
sitting position. You
can be perfectly
straight, the other
is bent over and
locked in a crooked
posture. The one
thing that is common
in these conditions
is that the pain is
restricted to the
lower back area.
This most common type
of problem,
mechanical back pain,
is completely
non-specific with
regards to the
injured structure or
structures.
Generally, the pain
gets worse with
certain activities or
positions. It is
usually relieved by
rest or changing
positions. Note,
extended bed rest may
aggravate this type
of problem.
This condition
responds extremely
well to conservative
care. At times,
spinal manipulation
alone is the
"miracle" affording
immediate relief.
More often, the
injury involves more
than just a
misalignment of
vertebrae or of your
pelvis. Nerves,
muscles, tendons,
ligaments and skin
can all have an
influence on the
degree of discomfort.
And each of these may
need to be addressed
to attain relief.
Back pain can be
divided into three
large classifications
- axial pain,
referred pain
and radicular
pain.
If you have multiple
episodes of this type
of pain, you will
want to engage
yourself in a
rehabilitation
program to help
resolve the
underlying causes of
the problem. Here,
the diagnosis goes
farther than just
finding out what is
causing the pain, but
additionally centers
on what weakness or
restriction you have
that ultimately
causes you to have an
episode. Here again,
we function much like
a "coach", finding
the cause and helping
to direct you towards
ways of avoiding and
limiting future bouts
with pain.
The most common type
of back pain is known
as
referred pain.
Here, patients
complain of having an
achy, dull type of
pain that seems to
move around. The
discomfort comes and
goes and varies in
intensity. This achy
pain starts in the
low back area and
commonly spreads into
the groin, buttocks
and upper thighs.
The treatment options
here are similar to
those used in
treating axial pain.
Diagnostic and
therapeutic measures
are aimed at
correcting
abnormalities in the
muscles, ligaments
and small joints of
the spine.
The last type of back
pain is known as
radicular pain.
In this case, the
pain is described as
deep and usually
constant. It follows
the nerve down the
leg and is often
accompanied by
numbness or tingling
and muscle weakness.
The most common
example of this type
of problem is the
sciatic pain
that radiates along
that sciatic nerve -
down the back of the
thigh and calf into
the foot. This type
of pain is caused by
injury to a spinal
nerve. Some of the
possible causes of
this are a disc
protrusion or bulge,
arthritic changes or
a narrowing of the
opening through which
the nerve exits.
While a few of these
cases will require
surgery, most respond
to conservative care.
Here the care will
consist of
multiple therapies,
all designed to
reduce inflammation,
balance your posture,
strengthen supporting
structures, attain
normal motion and
improve the health of
the nerve that is
involved.
In all types of back
pain, your health
habits play an
important role. For
example, there are
certain foods that
are high in the fats
that cause more
inflammation.
Limiting intake of
these animal fats and
increasing your
intake of the good
fats that reduce
inflammation may play
an important role in
your healing.
Smoking is another
health concern.
Statistically,
smokers are slow
healers with respect
to back pain. An
important part in
prevention is keeping
these back muscles
active and in good
tone.
One of the most
important areas in
chronic back pain
management is the
strength of your
abdominal wall and
your pelvic floor.
There are three major
abdominal muscles,
each with small
subdivisions. Any
weakness in one of
these sections can be
the root cause of a
chronic back problem.
Weakness in these
structures causes
your back muscles to
tighten and shorten.
This adversely
affects the lower
back on the small
joints and discs.
If you are interested
in helping to prevent
or at least limit
your chances of
having any of these
types of back pain,
talk to us about
testing and setting
up an exercise
program for
maintaining good
support for your back
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