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Back pain
Did
you know that an estimated 75 to 85 percent of all Americans will
experience some form of back pain during their lifetime? Most certainly
low back pain can be quite debilitating and painful. Good news,
most cases respond well with non-surgical treatment. However, it
has been estimated that 50 percent of all patients who suffer from
an episode of low back pain will have a recurrent episode within
one year.
The costs associated with diagnostic procedures alone are estimated
at $50 billion yearly. Back pain is one of the most common reasons
for missed work. In fact, back pain is the second most common reason
for visits to the doctor's office, outnumbered only by upper-respiratory
infections. The personal costs are immeasurable from chronic pain
alone, pain sometimes so great that it interferes with a healthy
and satisfying lifestyle.
Also, it is recognized that most cases of back pain are mechanical
in nature, and the pain is usually not caused by very serious conditions,
such as cancer, fracture, infection, etc. The anatomy of the spine
and the many conditions that negatively impact spinal health are
complex. The following information provides a simplistic explanation
of the causes for back pain:
Some common causes of lower back pain
On many occasions you first feel back pain just after you lift
a heavy object, move suddenly, sit in one position for a long time,
sustain an injury or have been in an accident. Prior to that moment
in time, there was often a pre-existing weakness, or loss of tissue
integrity in your spinal structures.
The specific structures in your back responsible for your pain
are difficult to determine in many cases. Whether identified or
not, there are several possible sources of low back pain:
- Bulging or herniated discs
- Injury or overuse of muscles, ligaments, facet joints, and the
sacroiliac joints.
- Muscle spasm (very tense muscles that remain contracted)
- Degeneration of the discs
- Poor alignment or fixations of the vertebrae
- Spondylolisthesis
- Osteoarthritis
- Spinal stenosis (narrowing of the spinal canal)
- Small fractures to the spine from osteoporosis
- Strain or tears to the muscles or ligaments supporting the back
- Spinal curvatures (like scoliosis or kyphosis), which may be
inherited and seen in children or teens
Less common causes of low back pain:
- Ankylosing spondylitis, which is a form of joint inflammation
(arthritis) that most often affects the spine
- Prostate Cancer
- Bacterial infection, in which bacteria are often carried to
the spine through the bloodstream from an infection somewhere
else in the body or from IV drug use. However, bacteria can also
enter the spine directly during surgery or injection treatments,
or as the result of injury. Back pain may also be the result of
an infection in the bone (osteomyelitis) or in the spinal cord
(most often in the material covering the spinal cord, called an
epidural infection).
- Spinal tumors, or growths that develop on the bones and ligaments
of the spine, on the spinal cord, or on nerve roots.
- Paget's disease, which causes abnormal bone growth most often
affecting the pelvis, spine, skull, chest, and legs.
- Scheuermann's disease, in which one or more of the bones of
the spine (vertebrae) develop wedge-shaped deformities. This causes
curvature of the spine (rounding of the back, or kyphosis), most
commonly in the chest region.
You are at particular risk for low back pain if you:
- Work in construction or another job requiring heavy lifting,
lots of bending and twisting, or whole body vibration
- Smoke, don't exercise, and/or are overweight
- Are over age 30
- Are pregnant
- Have bad posture
- Have arthritis or osteoporosis
- Have a low pain threshold
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