Causes/Symptoms/Treatment & Investigations of Back Pain

Back, having so many parts, makes easy to develop a problem into itself. Anything that puts pressure on the back muscles or nerves can cause pain. Any illness or damage to the spine also can cause pain. The cause of most acute back pain is unknown, but probably is due to minor strains, sprains, and overuse. Emotional stress may add to the pain, especially since it slows the rate of recovery. Other possible causes of back pain include a ruptured intervertebral disc, spinal stenosis, osteoarthritis, anykylosing spondylitis, an injury or accident, rheumatic-related problems or other conditions.


Many of the problems that cause back pain are the result of injury and degeneration of the intervertebral disc. Degeneration is a process where wear and tear causes deterioration. The disc is subjected to different types of stress as we use our backs each day. Bending over results in compression of the disc and may also cause the disc to bulge backwards towards the spinal canal and nerves. The facet joints must also shift to allow the bending to occur. Twisting and bending together is perhaps the greatest stress on the parts of the spine, especially the disc.
Probably, the earliest of changes that occur in the disc are tears in the annulus portion of the intervertebral disc. The annul us is a large round ligament and the tears in the annulus heal the same way as the tears in other ligaments do, that is by scar formation. Scar tissue is not as strong as normal i issue. The repeated cycle of many annular tears healing by scar tissue leads to the disc that finally begins to degenerate.


What happens when the disc begins to degenerate?


As the degeneration of the disc progresses the nucleus pulposus loses some of its water content. It becomes stiff and loses the ability to act as a shock absorber. The process may continue until the disc is collapsed. Bone spurs may form as the body's response to this degeneration. These spurs are thought to be the result of excess motion at the spinal segment. Eventually, bone spurs form around the nerves of the spine as well.


One of the most dramatic injuries to the lumbar spine is the Herniated Disc. In this injury, a tear in the annular ligament allows the nucleus pulposus to squeeze into the spinal canal. If the disc material compresses the nerve root, there is pain, numbness, and weakness in the areas supplied by the nerve. There is a considerable amount of evidence to suggest that it's not only the pressure that plays a part in the symptoms from a herniated disc. The nucleus material that is squeezed out against the nerve seems to set up an inflammatory response in the nerves causing pain.