It's hard to find someone who hasn't had back pain at some point in their life, isn't it? Sometimes, a minor sprain , a strain from lifting something heavy, or even a sudden, unexplained back pain can be very annoying. Most of the time, it goes away in a few days, but some back pain can be a sign of something else that needs our attention. So today, let's talk about the causes of back pain, how to diagnose it, and what treatments are available.
First, let's look at how our spine is made.
Simply think of our spine as a string of beads. It has 33 small bones called vertebrae . These bones are stacked on top of each other to form our spine. Between these bones is a jelly-like, slightly firm area called the intervertebral disc . This acts like a shock absorber in a car, absorbing the pressure when we run, jump, or lift heavy objects, protecting our spine from damage.
The spinal cord, a very important nerve that controls our entire body, runs through this entire spine.
Our spine can be divided into main parts:
- Cervical vertebrae: The 7 bones in the neck.
- Thoracic vertebrae: The 12 bones between the neck and lower back.
- Lumbar Vertebrae : The 5 strongest bones in the lower back. This is where most back pain comes from.
- Sacrum and Coccyx: The fused bones at the bottom of the spine.
Why do we get back pain?
There can be many reasons for back pain, not just one or two. Sometimes the cause is very simple.
- Accidents : Something like a fall, a car accident.
- Muscle Strains: This can happen when you lift a weight incorrectly and suddenly twist.
- Sports accidents: Injuries that occur while playing sports.
- Bad posture : Sitting in the same position for long periods of time, especially in a way that is harmful to the back.
Apart from these simple causes, there are many other causes, such as herniated discs and arthritis.
How does the doctor diagnose the disease?
When you go to see a doctor for back pain, he will first ask you questions about the pain, how it started, and examine you thoroughly. Then, if necessary, he may order tests like these to find the exact cause.
| Test | What do you see in this? |
|---|---|
| X-ray | You can check for things like the position of the bones in the spine, bone spurs, tumors, and fractures. |
| CT Scan | Conditions such as a herniated disc or spinal stenosis can be clearly seen. |
| MRI Scan | It can provide a very clear picture of the discs, nerve roots, and spinal cord. It is often used before surgery. |
Two special conditions that occur in the spine
While there are many specific conditions that can cause back pain, we'll talk about two in particular today. You may have heard of these.
1. Spondylolisthesis
What happens in this is very simple. One vertebra in our spine (vertebral RA ) slips forward or backward over the one below it. It's like one of the bricks in a row moving back and forth. This often happens at the very bottom of the spine.
Causes: There are several possible causes for this. It could be a congenital weakness, a fracture from an accident, a stress fracture from sports, or an infection.
Symptoms:
- Lower back pain
- Stiffness and tightness in the back and surrounding muscles
- Pain in the buttocks area
- Pain that travels down the legs (this is caused by the slipped bone pressing on the nerve roots)
- Muscle weakness or tingling in the legs
Treatment: In most cases, this condition can be controlled by physical therapy to strengthen the muscles around the spine. Your doctor may recommend painkillers (NSAIDs) such as paracetamol or ibuprofen or naproxen for pain. Sometimes an epidural steroid injection is given. Special medications such as gabapentin and pregabalin may also be given for nerve pain.
Only if these treatments do not provide relief and the pain is severe enough to interfere with daily activities should a decompressive laminectomy (surgery to relieve pressure on the nerves) be considered.
2. Cervical Nerve Pressure (Cervical Radiculopathy)
This is more of a neck problem than a back problem. What happens here is that a nerve root that comes out of one of the cervical vertebrae in our neck gets compressed for some reason.
Causes: In young people, this can often be caused by a ruptured disc, with the protruding parts pressing on the nerve. As people get older, it can also be caused by arthritis or other disorders.
Symptoms:
- The main symptom is pain radiating to the neck, chest, shoulders, and arms .
- Feeling of tingling or numbness in the fingers.
- Weakness of the muscles in the hands.
- Difficulty performing fine manual tasks (lack of coordination).
Treatment: This also includes painkillers, physical therapy, and steroid medications (oral or injectable). Physical therapy treatments include gentle cervical traction and exercises to help reduce pain.
Here too, if the nerve is severely compressed and there is weakness in the arm, surgery may be necessary to relieve the pressure. This decision will be made by your doctor and surgeon.
When should you see a doctor for back pain?
A simple backache should go away in a few days. But if you have any of the "red flags" below, see a doctor immediately. You may need to go to the Emergency Department (ETU) .
- Severe pain after an accident or fall.
- If the tingling and weakness in the legs is increasing.
- If you have difficulty controlling your bowels or urine.
- If you are losing weight for no reason, or if you have a fever.
- If the pain worsens at night or does not subside even after resting.
- If someone with a history of cancer develops new back pain.
Take-Home Message
- Even though back pain is very common, you should never ignore it.
- Back pain can be largely prevented by avoiding bad posture and using the correct technique when lifting weights.
- Spondylolisthesis and Cervical Radiculopathy are two conditions that require special attention and can involve nerves.
- If you have severe symptoms like numbness in your legs, weakness, or difficulty controlling your urine, it is an emergency. See your doctor immediately.
- It is very important to find the exact cause of your pain and get the most appropriate treatment for it. Therefore, do not treat based on guesswork, but follow medical advice.
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