WHAT CAUSES BACK PAIN WHAT ARE TESTS AND HOW DO THEY TREAT BACK PAIN
WHAT ARE CAUSES OF BACK PAIN: IS BACK PAIN DANGEROUS
Back pain has a variety of causes from the benign but uncomfortable to the dangerous. When you come to see the doctor about back pain he or she will ask a lot of questions about the history surrounding your back pain complaints as well as doing an exam and this will enable the doctor to form a differential diagnosis, a list of possible explanations that might explain the back pain. The doctor may ask questions like:
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Back pain is a symptom of a medical condition, not a diagnosis itself. Although the causes of back pain are usually physical, it is important to know that emotional stress can play a role in how severe back pain is and how long it lasts. Stress can affect the body in many ways, including causing back muscles to become tense and painful.
Medical problems that can cause back pain include the following:
Mechanical problems: A mechanical problem is a problem with the way your spine moves or the way you feel when you move your spine in certain ways. Perhaps the most common mechanical cause of back pain is a condition called intervertebral disc degeneration, which simply means that the discs located between the vertebrae of the spine are breaking down with age. As they deteriorate, they lose their cushioning ability. This problem can lead to pain if the back is stressed. Other mechanical causes of back pain include spasms, muscle tension, and ruptured discs, which are also called herniated discs.
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Injuries: Spine injuries such as sprains and fractures can cause either short-lived or chronic pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.
Acquired conditions and diseases: Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis; various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis, which is the buildup of uterine tissue in places outside the uterus; and fibromyalgia, which causes fatigue and widespread muscle pain.
Infections and tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the discs that cushion the vertebrae, which is called discitis. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.
It could actually be dangerous to not see a doctor for back pain. For example, in some cases back pain may have nothing to do with a "pulled muscle" or a "slipped disc" and could actually be caused by a tumor or other serious condition. Even though the natural history of back pain is favorable, it is important not to miss red flags for potentially very dangerous problems.One of the goals of the clinical examination is "to identify patients who require immediate surgical evaluation and those whose symptoms suggest a more serious underlying condition such as malignancy or infection".For example, there is an uncommon problem called Cauda Equina Syndrome. Cauda Equina Syndrome occurs when the nerve roots are compressed and paralyzed, cutting off sensation and movement. Nerve roots that control the function of the bladder and bowel are especially vulnerable to damage. Patients with signs of Cauda Equina Syndrome, such as bowel or bladder dysfunction, both sided sciatica or leg weakness, or numbness in a saddle distribution, require urgent surgical referral.
Among the tests that might be ordered are
They all have their strengths and shortcomings. For example, an xray is not very good at finding a herniated disc. In a herniated disc, the disc that separates two bones of the spine, the vertebra, is herniated so that the disc can push out and put pressure on the nerves. You've probably heard of sciatica. In sciatica there is pressure on the nerves that come out at the lower vertebra L4, L5 level and run into the legs. That's why a disc in the back can cause pain or numbness into the legs.
Treatments for Back Pain
Among the treatments doctors use for back pain are
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The statistics above were quoted from Healing a Bad Back Is Often an Effort in Painful Futility, an article that appeared in the New York Times. Further, they quote Dr. Richard Deyo of the University of Washington as saying, "a variety of studies have suggested that in 85 percent of cases it is impossible to say why a person's back hurts". That really seems like a very high number. What's clear is that alot of people do get relief from seeing a doctor and getting treated.
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