The back is comprised of 33 flat bones called vertebrae. Although you may experience pain in your lower back, you can have pain in any of the five regions of your spine. The vertebrae of the neck are called the cervical vertebrae, the chest is called the thoracic, the lower back is called the lumbar, and the base of your back is made up of the sacrum and coccyx.
Between each bone is a soft disc that allows for movement and provides cushioning. Each vertebra also has a small joint that links up with the bone below it called a facet joint. When you have back pain, the vertebrae, discs, or facet joints may be diseased.
Back pain is a common symptom that can arise from problems with the structure of the back or even an unrelated condition, such as a kidney infection. The most obvious condition that causes back pain is injury or trauma. This can include injury from an accident, such as a fall, or injury from improper use of the back, such as from lifting a heavy object incorrectly.
Trauma can cause breakage of the vertebrae, but more commonly, it causes the disc to rupture or “slip.” A slipped disc can put pressure on one or more of the nerves coming off the spinal cord and cause pain. The nerves branch off the spinal cord and snake between the vertebrae and discs. The nerves closest to the spine are called nerve roots, and they service large areas of the body. For instance, the sciatic nerve root in the lower back is responsible for providing feeling and movement to the entire leg.
Your spinal canal can also narrow, and this impinges on the spinal cord, causing pain and weakness to whatever nerve roots are in the area. This is a condition known as spinal stenosis.
Arthritis of the facet joints is another common cause of back pain, and it is the break down of the joint capsule and cartilage of these small structures. Osteoarthritis causes break down of the joint due to the wear and tear of aging, while rheumatoid arthritis occurs when the immune system attacks the joint structures as foreign.
Back pain manifests as an uncomfortable tightness or stiffening of the joints of the back or the muscles and ligaments that provide support to your spinal column. Your back may hurt upon any movement, but in many cases, it also aches at rest. Sitting may be difficult in some back pain scenarios, such as a pinched nerve root, or standing may make the pain worse, such as in spinal stenosis.
In the case of slipped discs, pain can manifest in a region at a great distance from the original injury. Once a nerve root is compressed by a ruptured disc, the nerve interprets painful stimuli as coming from the region the nerve services. For instance, if you have a slipped disc in your neck that presses on the one of the nerve roots of the upper body, you can feel pain down your arm to the fingers.
In rare and severe cases, nerve roots that control your bowel and bladder can become compressed and lead to difficulty controlling these functions. The symptoms can manifest either as incontinence or constipation, depending on how the nerve root is affected.
The treatment for back pain focuses on rest, medications, exercise, and, rarely, surgery. Rest is often recommended as a first line treatment for back pain because it allows for the inflammation to decrease. This is often enough for the back pain to resolve on its own. Medications are a common remedy for back pain, most notably the non-steroidal anti-inflammatory medications, such as ibuprofen.
In rare circumstances, your pain may be severe enough to require a narcotic pain medication, such as vicodin, lortab, or morphine. These medications can be delivered in a number of ways, such as through a transdermal patch, by mechanical pump inserted under the skin, or orally by mouth. Nerve pain caused by a pinched nerve is often treated with anti-seizure medications, such as gabapentin, or antidepressants, such as Cymbalta.
At SoCal Pain Center, we believe in managing your back pain with the least invasive methods first. This means that we are dedicated to pursuing physical therapy, chiropractic, and epidural injections to ease your pain. Often, just learning how to strengthen and stretch your back is enough to make the pain subside. For instance, completing exercises that stretch your lower back can help to strengthen the muscles in the region and allow for the proper functioning of the structures of the back.
In rare cases, we recommend surgery for your back. You may need spinal fusion to remove a disc and combine two vertebrae together. In some cases with a pinched nerve root, we may perform a discectomy that removes the bulging portion of the disc. Finally, in cases of spinal stenosis, the narrowing may be opened by removing portions of the disc or vertebra.
Having back pain that just won’t quit? SoCal Pain Center is a practice of caring, passionate pain management, chiropractic, and physical therapy specialists that can help you with a wide range of back pain problems.
Give us a call today for a consultation to find the least painful way to reduce back problems.