PAIN SERIES: BACK PAIN

The spine spans from the base of your head to the end of your tail bone, and back pain can occur anywhere along this length at one or more levels in the associated back soft tissues and bony structures. It can vary in intensity and frequency and is described as dull, ache pain when it involves the muscles, tendons, ligaments, and bones, or shooting and radiating when it involves the nerves. It can also be “referred” when the underlying cause projects pain away from it.

As you may already experience, back pain can be really complicated and difficult to manage. There are various types of back pain and a wide range of treatments to manage it. Here we give insights about back pain which may help you in finding the right treatment that works best for you.

Your back is subjected to various loads and stresses. Many of the back structures may be injured and result in back pain, including the muscles, nerves, facet joints, and intervertebral discs, as well as the bones, ligaments, and tendons.

What are the Types of Back Pain?

In general, back pain can be acute  when symptoms last for less than six weeks or chronic if the pain persists for longer than three months. A subacute category is sometimes described when back pain occurs between six weeks and three months. A different classification is described based on the region where the back pain occurs:

• Upper Back Pain – involves at least the upper half of the area of the thoracic spine where the ribs are attached to, beginning from the base of your neck to the lowest part of your shoulder blades.

• Middle Back Pain – described as back pain confined to the area between the lowest end of the shoulder blades to the lowest part of the rib cage.

• Low Back Pain – the most common and occurs within the area of the lumbar spine, from just beneath the lowest ribs to the top of your pelvic bone.

Given the complexity of the spine, it is usually difficult to determine the underlying cause of low back pain based on the presenting symptoms… a disc bulge may be mistaken for an arthritic facet joint due to similarities in symptoms, or in another case, a nerve root impingement can be due to compression by either a disc bulge or a bone spur…

What are the Causes of Back Pain?

Unlike the cervical (neck) and lumbar (low back) regions, the upper and middle back have limited mobility so back pain within these areas is not as common as the pain in the neck and low back area, and any pain that occurs in these regions can be due to causes other than just a muscle injury.

The following are some of the causes of back pain:

• Biomechanical/Injuries:  muscle strains, spasms, ligamentous strains, disc injury, myofascial pain syndromes, slipped or herniated discs, vertebral fractures, and spondylolisthesis.
• Congenital and Structural: spinal deformities (scoliosis, kyphosis, lordosis), osteoporosis, and spina bifida (a birth defect associated with an incomplete development of the spine and the spinal cord).
• Degenerative/disease Process:  spondylosis, spondylitis or spinal infection, tumors or cancer, arthritis, degenerative disc disease or osteoarthritis, spinal stenosis or the narrowing of the spinal canal with associated nerve impingement (sciatica), osteoporosis.

• Non-Spinal/Psychological:  kidney problems, pregnancy, ovarian cysts, endometriosis, fibromyalgia, stress, depression, anxiety

What are the Symptoms of Back Pain?

Symptoms are typically similar across all types of back pain, especially if it’s caused by muscle, ligaments, or  bone injuries. If there’s an associated nerve injury, neurological signs and symptoms depend on which segment of the spine or on the specific spinal nerve root compressed or irritated. Common symptoms of back pain due to muscular strain or ligamentous sprain are:

•  A dull, burning, or sharp pain
• Muscle tightness or stiffness
• Limited trunk range of motion
• Weakness in trunk musculatures

Neurological symptoms typically present as weakness in the arms and legs, numbness or tingling sensations, and bowel and bladder dysfunction. Other symptoms, such as fevers, chills, impaired bowel and bladder function, may appear and may be associated with a serious medical condition. In these cases, medical consultation should be sought so that appropriate treatment may be given.

Description of your back pain matters!

How you describe your pain, its localization and related symptoms are important to determine the exact cause. There are three common classifications of back pain based on description of pain:

• Axial pain. It’s a pain typically caused by conditions that result in muscle strain. Also referred to as mechanical pain and can be described as sharp, dull, constant, or throbbing.

Example: muscle strain and disc injuries.

• Referred pain. It is pain felt in parts of the body away from the exact cause and often described as dull and achy.

Example: degenerative disc disease of the lower back may refer pain in the hips and thighs.

• Radicular pain. It is pain described as an electric shock sensation due to compression and/or inflammation of a spinal nerve root and is often accompanied by weakness or numbness in the limbs.

Example: a herniated disc, spinal stenosis, and spondylolisthesis cause sciatica which presents as radicular pain in the legs with weakness and numbness.

The severity of pain is different from person to person… one with a disc bulge may experience excruciating and debilitating pain while another with the same condition feels nothing…

How are Back Pains Treated?

Back pains are treated depending on the cause. But regardless of what that is, the goals remain the same: 1) manage pain, 2) improve function, 3) provide education on the nature of the condition and treatment options, and 4) psychological support to prevent "chronification"  or long-term persistence.

In most cases, mild to moderate back pain can be managed with the following:

• Over-the-counter pain relief medications and muscle relaxants.
• Physical therapy modalities, such as TENS, heat or cold therapies, therapeutic ultrasound, etc.
• Stretching, strengthening, and stabilization exercises.
• Manual therapies, such as massage, mobilization, or spinal manipulation.

On neurological symptoms: Since the vertebral column encases the spinal cord, back pain of any type should be taken seriously as it may cause severe cases of neurological dysfunction due to direct damage to the spinal cord or the spinal nerves.

On psychological risk factors:  Psychological factors, such as depression, anxiety, fear avoidance behaviors, and sleeplessness, can make the pain worse and also need to be managed. Cognitive behavioral therapies, mindfulness, and reassurance are some strategies to address these issues.

On surgical management:  Surgery might help relieve some causes of back pain, but there are cases where it often fails. For severe cases, surgery may be necessary but is only an option when all conservative treatments are unsuccessful. Some common surgical procedures to relieve low back pain are discectomy, spinal fusion, and laminectomy.

There’s a Recovapro  for Every Back Pain!!!

Back pain without any serious underlying cause will gradually resolve on its own, but if it's really making it difficult for you to accomplish your everyday tasks, vibration therapy can be a pain relief option.

Recovapro’s vibration technology delivers therapeutic mechanical vibration through its innovative self-administered vibration therapy tools in the form of the Recovapro’smassage gun and the new RecovaBall!

Use the Recovapro massage gun to massage tensed back muscles due to back pain. When used cautiously, it can provide pain relief due to muscle strain, back stiffness, arthritis, and many more. Also, use it after a workout to help you recover faster and better.

Or try RecovaBall for a self-myofascial release and experience a more powerful trigger pointing session of back myofascial pain syndrome with a massage ball boosted with vibration therapy technology.