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eLearning Series:
Relieve My Back Pain NOW!
( 23 pages )
Causes
Of Back Pain
Most references
to back pain focus on lower back pain in the lumbar spinal
region. However, back pain causes in no particular
order are:
- Accidents
or injuries leaving muscle pain
- Osteoarthritis
with deteriorating cartilage
- Osteoporosis
with bone loss / fracture
- Fibromyalgia
- Major conditions
like cancer
Muscle, ligament
and tendon problems are generally at the root of the pain
problems along
with some weakness in the
lower
back. Other body parts in the region can also be associated
- like bones and small joints.
When no specific
cause is apparent, the term NSLBP (nonspecific low back pain)
is used.
Any number of reasons for this
pain can include degenerative disk disease, psychological
issues,
systemic disease, facet syndrome (similar to pinched
nerve symptoms), herniated disk, spondylolisthesis or the
forward
displacement of one of the lower lumbar vertebrae over
the vertebra below it or on the sacrum. Other factors
could be
spinal stenosis or constriction or spondyloarthropathy
(disease affecting spinal joints).
Let’s take a look
at each of these and what pain relief solutions are available.
DEGENERATIVE
DISK DISEASE – The degeneration of vertebral disks
is a natural part of the aging process. What
often happens
though, is that when the narrowing of the disk space
combines with the nociceptors (sensory receptors
that respond to
pain) in the outer annulus (in the disk space outside
the nucleus)
or dorsal root ganglion (spinal nerves) become
heightened, the result can be pain, although not always.
Sometimes
pain will be felt, and other times
not. For example
a minor accident like missing a step and landing
a little harder than usual on your feet might cause back
pain.
Certain
activities can aggravate degenerative disks, like
yard work or house cleaning movements. But overall, pain
associated with degenerative disk disease generally heals
within
a few
days
at most. Preventative measures like strengthening
muscle groups to lessen future traumas are usually
recommended along with
an analgesic or medication that helps relieve pain.
Only in few cases is an epidural, injection, block
or
surgery needed.
PSYCHOLOGICAL
ISSUES - If acute back pain turns into chronic stages,
factors like depression,
fear and anxiety
can increase
discomfort and pain. The longer the chronic
pain persists, the more these factors tend to play a role,
an increased
role over time. So treatment strategies may need
to include learning
coping skills and alternative lifestyle enhancements
to deal with the psychological factors present.
SYSTEMIC
DISEASE – This disease is the cause for up to
10% of back pain and largely among the elderly.
Causes
could
be cancer-related or related to reduced bone
mass or
simply the
aging process. Increasing or decreasing activities
as well as switching positions all may have no
affect on
pain relief.
Alternative therapies may be needed.
FACET
SYNDROME - Similar to pinched nerve symptoms,
this is believed to be associated with pain in
the back’s side
joints
and the main cause of up to 20 percent of back
pain cases (with buttocks and upper leg pain
increasing with long-term
standing, and when switching sitting / standing
/
lying positions). An injection of a local anesthetic
into the
facet joint helps
determine the diagnosis. However, since the
anesthetic relieves the pain at the same time and is used
as a short-term solution,
an x-ray doesn’t help with imaging the pain
results.
Recommended treatment includes rigorous lumbar
activities and body
mechanics exercises to learn proper or more
beneficial posture and
movement techniques.
HERNIATED
DISK – Also known as a ruptured or protruding
disk, a herniated disk extends
beyond
its own area
into a surrounding
region. Compression of the nerve root can
cause pain. And pressure on the fibers in surrounding
ligaments
can cause
pain. Although
an accident involving lifting could be the
cause of a herniated disk, it’s not necessarily
so.
For many,
the
cause is unknown;
pain can occur suddenly or gradually over
time. Relief for the pain can come from walking instead
of sitting
or standing,
and surgery is rarely required right away,
if at all in the event relief from pain happens
within
a limited
amount
of
time. During this time (up to several weeks)
any of the following might be effective to
use,
depending
upon your
healthcare
provider:
medication, physical therapy or
steroid spinal injections.
SPONDYLOLISTHESIS is
the forward displacement or slippage of one of the lower
lumbar vertebrae
(generally
the
fourth or
fifth) over the vertebra below it or on
the sacrum. This can be diagnosed
by x-ray. Pain
is believed
to occur
where the displacement is, at or below
the displacement, or from spinal stenosis, discussed
next. Depending
upon the patient,
strengthening exercises or a back support
may be all that’s required. In others,
surgery may be
needed.
SPINAL
STENOSIS – is the constriction or narrowing of
the vertebral canal. Mainly
due to aging,
as the gradual
lessening
of disk
space and changes in ligaments advance
upon the nerve roots below the lumbar
vertebra or L2,
pain can result.
It’s
often accompanied by numbness in the
legs and is not aided any
by walking. Different vertebra and varied
physical activities can affect the pain’s
location,
intensity, recurring
and duration.
To help diagnose this condition, healthcare
providers can use myelography, or an
x-ray of the spinal
cord after injection
of air or a radiopaque substance into
the subarachnoid space, with a post-CAT scan.
And depending
upon the patient, treatments
can vary and be minor with medication
if the pain gradually disappears, to epidural
corticosteroid
injections in
the epidural,
to blocks or surgery.
SPONDYLOARTHROPATHY
- This term refers to a variety of diseases
affecting spinal joints;
arthritis
variations - psoriatic
arthritis and ankylosing spondylitis,
the more
common of the two and
in males more often than women; and
sacroiliitis, accompanies inflammatory bowels. Diagnosis
consists of a physical
exam, history and testing including
x-rays, CAT or MRI.
As the
disease progresses slowly expect long-term
fusing of sacroiliac joints together
and joints between vertebrae together.
To relieve pain, there is treatment
with exercises
and
physical therapy
to promote
better enhanced posture and mobility
and some arthritic medications.
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