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(Sunday, 23rd Nov, 2014)
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Back pain

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Back pain

What causes back pain?

Back pain can be caused by a variety of conditions, some of which will rectify themselves in a short space of time and others which may require on-going treatment over a period of years.

Fortunately, the commonest cause of back pain is a muscular sprain which generally gets better over a relative short period of time. Painkillers or anti-inflammatory tablets may be helpful.

All cases of back pain should be taken seriously, as pain in any part of the back may signify the beginning of a problem elsewhere in the body.

When should I see a doctor?

If the pain is situated in the lower back and is bearable, most people will try some form of home remedy and gentle exercise before going to their GP. However, if the pain does not improve within a six-week period, a visit to the doctor is advisable. If any of the following warning signs are present along with lower back pain, it is important to see your doctor without delay:

  • Difficulty passing urine or opening the bowels.
  • Numbness around the back passage.
  • Weight loss or high fever.
  • Pain which is continuous and persists throughout the night.
  • A marked feeling of stiffness first thing in the morning.
  • A very numb, wooly type of feeling in the legs on walking, which improves when you stop and bend forwards.

The first two symptoms outlined above may suggest that pressure is being placed on the bundle of nerve fibres known as the cauda equina, which stretch down towards the sacrum and coccyx, or tailbone. While this is quite rare, it requires immediate treatment when it occurs.

The next three symptoms may be early warning signs of the onset of arthritis or a tumour on the spine, while the last symptom may be caused by narrowing of the vertebral canal through which the spinal cord runs. This condition is referred to as Spinal Stenosis.

How does the back work?

The spine is made up of individual blocks of bone called vertebrae. There are twenty-nine vertebrae and they are divided up into four distinct sections as follows:

  • The top seven vertebrae are in the neck and are referred to as the cervical spine.
  • The next twelve are chest vertebrae and are known as the thoracic spine.
  • The five vertebrae located in the lower back are known as the lumbar spine.
  • The remaining five are fused together to make up the tailbone, or sacrum and coccyx.

Discs lie between the vertebrae. These are made up of a web of connective tissue and a central jelly-like substance, and they act as shock absorbers. If the tough outer web is torn, the jelly-like substance can protrude and this is what is commonly referred to as a ‘slipped disc.’

The spinal cord runs through a canal in the middle of the vertebrae, and this is the nerve centre of the entire body. Nerves branch out from this cord and emerge at the sides of the vertebrae to travel to all parts of the body. When nerves get squashed by a damaged disc or by the small joints which join the vertebrae to each other (the facet joints), there will be a feeling of numbness or pain in the part of the body supplied by the squashed nerve.

The sciatic nerve, which emerges from the lower back, can be the cause of the very painful condition known as Sciatica. This nerve supplies the back of the leg and can often become squashed, giving rise to sharp pains right down the leg and the diagnosis of Sciatica.

Where does back pain usually start?

Back pain can start in any part of the spinal column, but the most common type of pain experienced is in the lower back. This is because the lower back (or lumbar spine) is the area which bears the most weight and is subjected to more twisting, turning and straining than any other part of the back.

Mechanical back pain is usually caused by factors which can be corrected such as bad posture; incorrect footwear; badly-designed seating, poor lifting techniques and lack of exercise, while the more serious causes of back pain will usually require medical intervention.

See also our article on mechanical back pain or back pain in pregnancy. Click the link here for more on living with chronic pain. Meanwhile, for medical Q&As on pain, click here (you may be required to register or login to access some of these links).

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