Back Pain

Updated 12 May 2016

Symptoms of Spinal problems

Symptoms may include restriction of movement, numbness in the legs and dizziness.

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If you experience any of the following symptoms, you could have a spinal problem:

- pain in the back 

- restriction of back movements 

- back pain accompanied by numbness or “pins and needles” in one or both legs 

- back pain radiating to the foot or knee 

- dizziness or disturbance of vision related to neck posture 

- difficulty standing up after sitting for prolonged periods 

- back pain after standing for a long period of time 

Structure of the back 

The back's bony framework, muscles, ligaments, tendons and nerves work together to bear the weight of your body and the loads you carry. The skeletal framework of the back provides considerable strength and flexibility, but because the spine is so central to the body's movements, even small amounts of damage can often cause much pain.

The spine consists of 33 bony segments, the vertebrae. There are seven cervical, 12 thoracic, five lumbar, five sacral and four coccygeal vertebrae. The two latter groups – the sacrum and coccyx – are fused and immobile. Between the cervical, thoracic and lumbar vertebrae lie the discs: tough, spongy "cushions" that act as shock absorbers for the vertebrae and give the spine flexibility. Strong elastic ligaments hold the vertebrae and discs firmly together in a column. Muscles attach to the vertebrae by fibrous connections called tendons. The complex layers of back muscle contract to move your back and upper body.

The spinal column also protects the spinal cord, which runs down through a canal formed by the vertebrae. Nerves (roots) from the spinal cord branch out and leave the spine through spaces between the vertebrae at the levels of the discs.

When to see a doctor

Contact your doctor immediately if back pain is due to a fall or blow to the back. If the pain is suspected to be muscular, contact your doctor if it does not improve after about a week.

Back pain can occasionally signal a serious medical problem. Consult your doctor if you have back pain as well as any of the following symptoms:

- bladder or bowel control problems (such as difficulty passing urine) 

- numbness in the groin or in the vicinity of the anal region 

- weakness, numbness or "pins and needles" in the legs 

- fever 

- rapid weight loss 

- a history of cancer 

- abdominal pain

- pain running down one or both legs

- you feel unsteady on your feet 

- the pain is increased when lying down 

- the pain wakes you at night 

- the pain is unrelated to movement 

- the pain is localised in the upper back (thoracic spine) 

- a history of corticosteroid use 

- a history of intravenous drug use 

- a history of urinary tract infection 

- in a child: any severe back pain that persists for more than three days 

Read more: 

Diagnosing back pain 

Causes of back pain  

Risk factors for back pain 

Reviewed by Dr Pradeep Makan, orthopaedic surgeon, Melomed Gatesville and Life Vincent Pallotti Hospital in Cape Town and part-time lecturer in the department of orthopaedic surgery at the University of Cape Town, 2016




 

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Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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