Publications
Partners
Back pain is second only to headache as the most common cause of pain. It can be acute, recurrent or chronic and is mostly caused by minor injuries, “slipped” discs, or problems with the bones of the spine.
Ageing, a sedentary lifestyle, poor posture, obesity, genetics, certain work environments, pregnancy, smoking and even psychological factors can all put you at risk of back pain.
Good back posture and regular exercise can greatly help prevent or postpone back problems.
Some symptoms – such as back pain combined with bladder or bowel control problems – could indicate a serious underlying medical cause. In most cases, however, it's appropriate to wait about a week before you go to the doctor with back pain. Eighty to 90 percent of back pain resolves spontaneously within six weeks.
Only about 5 percent of back pain patients will actually need an operation to correct the problem. Always ask for a second opinion if back surgery has been recommended.
Structure of the back
The back's system of bones, muscles, ligaments, tendons and nerves work together to bear the weight of your body and the loads you carry. The structure of the back provides great strength and flexibility, but because the spine is so central to the body's movements, even small amounts of damage can often cause 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 – which make up the sacral spine, are fused and immobile.
The cervical, thoracic and lumbar vertebrae can move, however, and between each of these 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, the 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 from the spinal cord branch out and leave the spine through spaces between the vertebrae at the levels of the discs.
Back pain can occur anywhere along the spine, but the most common site is the lower back or lumbar region. This is because the lower part of the back bears the weight of the upper body, as well as the weight of any items you’re carrying. Your lumbar spine also twists and bends more than the upper back, making it more vulnerable to injury.
Types of back pain
Back pain may be acute, recurrent or chronic.
Most cases of back pain are acute (the pain starts suddenly and intensely), and usually last a short time (less than a month). Acute back pain is not usually caused by a serious medical condition and most cases get better within a few days.
Recurrence is common however, and takes the form of repeated episodes of acute pain with pain-free intervals.
Chronic back pain is present pretty much all the time, and persists beyond three months. Even slight movements can trigger it.
Recurrent or chronic pain is usually more problematic than acute pain and often requires advice from a specialist doctor.
Quiz
Test your knowledge about back pain: True or False?
1. The most common site of back pain is the thoracic region.
2. Only about 5% of back pain patients will require corrective surgery.
3. Smoking, obesity and pregnancy are among factors that can raise your risk for back pain.
Answers: 1: False. The lumbar, or lower back region is the most common site of pain. 2 and 3: True.
(Olivia Rose-Innes, Health24, December 2012)
