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Back pain may be acute or chronic. Most cases of back pain are acute i.e. the pain starts suddenly and intensely, and usually lasts a short time (less than a month). Acute back pain is not usually caused by a serious medical condition, and most cases resolve within a few days without treatment. Recurrence is common, however. Repeated episodes may eventually lead to chronic back pain.

Chronic back pain persists beyond three months, and even slight movements can trigger it. Chronic pain is usually more intractable than acute pain, and often requires specialist advice.

The spine consists of 33 bony segments, the vertebrae. Between 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 called tendons. The complex layers of back muscle contract to move your back and upper body.

The spine 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.

The following factors can increase your risk for back problems:

• Ageing. Discs begin gradual deterioration by age 30. With age, the discs lose moisture and shrink. This puts more stress on the facet joints which become arthritic with resultant back pain.
• Sedentary lifestyle. Being unfit increases your risk for back pain, especially if you attempt an unaccustomed activity. Lack of exercise leads to the following conditions, which may threaten your back:
  • Muscle inflexibility: restricts the back's ability to bend and rotate.
  • Weak back muscles: increases load on the spine and the risk of disc compression.
  • Weak stomach muscles: increases strain on the back and causes the pelvis to tilt abnormally.
  • Obesity: increases weight on the spine and pressure on the vertebrae and discs. A large belly pulls the spine forward and out of alignment, increasing the risk of back strain.
• Poor posture and spending long periods in one position e.g. working at a computer, slouching in front of TV.
• Obesity. The increased weight causes wear and tear of the disks and facet joints.
• Genetic factors. Some people are genetically susceptibility to back pain, usually from inheriting spinal structural abnormalities. Mutation of the COL9A2 gene may be linked to about 10% of sciatica cases. This gene plays a role in producing collagen, an important protein component of the discs. The defective gene may cause disc deterioration, leading to sciatica.
• Work that stresses the back: risky activities include lifting, forceful movements, bending and twisting into awkward positions, repetitive movements and vibration (as occurs with long-distance truck driving).
• Improper body mechanics during sporting activities can damage the back e.g. a jerky golf swing or incorrect use of exercise equipment. Cyclists often experience low back pain, which is often resolved by adjusting the angle of the bicycle seat. Some research suggests that, over time, high-impact exercise such as rugby or aerobics may increase the risk for degenerative disc disease.
• Pregnancy makes women prone to back pain due to shifting of abdominal organs, forward redistribution of body weight, and loosening of ligaments in the pelvic area prior to delivery.
• Smoking, possibly because it decreases blood circulation to the tissues of the back. The association may also be due to a generally unhealthy lifestyle.
• Psychological factors. Research indicates that in many people, pre-existing depression and feelings of helplessness may contribute negatively to the perception of pain and the ability to cope with back problems. People in depression are also more likely to have vague physical symptoms, including back pain.

Read more:
Diagnosing back pain

 

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