What is Back Pain
Back problems can be caused by an extraordinarily wide range of problems – some of them originating elsewhere in the body, but with pain being transmitted (referred) to areas of the back by the nervous system. Back pain is one of the most common reasons people seek medical attention. It is also the symptom that prompts most patients who get chiropractic care. The majority of backache sufferers complain of pain in the lower back followed by discomfort at the base of the neck.
There are many structures in the lower back that can cause severe pain. These include muscles, ligaments, tendons, bones, joints and discs. During our development, we create a great deal of overlap of nerve supply to all of these structures. This makes it nearly impossible for the brain to distinguish between injury to one structure versus another. For example, a torn or herniated disc can feel identical to a bruised muscle or ligament injury. This is where an examination into the cause of the pain is important; each of these different structures may need a different type of treatment to resolve your pain.
Classifications of Back Pain
Back pain can be divided into three large classifications- axial pain, referred pain and radicular pain.
Axial
The most common condition is known as axial, or mechanical back pain. This pain can run the gamut from a very sharp to a dull ache. It may occur all the time or it may come and go. It also varies in intensity from very mild to extremely severe. This condition responds extremely well to conservative care. At times, spinal manipulation alone is the "miracle" affording immediate relief. More often, the injury involves more than just a misalignment of a vertebra or of your pelvis. Nerves, muscles, tendons, ligaments and skin can all have an influence on the degree of discomfort. And each of these may need to be addressed to attain relief.
If you have multiple episodes of this type of pain, you will want to engage yourself in a rehabilitation program to help resolve the underlying causes of the problem. Here, the diagnosis goes farther than just finding out what is causing the pain, but additionally centers on what weakness or restriction you have that ultimately causes you to have an episode. Here again, we function much like a "coach", finding the causes and helping to direct you towards ways of avoiding and limiting future bouts with pain.
Referred
The most common type of back pain is known as referred pain. Here, patients complain of having an achy, dull type of pain that seems to move around. The discomfort comes and goes and varies in intensity. This achy pain starts in the low back area and commonly spreads into the groin, buttocks and upper thighs. Diagnostic and therapeutic measures are aimed at correcting abnormalities in the muscles, ligaments and small joints of the spine. The treatment options here are similar to those used in treating axial pain.
Radicular
The last type of back pain is known as radicular pain. In this case, the pain is described as deep and usually constant. It follows the nerve down the leg and is often accompanied by numbness or tingling and muscle weakness. The most common example of this type of problem is the sciatic pain that radiates along that sciatic nerve - down the back of the thigh and calf into the foot. This type of pain is caused by injury to a spinal nerve. Some of the possible causes of this are a disc protrusion or bulge, arthritic changes or a narrowing of the opening through which the nerve exits.
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