Acute back pain or low back pain is defined as pain that occurs posteriorly from the region between the lower margin of the ribs to the lower back and that lasts for less than six weeks. Sciatica , on the other hand, is pain that radiates down the back of the leg to the big toe.
Knowing the various etiologies, along with the history and physical examination, allows clinicians to accurately and quickly classify most causes of pain. Although most patients recover rapidly with minimal treatment, adequate evaluation is critical to identifying rare cases of serious underlying disease .
Without alarming clinical signs, diagnostic imaging and laboratory tests are often unnecessary. While there are numerous treatments for acute nonspecific low back pain, nonsteroidal anti-inflammatory drugs, acetaminophen, and muscle relaxants are among the most helpful.
Additionally, targeted physical therapy, such as the McKenzie Method and spinal stabilization exercises , can reduce recurring pain and the incidence of recurrence.
Back pain: what it is and anatomy of the column
The back is made up of a complex structure of muscles, ligaments, tendons, joints and bones , which work together to support the upright position and allow movement and mobility of the trunk. The bone structure is one of the strongest parts of the body, but at the same time it has great flexibility and resistance .
Back pain can occur in any area . Depending on the location it can manifest itself:
to the chest
towards the sacrum.
The most common pain occurs downwards , as it carries most of the weight of the upper body.
The vertebral column is made up of the overlapping of 24 vertebrae , connected by joints that have the shape of discs placed between them, supported by ligaments and muscles.
Within the canal formed by overlapping vertebrae, is the spinal cord , part of the central nervous system. It extends from the base of the brain to the second lumbar vertebra in adults. In the final segment of the column, in the lower back, the vertebrae fuse together , being devoid of intervertebral discs.
As we age, the structures of the spine, joints, discs and ligaments undergo a wear and tear process.
The spine remains strong, but the back can stiffen, sustain deformities and decrease range of motion , which can cause back pain.
Read More: TEETH DEEP CLEANING – WHEN YOU NEED IT
The vertebral column, also called rachis, is therefore divided into sections:
- cervical consisting of 7 vertebrae (C1 to C7)
- thoracic (or dorsal) consisting of 12 vertebrae (T1 to T12)
- lumbar consisting of 5 vertebrae (L1 to L5)
- sacral formed by the fusion of 5 vertebrae (S1 to S5).
Read More: How Does Instant Scripts Work?
Types of back pain
Pain in the lumbar area, located in the lower back , can be related to damage to the discs between the vertebrae, ligaments around the spine and pressure exerted on certain nerve structures starting from the spinal cord, as well as organ disorders abdominal and pelvic internals.
Instead, upper back pain can occur due to heart disease, aortic disease, chest tumors or inflammation of the intervertebral discs, as well as ligament and muscle injuries.
In this way it is possible to make a classification of back pain according to its origin.
- Muscle pain : caused by incorrect position, twisting or straining.
- Neuropathic : Caused by pressure on a nerve.
- Joint pain : affects the intervertebral discs.
- Bone pain : in the presence of osteoporosis.
The most common causes of acute back pain can be:
- tight muscles or ligaments
- muscle spasm
- muscle tension
- damaged intervertebral discs
- wrong location
- muscular efforts.
Structural problems and back pain
A variety of structural problems can lead to relapsing or chronic back pain .
Rupture of an intervertebral disc
Each vertebra of the column is anchored to intervertebral discs which cushion the movement. So, if the disc ruptures, it puts pressure on the structure of the spinal cord, causing pain.
Read More: INTELLECHART EHR VS LIQUID EHR: COMPARISON 2023
Symptoms of Back Pain
Back pain can hide a multitude of causes, from trivial to serious and the location of the pain is one of the main indicators of the cause.
It can occur in the upper back or lower back , radiating to the leg or buttocks.
Some cases may be associated with other painful sensations or numbness elsewhere in the body , from migraines to pain in the shoulders and arms.
Another indicator is the duration of the disturbance , which classifies pain as chronic or acute depending on whether it has persisted for more or less than six weeks.
Causes of back pain
Pain is a symptom, not the condition itself. The main indicator of the cause that generates suffering is its duration and intensity.
Sudden back pain that hasn’t lasted for more than six weeks is considered acute and can be caused by:
- trauma (fall)
- lifting heavy objects
- exaggerated movements, performed incorrectly.
If it has lasted for more than three months , it is considered a chronic condition , it is less common and can be a symptom of a number of diseases for which investigations are needed to establish a diagnosis.
Low back pain
The vertebrae are constantly stressed because they support most of the body weight. Low back pain is the most common back pain and affects the area between the five lumbar vertebrae and the first sacral.
A thorough history and physical exam are usually sufficient to identify any serious conditions that may be causing pain. This helps doctors determine whether the pain is acute, caused by an accident, or chronic .
If pain persists, an X-ray, CT scan, or MRI may be done , which provides information about the condition of the soft tissue and bone structure, which, combined, can determine the cause.
To identify possible causes in the muscles, spinal cord, nerves or intervertebral discs, more detailed investigations are carried out, highlighting herniated discs or problems with:
- blood vessels
- bone structure.
On the spine bone scans can detect tumors or compression fractures caused by osteoporosis . Contrast substances can also be used.
Back pain: when to worry
My opinion remains to be visited by your family doctor even if acute back pain improves in a few days and passes in a few weeks with only the treatment of the painful area and with rest.
Particular importance assumes the cause of the pain installation : after a physical effort, a prolonged position or a trauma such as a fall.
In the latter case it is good practice to contact the doctor and decide together whether to carry out further investigations . In the case of a chronic variant, however, it is advisable to go to the doctor with the appearance of:
- weight loss.
- Inflammation or swelling in the back.
- Persistent pain that doesn’t get better.
- Radiating pain to the legs or below the knee.
- Urinary or fecal incontinence, installed suddenly or in a short time.
- Difficulty urinating.
- Sudden constipation with no other obvious cause.
- Numbness and tingling in the buttocks, anus, genitals, thighs.
- Locomotor difficulties in the legs and arms.
- Weakness of the feet.
- Inability to make arm movements.