Why Do I Have Back Pain?


Back pain affects most people at some point in their life. Generally it presents as muscular, skeletal or neurological and can be treated fairly easily if assessed early!

Muscular refers to muscle tissue and tendons that may be in spasm, inflamed, stiff or fatigued. Furthermore muscles can be chronically torn if not treated and tendons can become inflamed (tendonitis).

Skeletal refers to our joints including cartilage and ligaments. Joints may be stiff,  inflamed  or the cartilage may be suffering from wear and tear. Ligaments, which attach bone to bone, may become sprained.

Neurological refers to pain from nerve compression and irritation which may lead to numbness, tingling, sharp or shooting pain often in the limbs. The sciatic nerve for example can become compressed and cause sciatica.

Consult your GP or medical help urgently if your back pain is associated with any of the following:

Known as red flags

 

  • Constant deep ache not relieved by laying down and not aggravated by movement.
  • Fever >38c
  • Unexplained weight loss
  • Swelling in the back
  • Pain or tingling into your legs or feet
  • Numbness around your genitals/buttocks
  • Loss of bladder/bowel control

What is a muscle spasm?  This is an involuntary contraction of muscle fibres. This usually occurs when the muscle is acting in a protective way – like a protective reflex to protect an underlying damaged tissue from further damage. Finger muscles may spasm whilst writing for prolonged periods ie in an exam. Muscle spasm may also be caused by dehydration, loss of fluids during exercise without replacement can lead to fatigued muscles and eventually spasm. It is thought that it only takes a 2% reduction in body weight due to  fluid loss to have a 10-20% reduction in sport performance.

What is sciatica? Many patients come to see us here at Dynamic Osteopaths saying that they think they have sciatica, however many cases are incorrect. Sciatica is a symptom of a number of possible causes,  the sciatic nerve is the longest and thickest peripheral nerve in the body, extending from our low back to our foot. Sciatic pain can be sharp, shooting pain and numbness from the low back through the buttock and down the back of the thigh to the calf and foot.

Sciatic Nerve

The main causes of sciatica are:

  • A  herniated disc pressing on a nerve root that compresses the sciatic nerve.
  • Spinal stenosis: narrowing of the spinal canal usually due to ageing, as due to arthritis the joints become enlarged and choke the nerve.
  • Piriformis syndrome, as the sciatic nerve run under or through the piriformis muscle in the buttock the nerve may become squeezed or compressed giving ‘sciatic like’ pain.
  • Sacro-Illiac joint dysfunction. As the 5th lumbar nerve lies on top of this pelvic joint any inflammation caused by the  joint dysfunction may cause ‘sciatic like’ pain.
  • Spondylolithesis  is a forward slippage of one vertebrae on another due to a fracture which can pinch the nerve and cause sciatica.
  • Other possible causes for sciatica can be in pregnancy due to constantly changing posture and  although rare, a spinal tumour.

 

What are facet joints? Facet joints are the joints  between each vertebrae, on either side,  that control and facilitate the movement of the spine. Like many joints of the body they are surrounded by a capsule and can be very pain sensitive. Therefore any trauma to the joint or capsule can be very painful and send the muscles in the surrounding area into a spasm.

Facet joint pain can be due to a sudden trauma involving a quick over- rotation of the lumbar spine, common in squash players, which causes acute inflammation and or a ‘locking’ sensation of the joint. Mostly facet joint problems are chronic and are due to ageing and arthritis in the joints. The joints become enlarged and grow spurs which cause pain on rotation and other movements of the lumbar spine.

Facet joints control movement

 

How can Dynamic Osteopaths help?

When you visit an osteopath with back pain, they will first listen to you explain your symptoms and then ask some questions which will include onset of pain, what may make it better or worse and if you have any leg symptoms. They may ask some questions about your general and past health which you may think irrelevant, but this is to build a full picture of you as a whole person and to make sure that there is no under-lying medical problem (RED FLAGS).  The osteopath will then observe your posture and feel how your back is moving and carry-out any relevant clinical tests. All this is to be able to form a diagnosis before treating or referring on to a specialist consultant or further investigations (MRI, X-Ray).

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