Common causes of back pain

Sprains and strains are cited as the reasons for causing the ailment which can be intensely painful


Strains

Despite their size and strength, muscles of the lumbar spine can rip or tear. This is called a muscle "strain".

A heavy load or sudden force applied to the muscles before they are ready for activity may result in a strain. The muscle essentially rips, along with the blood vessels within the muscle tissue. This may cause bleeding into the injured area.

It can take up to two to three hours before sufficient bleeding or irritation sets in to produce significant pain. This explains why many people often can tolerate finishing the task at hand, only to suffer from intense pain later. This tear in the muscle tissue is followed by symptoms like: Pain, swelling, muscle spasms.

Sprains

Sprains refer to an overstretching of one or more ligaments of the back. The ligaments can be stretched beyond their natural integrity and in some cases can completely tear.

It is common to have ligament sprains and muscle strains occurring together. This is especially the case in severe falls and motor vehicle accidents.

Other conditions that can cause back pain include:

Disc injury
Spinal stenosis
Osteoarthritis of the spine
Spondylolisthesis
Ankylosing Spondylitis
Osteoporosis and fractures of the lumbar spine
Pregnancy
Fibromyalgia

Disc injury

A herniated disc, also called a "slipped disc", is a disc that bulges out from its position between two vertebrae. There are four types of disc herniation:

Disc bulge or protrusion results when the disc bulges out from between two vertebrae without rupturing its surrounding envelope, the annulus fibrosis.

Disc prolapse results when the inner jelly-like central part of the disc (the nucleus pulposis), seeps into the outermost fibres of the surrounding envelope.

Disc extrusion results when a tear occurs in the surrounding envelope of the disc, and the inner jelly-like central part of the disc leaks out of the disc.

Sequestrated disc occurs when disc fragments are separated from the disc, coming to lie well outside the disc space in the spinal canal.

A herniated disc has the potential to cause compression against a nerve, producing what is called radicular pain. Radicular pain is also called sciatica. This pain is caused by compression of the nerves as they exit the spinal column. The pain may be felt radiating into the buttock or down the leg, and may be accompanied by a sensation of numbness or tingling in the leg.

Spinal Stenosis

Stenosis means a constriction or narrowing. Spinal stenosis refers to narrowing of the spinal canal, a condition usually affecting people over age 50.

It results mostly from degenerative changes, or osteoarthritis in the spine, particularly from bony formations called osteophytes, around the joints of the spine. These bony overgrowths, together with thickening of the ligaments inside the spinal canal, narrow the available space in the spinal canal for the spinal cord and its nerves, and may place pressure on these structures.

The condition may cause back pain and pain in the thigh or leg, that often is made worse with long periods of standing or walking, particularly downhill, as well as weakness in the legs.

When symptoms are severe and persistent, and do not respond to conservative therapy, surgical treatment may be necessary to take pressure off affected nerves.

Osteoarthritis of the spine

Osteoarthritis refers to joint damage that results from "wear and tear". The cartilage (the tissue that lines the joints) between the vertebrae may become increasingly damaged. This may affect a single joint or any number of joints of the spine. These changes to the joints are also known as degenerative changes.

The main features of osteoarthritis of the spine are the development of bony outgrowths, called spurs, along the junction of vertebral bodies and discs. This is believed to be a natural result of stresses applied to the spine throughout life. Other features are narrowing of the joint due to cartilage loss between the affected vertebrae, and sometimes small areas of erosion of the bone beneath the joint.

A condition called facet degenerative joint disease is a wear and tear, or osteoarthritis, of the facet joints of the spine (which are the joints on the sides of the spine). Backward bending and twisting of the spine often aggravates it.

Spondylolisthesis

Spondylolisthesis is a condition in which one vertebra slips forward on the one beneath it. It may result from a number of causes, including trauma to the spine or osteoarthritis (wear and tear) of the spine, or it may have been acquired from birth. The amount the vertebra has slipped forward on the one beneath it may be minimal or very significant.

There may be no symptoms or there may be back pain and the back may feel stiff.

If the slip has caused pressure on a nerve root, pain may be felt in the buttocks or thigh.

With a major slip, an increase in the bend of the lower back can be noticed (called increased lordosis).

Treatment depends on the severity of the condition and the symptoms. This may range from simple exercises and physical therapy to spinal fusion to stabilise the spine.

Ankylosing Spondylitis
Ankylosing spondylitis is a type of arthritis that primarily affects the spine. "Ankylosing", in Greek, means, "causing stiffness and immobility of a joint," and "spondylitis" means inflammation of one or more vertebrae.

Ankylosing spondylitis causes inflammation of the ligaments and tendons that connect the vertebrae and ultimately results in fusion of the spine. This occurs because the inflammation causes some damage to the bone, and the body heals this damage by growing new bone, which replaces the elastic soft tissue at the back of the spine. This can result in stiffness and pain. In some cases, as the fusion progresses, the spine curves forward, causing a person to stoop.

Ankylosing spondylitis occurs sometimes in people with psoriasis and inflammatory bowel disease.

Stiffness and pain usually begins in the pelvis and at the base of the spine, and progresses upward through the back and to the neck. The back is generally stiff in the morning and improves during the day. Early diagnosis and treatment can control the pain and stiffness.

Osteoporosis and fractures of the lumbar spine

Osteoporosis is a condition in which bone density and bone strength decreases, making a person more susceptible to fractures. It is a major cause of bone fractures in postmenopausal women and older persons in general.

Because the signs of osteoporosis are subtle and can be easily missed, many people do not know they have osteoporosis until a bone actually breaks. In many cases it is the vertebrae that fracture, causing back pain or deformity. The hip and wrist are also common sites of fractures resulting from osteoporosis.

After menopause, osteoporosis is more common in women. Bone loss in the spine results in re