Back Pain Causes and Myths

Back Pain Causes and Myths

Back Pain Causes and Myths

Causes of Back Pain

Why me?

I don't know what I did

Suddenly my back "went out"

I wasn't lifting anything heavy

These are questions often heard when someone develops acute low back pain. Most episodes occur without obvious preceding warnings or causative factor.

Over 80% of the population suffer back pain at some time, most notably in middle age. Luckily less than 1% of this is due to serious underlying disease and this is where hospitals and thier consultants become neccesry . So why does it happen? It is probable that the spine has been silently undergoing a process of damage - a combination of ageing and wear and tear, which then weakens the back to a point where a little additional strain or overuse is now sufficient to set off an acute spasm.

Often this is like the tip of the iceberg. The stored accumulation of damage is now only being revealed after two, three, four decades worth of damage lies undiscovered. Weakened back muscles and damaged ligaments especially can lead over time to the spine becoming progressively more vulnerable to overstrain injuries at lower and lower loading levels. As a result, once the first attack of back pain has occurred there is a 50-60% risk of another episode within the next year. The natural history of back pain is for increasingly frequent episodes with often an increase in severity over time and with the episodes lasting longer. The tolerance of the spine to do work is being progressively reduced until one day it fails. Therefore greater attention needs to be paid to caring for the spine in the future and not, as unfortunately currently seen, just focusing on pain relief.

With increased awareness of these factors and good follow up advice there is no reason why the future cannot be bright even with occasional backache as opposed to bouncing from one acute episode to the next getting weaker each time it occurs.

Back pain myths.

My doctor says - "I have just pulled a muscle in my back or neck."

If pain comes on after only a minor movement it is highly unlikely to be a "pulled muscle". Simple muscle strain or tear are relatively rare causes of back pain. Muscles do play their part in joint problems by "splinting" the painful joint, it is a fundimental mistake and not particulary helpful to simply dismiss back or neck pain as muscular strain. Unfortunately it is common to see patients who are regularly disappointed by various treatment because of this type of inappropriate attitude towards diagnosis. There is an expectation that in the modern age of medicine that you should be able to identify the cause of the pain. The magority of specialists in this field would openly admit that in 70-80% of the time it is impossible to know precisely what is wrong. Patients therefore often enter into a frutiless, frustrating quest as to the cause, which often is a distraction from getting on with the business of improving the mobility of spinal joints which will lead to physical relief over time, ie there are no quick fixes.

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