What Causes Spine Pain?

Did you know that approximately 85% of the population suffers from back pain at least once in their lives? With back pain so prevalent, it’s important for sufferers to understand why it occurs and how it can be treated. Today we explain the causes of spinal pain and what techniques we can use to manage and treat this type of pain.

Spinal pain and its repercussions

A recent global survey found that spine or back pain was the number one cause of disability and one of the five most common reasons for medical consultation. As well as pain in the immediate spine area, back pain can affect many other aspects of our daily lives, from mental health to sex life.

The high occurrence of back pain means that medical professionals are working hard to better understand the underlying pathology of the condition. However, very few advances have been made to give a specific diagnosis for everyone that suffers. The causes of back pain are often non-specific and multi-faceted.

Causes

Pain in the back and spine has been linked to:

• Intervertebral disc degeneration
• Injuries to spinal structures
• Innervated spinal ligaments

Other causes or risk factors of back pain include:

• Obesity and smoking
• Lack of exercise
• Bad posture at work
• Awkward lifting and hard manual labour
• Psychological factors

Diagnosis

Although accurate diagnosis still presents a challenge, issues affecting the intervertebral discs and facet joints are the two most common sources of back pain. Their diagnostic prevalence is 42 and 31% respectively.

In the absence of severe neurological problems, an aggressive diagnosis is not necessary. However, it is very important that medical professionals look out for red flags that may indicate serious spinal pathologies: malignancy, cauda equine compression and vertebra infection.

Red flags include (but are not limited to):

• Rapidly progressive sensory or motor deficits
• Bowel and bladder changes
• The constant and non-mechanical nature of pain
• A past medical history of cancer
• Night pain.

The presence of any of these red flags warrants further, urgent clinical investigation.

As well as pain resulting from physical sources such as intervertebral disc and facet joints, there are other potential contributory factors including mental health, quality of life and work environment. The most widely-investigated psychological factors that contribute to back pain are anxiety, depression, fear avoidance and beliefs about pain. These may all play a role in the recurrence or exacerbation of pain, and clinicians face the challenge of identifying these.

Management

Primary care clinicians are challenged with managing not just one condition, but one of many. Therefore, the assessment of back pain by experienced healthcare professionals is imperative for effective and safe management.

Most patients who suffer from an acute episode of back pain do not seek medical advice as the issue resolves on its own. However, around 30% of first-time sufferers report back pain for a period of more than four weeks. Sometimes, their symptoms continue for more than a year.

Treatment

Evidence suggests that early intervention in back pain is key. With better knowledge of their condition, professional advice and an individualized treatment program, sufferers can avoid chronicity and disability. Clients can also return to work faster.

Techniques to treat back pain include exercise and physiotherapy, pharmacological treatments, manual therapy and a combination of physical and psychological programmes.

Passive intervention such as applying topical, low-level heat every four hours, in combination with physical exercise, helps to provide relief for back pain. This will also help you return to your daily routine much faster.

Physical exercises can also help. Simple, effective exercises include lower back extension from prone position and knee hugs. These exercises are beneficial for pain relief as well as helping to avoid the onset of psychological factors. These may, in turn, trigger depression and anxiety because of temporary disability, restriction and pain. Reducing daily activities and bed rest are ineffective and can lead to the worsening of symptoms.

The American College of Physicians (ACP) suggests that acupuncture and massage therapy help to relieve pain and aid functional movement. In the long-term, the most beneficial approach is a workplace assessment. The assessment will give you practical recommendations to improve your comfort in your workplace.

Our suggestion

The symptoms of an acute episode of spine pain may resolve within the first four weeks. Without proper investigation though, recurrence and chronicity are common due to misdiagnoses and mismanagement. Physical activity, together with an individualized treatment program, will help you return to your active lifestyle as soon as possible.