What Causes Back Pain
Back Pain & Muscle Wasting
Muscle wasting is the most common of all factors in back pain and plays a significant role in the majority of back pain cases. Muscle wasting deep in the core. Our spines have adapted to lead an upright existence. It is a radical piece of design that relies heavily on strong trunk muscles. Without the supportive action of the core muscles, chronic strain can build up in the spinal tissues. The exact tissues that get sore when you have back pain.
Back Pain & Scar Tissue
Scar tissue is a far more common cause of back pain than most people realise. Scar tissue from old injuries that weren’t properly rehabilitated is a major cause of back pain. Scar tissue can form in relation to injury but it can also build up gradually due to things like bad posture. The presence of scar tissue in the soft tissues can cause irritation of the spinal tissues and contribute to chronic back pain.
Back Pain & Muscle Damage
Muscle damage in the spines supporting muscles, caused by pregnancy, childbirth, injury or surgery, leaving the back with improper support. The simple fact is that sometimes if a muscle is cut or torn the function of that muscle is affected, often even after the wound has healed. Many people who have had abdominal or pelvic surgery suffer from long lasting weakness and dysfunction on the muscles that support the spine, a perfect recipe for back pain.
Back Pain & Foot Problems
Even the most sedentary of us take millions of steps per year on hard surfaces like concrete, tarmac & paving. The forces generated when your heel strikes concrete are more significant than you think. If your arches are particularly high or particularly flat the strain of walking on hard ground in fashionable footwear is magnified many times. Not only are these kind of foot issues a major cause of knee pain, ankle pain, foot pain and hip pain, they are also a major cause of back pain.
Back Pain & Sedentary Work
There is no escaping from the fact that we evolved over millions of years to be a highly active organism. The amount of movement involved in child rearing, nest building, water gathering, foraging, hunting & evading vicious packs of honey baggers is what we were made for ….. and now we ‘write code’. Our bodies are adapted to move. Prolonged sitting or even standing at work for more than 30 hours a week can lead to back pain; by slowly but surely weakening the postural muscles, tightening the fascia and compressing the spinal bones.
Back Pain & ‘Poor Technique’
Poor execution of movement in sports and exercise can place unnatural strain on the spinal tissues and cause back pain. Improper training methods are a major cause of pain and injury. Lifting heavy weights without good technique is the obvious one. An extremely common cause of back pain is distance running on hard surfaces like tarmac with poor form. Running on hard ground without correct technique & hip strength can place significant strain on delicate spinal joints and cause back pain. Mistakenly thinking that sit-ups & planks are a core exercise is also an ironic & very common cause of exercise related back pain.
Back Pain & Lifestyle
There are many lifestyle choices that can harm our spinal systems badly enough to cause back pain.. A great example would be the classic ‘supporting a child on your hip while doing things around the house’ on a daily basis. Another example would be the patient who plays video games for 12 hours a day and doesn’t exercise. Being forced into unnatural mobility scenarios by life is perfectly normal and healthy; it’s when these movements are excessively repetitive that they can become a cause of back pain.
Back Pain & Stress
Most people who show up at their chosen healthcare providers office with a fresh case of back pain have some kind of increased stress. Occupational, financial and relationship stresses are major triggers for episodes of acute back pain in a percentage of individuals. It is important to use the term ‘trigger’ as opposed to ‘cause’ here because if you have a healthy strong spine it is not likely that stress is going to trigger bad back pain. If however, you are suffering from some of the issues listed above, stress can trigger those latent issues into an episode of pain.
Back Pain & Internal Organs
There are many complex connections within the human body, more than the minds of the genius level experts can comprehend. One area in which there is a great deal of complex connectivity is within the sensory part of the nervous system. You can have pain in your neck and feel it as a headache (cervicogenic headache). You can have pain in your back and feel it in your leg (sciatica). You can also have pain in an internal organ and feel it in your back. The most common example is the kidney which due to its location is a pretty obvious contender for creating what feels like back pain. Other organs including the gut and reproductive system can refer pain to the lower back too.
Back Pain & Osteoarthritis
In many ways osteoarthritis is just an extension of the movement problems our spines face, hence the term ‘wear & tear’. All the years of weight bearing and compression combined with certain other factors causes arthritic change in the spine of essentially all of us over the age of 60. While there can be a connection between back pain and osteoarthritis there is often none. It is a complete myth that all arthritic spines hurt, it is also a myth that osteoarthritis and back pain are strongly connected. A clue to this fact is that elderly people get severe back pain far less frequently than those in their 40’s and 50’s.
Back Pain & Inflammatory Arthritis
Inflammatory arthritic conditions are body-wide conditions with the capacity to cause joint pain and back pain. These types of arthritic conditions include rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. These forms of arthritis are not common causes of back pain but they do nonetheless show up. We still know very little about the full complexity and subtlety of many of these auto-immune type conditions, many of which may be more to do with the health of the gut than anything else.
Back Pain & Bone Disease
On occasions back pain can be caused by disease within one or more of the spinal bones. In older people with osteoporosis a vertebra can become seriously weakened and become susceptible to fractures. Other ways a bone can become weakened by disease include cancer, kidney disease and endocrine disease; if the bone is sufficiently affected any of these can turn into back pain. Often these type of issues will not make themselves known until they have caused a bone fracture.
Thankfully it is not that likely that your back pain is being caused by a disease process. If however you are sweating profusely and getting a lot of pain at night, losing weight without any change of diet or exercise or feeling increasingly unwell in combination with back pain, get yourself checked out ASAP.
Back Pain & Major Injuries
It probably goes without saying that significant injuries to the spine and it’s associated tissues can cause bad back pain. True injuries to the spine are not that common and usually only occur under more extreme accidents. Probably the most common are spinal fractures in contact sports and vehicle accidents. If you badly injure your spine in a sporting context or in a serious accident you will almost certainly know all about it in the form of serious amounts of back pain. Hospitals do an excellent job screening for these types of injuries so very few of them slip through the net these days.
Back Pain & Infections
Spinal infections are another less common cause of back pain that nonetheless should be considered. Infection should be considered if there is a ‘hot spot’ on in the spine of someone who hasn’t injured themselves or had any previous instances of back pain, or who has other symptoms of infection like fever. There are basically 2 kinds of spinal infection. There is a slow creeping kind that can behave a lot like normal back pain and is often misdiagnosed as a result, and there is also a far more aggressive kind of acute infection that makes people very sore and very sick very fast. There are numerous possible causes of spinal infection – all of which warrant a serious medical investigation.
Back Pain & Cauda Equina/Cord Compression
If your spinal cord or it’s root become compressed you can most certainly get back pain as a result. Some of the issues we have discussed above including fractures, tumors and large disc protrusions can all potentially compress the spinal canal and cause serious issues. Compression of the spinal canal causes pain or loss of sensation around the saddle region and down both legs, in combination with loss of bowel/bladder control. These issues are a very definite indicator that it’s an emergency hospital visit that you need as opposed to a trip to your osteopath or chiropractor.