What are the causes of back pain?
The causes of most back pain are:
- Muscle strains
- Ligament sprains
- Disc problems
- Irritated joints
- Irritated nerves
- Arthritis or degeneration
- Poor posture
- Traumas – such as automobile accidents, work related or sports injuries
Back pain can be further complicated by emotional stress.
And sometimes it is not even back pain but the internal organs of the body expressing their illness.
It’s not a short topic, but let’s break it down into easy to manage pieces. This will give you a better understanding of back pain.
To begin, Let’s go over some of the key players in your back so you can understand what’s going on:
1. Five lumbar vertebrae
Labeled in descending order they are L1-to L5. The “L” stands for lumbar. Lumbar means low back.
2. Five discs between each of these vertebrae
They are spacers so the bones don’t get too close. They provide shock absorption, and they help carry the weight of the body. The discs also allow flexibility and motion. Discs are ligament-like in that they hold two vertebrae together like glue. And one bone on top of another bone with a disc between makes a joint. These joints provide motion for the body.
3. Ten facet joints
There is one on each side of each vertebra. They help guide your moving backbones. They keep them from moving too far which would damage your joints.
So each level has a three-joint complex: the disc, and two facet joints.
4. Several muscles
They have colorful names like psoas, illiacus, quadratus lumborum. Muscles have only two goals in life, contract and relax. When they do this, they move your bones and your body around.
5. Many Ligaments
Muscles must attach to bones. But you cannot ask a nice red muscle to attach straight into white bone. It is not a match made in heaven. So as your muscles get closer to the bone, they change into a more fibrous rope-like white tissue. This white tissue is acceptable to the bone and it gets glued on tight by the body.
6. Bundles of Nerves
They must pass out of the spinal column and travel all over the body. How many nerves serve your back or leave the back to go elsewhere? Imagine rush hour traffic in Boston. Then make your drive home last a month. It’s a lot of nerves.
7. A blood supply
This is most important when it comes to feeding muscles and bones. It also plays a role in swelling and inflammation.
Now that we now some idea of how your back functions, let’s go over some of the problems that cause back pain.
A common cause of low back pain is a strain of the muscles or if more involved a sprain of the ligaments.
1. Muscle Strain
A strain of your back muscles or any muscle is also called a “pulled” muscle. The muscles overstretch and some of them can tear.
It often occurs if you overuse the muscles or use the muscle in an awkward manner. Or If you misuse the muscles by lifting something too heavy. Your muscle’s contraction becomes too strong and the muscle becomes strained. And the more muscle fibers torn, the worse the strain becomes.
If the strain becomes great enough, the ligaments attached to the muscles can also tear. An example of this type of injury would be motor vehicle accidents.
2. Ligament Sprain
Ligament tears are called sprains. Like muscle strains, the more trauma to the ligaments, the worse the sprain. The more ligament fibers torn.
The symptoms of a ligament sprain are like a muscle strain but do not involve cramping.
Medical literature grades muscle strain and ligament sprain from 1-3. Grade 1 involves less damage than grade 3.
The back pain from a strain or sprain comes from inflammation and swelling. There can be discoloration like bruising. The more fibers of the ligaments and muscles torn, the more discomfort.
3. Facet Syndrome
The facet joints of your spine can also be a source of pain in the back. When this occurs it’s called Facet Syndrome.
Often it is pressure placed on these joints that is the source of the pain. Facet joints in the low back are not meant to bear a lot of weight or pressure.
Causes of pressure and / or irritation of these joints are:
- Degeneration or arthritis
- Poor nutrition
The pain from the facets is located over the joint in the back. But facet joints can also radiate to the buttocks, groin, hips, and the back of the thighs.
***One sign of facet joint pain is if extending backward is more painful that flexing forwards.
4. Disc Problems
The disc helps make up the third joint in the spine, and can also be a source of discomfort.
The disc consists of a thick outer ring that is like a ligament. This is the annulus fibrosus. Inside this ring is a jelly-like substance called the nucleus pulposis.
The discs can cause pain in some but not all cases if they bulge. When they bulge there can be small tears in the wall of the disc that can be painful.
If the disc tears more, the jelly-like material in the center can leak out through the wall. This is often called a disc protrusion or herniation. And when this protrusion occurs it can press on the nerves of the spine causing nerve pain like sciatica. The leg muscles may also become weak when walking and the foot may drop.
5. Degeneration or Arthritis
Arthritis or degenerative disc disease (DJD) can cause back pain.
This occurs when the jelly-like nucleus inside the disc loses water and starts to tear. The disc begins to thin and the vertebra above and below form bone spurs called osteophytes. Causes of degeneration can be trauma, sports, some daily activities, time, and age.
The pain pattern for osteoarthritis or DJD can sometimes point toward the problem.
There may more pain with activities like bending, lifting, twisting, and sitting. The pain may feel better with walking or during exercise. Changing position can help the pain as does lying down.
The nerves can pinch with a thinning disc. This may lead to numbness, tingling, or pain in the legs. Sciatica is the name for pain traveling down the sciatic nerve in the leg. The disc can become more involved, like when it protrudes or herniates. Then the muscles in the leg can again become weak and the foot again can drop when walking.
Posture can play a role in pain by placing unnecessary strain on our backs.
Posture is considered the position in which we hold our bodies while standing, walking, sitting, or lying down.
Good posture is: A). The correct alignment of body parts that is B). Supported by the right amount of muscle tension against gravity.
Posture involves the way we hold our bodies when we sit, stand, or lie down. When posture is correct, the tension on our muscles from gravity is appropriate. When this occurs our balance is good.
Maintaining normal posture is something that we do without even thinking about it.
Like a self-driving car, certain muscles do it for us. Large muscles like the hamstrings and those found in the back. These muscles combine together with the ligaments of your body. Ligaments are tissue that hold the skeletal bones together like glue. The contraction of large muscles and use of ligaments stop the forces of gravity.
This prevents us from tumbling forward and onto the ground.
Having good posture checks off all the following:
- It allows muscles to work at peak performance, conserving energy, and preventing fatigue.
- It helps prevent muscle strain from overuse and the pain involved with muscle tears.
- It helps keep our joints in proper alignment. This prevents wear and tear that leads to degenerative arthritis.
- It takes the stress out of the ligaments, which means they have less chance of injury.
Poor posture does the opposite, creating a lot of strain on the body. Poor posture can cause important muscles to relax at the wrong time. This opens the body and back up to injury and pain.
The most common thieves of good posture:
- Weak muscles
- Tight muscles
- Being overweight
- High heeled shoes
If you have a poor work environment or a workspace that promotes bad posture it makes things worse. Other factors are unhealthy sitting and standing habits.
When all these factors come together, the end result can be back pain.
7. And finally, there are the things life throws at you.
Things that may be out of your control. Things like car accidents, sports injuries, cutting corners by lifting wrong, and falls.
These can bring on back pain from any of the above categories. Ranging from a simple strain to waking up that arthritis.
And while it may seem overwhelming reading this, understand that chiropractic can help. In almost any of the above situations, chiropractic treatment can be of value. It helps by assisting your body in doing what it has been trying to do since the problem began….to heal.