Non-specific Back Pain
Back pain is a common reason for seeking physical therapy as it can be uncomfortable and debilitating. It can result from injury, activity, and some medical conditions. Back pain can affect people of any age for different reasons. As people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.
The human back is composed of a complex structure of muscles, ligaments, tendons, discs, and bones, which work together to support the body and enable one to move around. The segments of the spine are cushioned with cartilage-like pads called discs. Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear. Damage can result from strain, medical conditions, and poor posture among others.
Causes of non-specific Back Pain
Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are strained muscles or ligaments, muscle spasms, muscle tension, damaged discs, injuries, fractures, or falls. Some activities that can lead to strains or spasms include lifting something improperly, lifting something that is too heavy, or making an abrupt and awkward movement.
A number of structural problems may also result in back pain:
– Ruptured discs:
Each vertebra in the spine are cushioned by discs. If the disc ruptures there will be more pressure on a nerve, resulting in back pain.
– Bulging discs:
In much the same way as ruptured discs, a bulging disc can result in more pressure on a nerve.
– Sciatica:
A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disc pressing on a nerve.
– Arthritis:
Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as Spinal Stenosis.
– Abnormal curvature of the spine:
If the spine curves in an unusual way, back pain can result. An example is Scoliosis, in which the spine curves to the side.
– Osteoporosis:
Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
– Kidney problems:
Kidney stones or kidney infections can cause back pain.
Back pain can also result from some everyday activities or poor posture. Examples include twisting, coughing, sneezing, muscle tension, over-stretching, bending awkwardly or for long periods, standing or sitting for long periods, straining the neck forward when driving or using a computer, and sleeping on a mattress that does not support the body or keep the spine straight.
Some medical conditions below may also lead to back pain:
– Cauda Equina Syndrome:
The cauda equina is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.
– Cancer of the spine:
A tumor on the spine may press against a nerve, resulting in back pain.
– Infection of the spine:
A fever and a tender, warm area on the back could be due to an infection of the spine.
– Other infections:
Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.
– Sleep disorders:
Individuals with sleep disorders are more likely to experience back pain, compared with others.
– Shingles:
An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.
Symptoms of Back Pain
Back pain is a pervasive condition that can significantly impact daily life, often manifesting through a variety of persistent symptoms. Here’s a closer look at the signs indicating the
necessity for back pain treatment in Singapore:
- Persistent Aching or Stiffness: Chronic back pain typically presents as a continuous or intermittent ache in the affected area. The discomfort may vary in intensity but tends to linger for weeks, months, or even years, leading to a sense of stiffness and discomfort that disrupts daily activities.
- Limited Mobility and Flexibility: Chronic back pain often causes restrictions in range of motion and flexibility. Activities that involve bending, twisting, or lifting may exacerbate discomfort, making it challenging to perform routine tasks or participate in physical activities.
- Radiating Pain: Chronic back pain can radiate beyond the primary site of discomfort, affecting other areas of the body. This referred pain may travel down the legs or into the arms, shoulders, or neck, depending on the underlying cause of the pain.
- Muscle Tension and Spasms: Persistent back pain can lead to muscle tension and spasms in the surrounding muscles. These involuntary contractions may further exacerbate discomfort and contribute to a cycle of pain and muscle dysfunction.
- Pain Aggravated by Movement: Activities such as standing, walking, sitting for prolonged periods, or transitioning between positions can aggravate chronic back pain. Changes in posture or movement may trigger flare-ups of discomfort too.
Guide to Diagnosing Back Pain
Diagnosing back pain involves a thorough assessment to determine the underlying cause of the discomfort. Here’s how it is done:
- Medical History: The healthcare provider will begin by taking a detailed medical history, including the onset, duration, and nature of your back pain. They will inquire about any previous injuries, surgeries, or medical conditions that may be contributing to the symptoms.
- Physical Examination: A physical examination of your spine, muscles, and nerves is conducted to assess for any abnormalities or areas of tenderness. The healthcare provider may also evaluate your posture, range of motion, and muscle strength to identify potential sources of pain.
- Diagnostic Imaging: In some cases, diagnostic imaging studies such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be ordered to provide detailed images of the spine and surrounding structures. These imaging modalities can help identify structural abnormalities, such as herniated discs, spinal stenosis, or fractures.
- Nerve Study: This may be performed to evaluate nerve function and detect any signs of nerve compression or damage. It includes testing your reflexes, sensation, and muscle strength in the arms and legs.
Once the underlying cause has been identified, your healthcare provider will recommend the most appropriate back pain treatment tailored to your needs.
Non-specific Back Pain Treatment
Physical therapy can help with back pain. A physical therapist will firstly recommend stopping or modifying any activity that exacerbates the back pain. Gentle manipulation of the spine, pelvis, and legs is a common way to treat lower back pain. The therapist will gently move the body and apply pressure to readjust tight muscles or vertebrae that are misaligned. Heat therapy, Cryotherapy, and therapeutic ultrasound therapy are also used in the treatment of back pain to improve the flow of oxygen to muscles, help damaged tissue heal, and relieve pain. Personalised exercises will then be prescribed and expanded as the pain subsides and achieves better movement and flexibility. If in doubt, please seek professional advice.
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