What are the main areas of back pain. How can different types of back pain be classified. What structures in the back can cause pain. Why is accurate diagnosis of back pain challenging. How do doctors diagnose the cause of back pain. What is the importance of describing pain symptoms in detail.

Common Causes and Locations of Back Pain

Back pain is a complex and often challenging condition that affects millions of people worldwide. The back is a intricate structure composed of bones, muscles, nerves, and other tissues, making it susceptible to various types of pain and discomfort. Understanding the different areas where back pain can occur and its potential causes is crucial for proper diagnosis and treatment.

Upper Back Pain

Upper back pain typically affects the area between the base of the neck and the bottom of the ribcage. Common causes include:

• Poor posture
• Muscle strain
• Herniated discs
• Osteoarthritis
• Myofascial pain syndrome

Middle Back Pain

Middle back pain occurs in the region below the rib cage to the lower back. Potential causes include:

• Muscle strain or sprain
• Poor posture
• Herniated or bulging discs
• Fractured vertebrae
• Osteoarthritis

Lower Back Pain

Lower back pain is the most common type of back pain, affecting the lumbar region. It can be caused by:

• Muscle or ligament strain
• Herniated or bulging discs
• Sciatica
• Spinal stenosis
• Degenerative disc disease

Classification of Back Pain Types

Back pain can be classified into several categories based on its characteristics and underlying causes. Understanding these classifications can help in better diagnosis and treatment planning.

Acute vs. Chronic Back Pain

Acute back pain typically lasts for a few days to a few weeks and is often caused by sudden injury or strain. Chronic back pain, on the other hand, persists for 12 weeks or longer and may be due to underlying conditions or persistent issues.

Mechanical vs. Radicular Back Pain

Mechanical back pain is localized to the spine and surrounding muscles, while radicular pain radiates along the path of a nerve, often causing symptoms in the arms or legs.

Nociceptive vs. Neuropathic Back Pain

Nociceptive pain results from tissue damage or inflammation, while neuropathic pain is caused by nerve damage or dysfunction.

Anatomical Structures Causing Back Pain

The back is composed of various structures, each of which can potentially cause pain when injured or affected by certain conditions. Understanding these structures is essential for accurate diagnosis and treatment.

Muscles and Ligaments

Muscles and ligaments in the back can be strained or sprained, leading to pain and discomfort. This is often caused by sudden movements, lifting heavy objects, or poor posture.

Vertebrae and Facet Joints

The vertebrae are the bones that make up the spine, and the facet joints connect these bones. Conditions such as osteoarthritis or fractures can cause pain in these structures.

Intervertebral Discs

The intervertebral discs act as shock absorbers between the vertebrae. Herniated or bulging discs can cause significant back pain and may also lead to nerve compression.

Spinal Nerves

Nerves that exit the spinal cord can become compressed or irritated, leading to pain, numbness, or weakness in the back and extremities.

Challenges in Diagnosing Back Pain

Diagnosing the exact cause of back pain can be challenging due to several factors. Understanding these challenges can help patients and healthcare providers work together more effectively to reach an accurate diagnosis.

Overlapping Symptoms

Many back conditions can present with similar symptoms, making it difficult to pinpoint the exact cause without further investigation.

Individual Pain Perception

Pain is a subjective experience, and two people with the same condition may report vastly different levels of discomfort.

Multiple Potential Causes

Back pain can often result from a combination of factors, rather than a single identifiable cause.

Diagnostic Approaches for Back Pain

Accurate diagnosis of back pain typically involves a combination of methods to identify the underlying cause and develop an effective treatment plan.

Medical History and Physical Examination

A thorough medical history and physical examination are the first steps in diagnosing back pain. The healthcare provider will ask about the nature, location, and duration of the pain, as well as any associated symptoms.

Imaging Studies

Imaging studies such as X-rays, MRI scans, or CT scans may be used to visualize the structures of the back and identify potential causes of pain.

Diagnostic Injections

In some cases, diagnostic injections may be used to help identify the source of pain by temporarily numbing specific areas or structures in the back.

Importance of Detailed Pain Description

Providing a detailed description of your back pain is crucial for accurate diagnosis and effective treatment. Healthcare providers rely on patient-reported symptoms to guide their diagnostic process and develop appropriate treatment plans.

Key Aspects of Pain Description

When describing your back pain, consider the following aspects:

• Location and distribution of pain
• Quality of pain (e.g., sharp, dull, burning)
• Intensity of pain
• Duration and frequency of pain episodes
• Factors that worsen or alleviate the pain
• Associated symptoms (e.g., numbness, weakness)

Types of Pain Descriptions

Healthcare providers often classify back pain into three main categories based on patient descriptions:

1. Axial pain: Localized pain confined to a specific area of the back
2. Referred pain: Pain that moves around and may be felt in areas away from its source
3. Radicular pain: Pain that follows the path of a nerve, often described as electric shock-like or searing

Treatment Approaches for Back Pain

Once a diagnosis has been established, various treatment options may be considered to address back pain. The most appropriate treatment plan will depend on the underlying cause, severity of symptoms, and individual patient factors.

Conservative Treatments

Conservative treatments are often the first line of defense against back pain and may include:

• Rest and activity modification
• Physical therapy and exercises
• Over-the-counter pain medications
• Heat or cold therapy
• Massage and manual therapy

Medications

Various medications may be prescribed to manage back pain, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants
• Opioid pain medications (in select cases)
• Antidepressants or anticonvulsants for neuropathic pain

Interventional Procedures

In some cases, interventional procedures may be recommended to address back pain, such as:

• Epidural steroid injections
• Facet joint injections
• Radiofrequency ablation
• Spinal cord stimulation

Surgical Options

Surgery is typically considered a last resort for back pain and may be recommended in cases of severe or persistent symptoms that have not responded to conservative treatments. Surgical options may include:

• Discectomy for herniated discs
• Laminectomy for spinal stenosis
• Spinal fusion for instability or severe degenerative changes
• Artificial disc replacement

Understanding the various types of back pain, their potential causes, and the diagnostic and treatment approaches available can help patients better navigate their journey towards pain relief and improved quality of life. By working closely with healthcare providers and providing detailed information about their symptoms, individuals with back pain can play an active role in their treatment and recovery process.

Understanding Different Types of Back Pain

As you may already know through personal experience, back pain can be uniquely complex and difficult to diagnose and treat. There are many types of back pain, and a wide range of treatments that may or may not work for the same condition.

Here we outline several insights that you may find helpful in your journey to finding and participating in a treatment approach that works for you.

A common cause of pain in the back is muscle strain. Watch: Lower Back Strain Video

Back pain is a complicated, personal experience

The intensity and manageability of pain are very different for every person. For example, one person with a herniated disc may experience excruciating pain while another person with the same condition has no symptoms at all. Similarly, a muscle strain can range from mild to debilitating.

See Pain Generated by the Spinal Disc

With some conditions, back pain can flare up and then subside, only to flare up again after a few weeks or months and gradually intensify over time. Because only you know your level of pain, your treatment will most likely be more successful if you are an active participant in making decisions about your medical care.

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Many structures in your back can cause pain

Spine Anatomy Overview Video

Your back is subjected to various strong forces throughout the day, such as from twisting, sudden jolts, or poor posture when sitting hunched over. Any of your spine’s many interconnected and overlapping structures are capable of becoming injured and producing back pain. Common anatomical causes of back pain include:

• Large muscles that support the spine
• Spinal nerves that exit the spinal canal and may go to the legs or elsewhere
• Facet joints that connect the vertebrae along the back of the spine
• Intervertebral discs that provide shock-absorption for the bones

For more information, see Spinal Anatomy and Back Pain.

Bones, ligaments, tendons, and other anatomic structures are also capable of causing back pain.

See Causes of Lower Back Pain

The underlying cause of pain may be hard to identify

It is usually difficult for the brain to distinguish between injury to one spinal structure versus another nearby. For example, a torn or herniated disc may feel similar to an arthritic facet joint due to their close proximity. In some cases, the same nerve root can be compressed or irritated by different structures, such as a disc or bone spur.

See Spinal Cord and Spinal Nerve Roots

Your physician will take a thorough medical history, discuss your symptoms, and conduct a physical exam in order to accurately diagnose the cause of back pain. Sometimes diagnostic tests—such as X-rays, MRI scans, or diagnostic injections—are needed when trying to locate or confirm the underlying cause of pain.

See Getting an Accurate Back Pain Diagnosis

Description of your pain is important

Referred pain is pain felt in parts of the body other than the anatomical cause.

How you describe your pain, its area of distribution, and any related symptoms are important to determine a back pain diagnosis. Three common classifications of back pain include:

• Axial pain. Also called mechanical pain, axial pain is confined to one spot or region. It may be described a number of ways, such as sharp or dull, comes and goes, constant, or throbbing. A muscle strain is a common cause of axial back pain as are facet joints and annular tears in discs.

  See Axial Back Pain: Most Common Low Back Pain

• Referred pain. Often characterized as dull and achy, referred pain tends to move around and vary in intensity. As an example in the lower back, degenerative disc disease may cause referred pain to the hips and posterior thighs.

  See Low Back Pain with Referred Pain

• Radicular pain. Commonly described as electric shock-like or searing, radicular pain follows the path of the spinal nerve as it exits the spinal canal. This type of pain is caused by compression and/or inflammation to a spinal nerve root. In the lower back (lumbar spine), radicular pain may travel into the leg. Other terms for radicular pain are sciatica or radiculopathy (when accompanied by weakness and/or numbness). It can be caused by conditions such as a herniated disc, spinal stenosis, or spondylolisthesis.

  See Radiculopathy, Radiculitis and Radicular Pain

Once your doctor reaches an accurate diagnosis for your back pain, an effective treatment plan can begin.

Radicular pain follows the path of the nerve into the arm or leg and may be accompanied by numbness or weakness.

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Pain is still real even if no anatomical reason is found

Even after many tests and doctor visits, in a small percentage of patients the anatomical cause for your back pain may remain elusive. If this is the case, the pain still needs to be treated and there are a variety of nonsurgical care options that can help alleviate or manage the pain.

Psychological factors, such as depression and sleeplessness, can make the pain worse and also need to be included as part of a comprehensive treatment program.

See Chronic Pain and Insomnia: Breaking the Cycle

For persistent back pain and/or any neurological symptoms, it is always important to see a qualified spine specialist for a diagnosis. Ultimately, participating in the decision-making process about your medical care may help you have a better outcome. Understanding your pain is an important element of this process.

Learn more:

When Back Pain May Be a Medical Emergency

Preparing to See A Doctor for Back and Neck Pain

Dr. Grant Cooper is a physiatrist with several years of clinical experience, specializing in the non-surgical treatment of spine, joint, and muscle pain. He is the Co-Founder and Co-Director of Princeton Spine and Joint Center and the Co-Director of the Interventional Spine Program.

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Editor’s Top Picks

• When Acute Pain Becomes Chronic Pain

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• Video: Understanding Different Types of Back Pain

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Types of Back Pain | WCM Center for Comprehensive Spine Care

Types of Back Pain: Middle Back Pain vs.

Thoracic Back Pain

When it comes to back pain, one size doesn’t fit all. Not only can pain occur anywhere along the spine or in the adjoining muscles, but it can vary drastically in intensity and frequency. Because the spine is the casing that protects the most important elements of the Central Nervous System, back pain of any kind can be a warning sign of damage that should be taken seriously. Left untreated, some causes of back pain can lead to permanent spine or nerve damage.

Types of Back Pain

Back pain of any kind can be either acute or chronic. If the pain is acute, symptoms are generally sudden and temporary. In chronic cases, however, the pain returns regularly, over time—sometimes unpredictably—and can make everyday activities difficult.

Back pain can occur for a variety of reasons, including the following:

• Herniated disc(s)
• Muscle strains (from overuse or poor posture)
• Muscle injury
• Pinched/compressed nerves
• Narrowing of the spinal canal (spinal stenosis)
• Vertebral fracture(s)
• Osteoporosis
• The natural processes of aging
• Spondylitis (a spinal infection that creates inflammation)
• Scoliosis
• Tumors
• Degenerative disc disease

… and more

The regions of the back and spine can be separated into multiple sections: the cervical region (the vertebrae of the neck), the thoracic region (the vertebrae of the upper back), and the lumbar region (or lower back). The “middle back” is a somewhat generalized term that refers the area below the ribs and above the hips.

Middle and thoracic back pain are not as common as neck and lower back pain, of course, as the vertebrae in the middle regions of the spine do not typically flex as much as the vertebrae at the ends of the spine, which allow you to move your head and hips. For this reason, middle and upper back pain can often be a sign of something other than muscle stress.

Thoracic Back Pain

The thoracic spine comprises the twelve vertebrae to which the ribs attach and could, therefore, be described as the “upper back” region. When compared with neck (cervical) pain, middle back pain and lower (lumbar) back pain, pain in the thoracic region of the spine has a greater probability of being caused by a serious underlying condition. ¹ Because of this, it’s important to keep an eye out for incidents and symptoms such as these:

• Fever and/or chills
• Unexplained/uncontrollable weight loss
• Noticeable deformity
• Nerve pain/numbness/tingling in the legs or lower body
• Severe stiffness, particularly in the morning (which could be a sign of rheumatoid arthritis)
• Physical trauma (e. g., from a recent car accident)
• Onset of pain before the age of 20
• Onset of pain after the age of 50
• Constant, severe pain that is not helped by changing position

… and others

If you experience thoracic back pain after a recent trauma or develop any of these unusual symptoms at the same time, do not hesitate to see a doctor. Because this portion of the spine is connected to the ribs that keep your lungs and heart protected, damage to the thoracic vertebrae can affect your cardiopulmonary system as well.

Middle Back Pain

Although middle back pain is sometimes considered synonymous with thoracic back pain, it can generally be described as pain that occurs above the lumbar region of the spine but below the rib cage. In cases of middle back pain, the symptoms can be vague and difficult to diagnose, which can be especially frustrating in chronic cases.

There are a number of elements that can increase a person’s risk of developing middle back pain, including the following:

• Pregnancy
• Weight gain/obesity
• Lack of physical activity
• Stress and anxiety
• Smoking

… and more

As with thoracic back pain, any sudden or unusual symptoms like fever, chills, dizziness, or weight loss can be a sign of something that goes beyond back pain. If you experience such symptoms, seek medical attention right away.

Treatment (and Prevention) of Back Pain

The treatment for a patient’s back pain depends strongly upon its cause and location; however, many conditions can be at least partially relieved by a combination of non-invasive techniques, including professional massage, physical therapy, and other treatments that can be performed by the patient at home.

For particularly severe spinal conditions that can’t be treated by non-invasive means, there are a number of surgical options that can be employed, some of which are minimally invasive. For both thoracic and middle back pain, common surgeries include discectomy and/or vertebral fusion.

As its name suggests, a discectomy involves the removal of all or part of an injured spinal disc. Vertebral fusion, on the other hand, focuses on creating a strong structure from two adjacent vertebrae by physically joining them together (often also replacing the disc with an appropriate spacer). In some cases, these two procedures will be performed together.

The most important thing an individual can do is to protect his or her back before a painful condition can develop. To maintain good back and spine health, doctors recommend developing an appropriate diet and exercise regimen, using proper posture, sleeping on your side for good spinal support, quitting health-impacting vices like smoking or excessive drinking and generally reducing stress. ²

The following few exercises take only a few minutes a day to complete and are recommended by the Mayo Clinic for the prevention of back pain:

1. Knee-to-chest stretch: Lie on your back with your feet flat on the floor and your knees bent. Pull one knee to your chest and hold it for five seconds, making sure your spine stays pressed to the floor. Return to the first position and repeat with the other leg for two to three repetitions.

2. Bridge exercise: From the same starting position as the first exercise, tighten your abdominal and gluteal muscles and bring your hips up so that your body forms a straight line. Hold the position for three breaths, then return to the starting position. Repeat for five repetitions on the first day and work your way up to 30, over time.

3. Cat stretch: Start on your hands and knees, then arch your back slowly upward. Next, arch your back slowly in the other direction, letting your midsection sag downward. Return to the first position. Repeat this exercise twice a day for three to five repetitions.

4. Shoulder blade squeeze: Sit on a chair that does not have arms and assume proper posture. Without changing posture, pull your shoulder blades together and hold them for five seconds before returning to the starting position. As with the cat stretch, repeat this exercise twice a day for three to five repetitions.

Weill Cornell Medicine: Comprehensive Spine

If you’re experiencing back pain of any kind that preoccupies you, makes it difficult to accomplish everyday tasks, and/or is accompanied by other symptoms, it’s time to be seen by a spine specialist.

Weill Cornell Medicine: Comprehensive Spine in New York, NY is one of the nation’s foremost providers of minimally invasive spinal surgery and treatments. Our experienced neurological professionals will be able to diagnose your condition, determine its severity, and help you identify the best course of action with regard to back pain treatment and management.

Don’t let your back pain control your life; contact us today at 888-922-2257 to make an appointment to be seen by one of our expert physicians.

Sources

1. http://patient.info/doctor/thoracic-back-pain

2. http://www.everydayhealth.com/pain-management/back-pain/quick-tips-to-help-prevent-back-pain.aspx

Lower back pain: what to do company blog

Answering questions: Causes of pain in the lumbar region? What to do? Who to contact?

Causes of pain in the lumbar region

Lower back pain: how often do you ignore this symptom, associating it with prolonged sitting at the monitor or lifting weights? In fact, this is a rather alarming signal of your body, since the cause of this pain can be hidden in diseases of the kidneys, liver and intestines, and not only in problems of the musculoskeletal system or severe overwork.

Thus, your main task is not to delay the visit to the doctor and not to hush up this pain. The main task of the doctor is to find out what exactly caused the deterioration of the condition and take the necessary measures.

Pain in the lumbar region: what hurts there?

• In 95% of cases, back pain is associated with muscles, ligaments and joints. Patients often describe this condition as “pulled back”. These pains are unpleasant, but not dangerous, and in most cases go away on their own in 2-3 days.

How do you feel?

Aching pain in the back (acute and chronic).

Who to contact?

If after 3 days you did not feel relief, this is a sure signal: you should urgently make an appointment with a doctor – a traumatologist, a neurologist.

• 3-4% of pain is associated with sciatica, osteochondrosis, intervertebral hernia.

How do you feel?

• Sciatica usually causes persistent sharp (stabbing) or dull pain. More often localized on one side. Pain can radiate to the thigh, lower leg, buttock and cause numbness.

• Osteochondrosis manifests itself as pulling pains in the back, which radiate to the leg, become stronger when sneezing, coughing, exerting.

• Acute, radiating pain in the limbs can signal an intervertebral hernia. It occurs when bending over, lifting weights, aggravated by sneezing, coughing, moving, accompanied by weakness in the leg.

Who to contact?

Traumatologist, neurologist, neurosurgeon.

• 1-2% of pain in the lumbar region is associated with injuries, inflammatory diseases of the spine. The same percentage group includes oncology, diseases of the cardiovascular system. The gastrointestinal tract often reports itself with radiating pain in the lumbar region and back (for example, appendicitis, gastric and duodenal ulcers).

Diseases of the urinary system (cystitis, pyelonephritis, and especially urolithiasis) are most often manifested by pain in the lower back. Moreover, the pain can be so acute that you immediately contact an ambulance.

In diseases of the female genital organs, along with pain in the lower abdomen, pain in the sacro-lumbar spine may occur. Moreover, it can disturb you periodically during menstruation, during sexual intercourse, or be long-term and become chronic.

Thus, there are a large number of reasons for the occurrence of pain in the back, and some of them indicate dangerous symptoms. To make a correct diagnosis and receive adequate treatment, you need to consult a specialist.

When not to hesitate

The main signal that a visit to the doctor cannot be postponed is the regularity of pain. If from time to time you feel that your back is twisted, shot, and the pain goes away in 2-3 days, most likely there are no terrible symptoms. If pain of low or medium intensity accompanies you all the time, you can only temporarily drown it out with painkillers, it is becoming more and more difficult for you to choose a position in which it does not hurt – it is dangerous to delay. It’s better to see a doctor immediately!

Does your back hurt after sleeping?

Do you feel stiffness, pain and discomfort in your back, in your right or left side, in the region of your sacrum before you even get out of bed? The reason is not only that you “lay down” on your back or sleep on a low-quality mattress.

Back pain after waking up has its own reasons:

• the day before you overworked and overloaded your back with heavy lifting;
• back muscles are weakened;
• you already have a diagnosis of “intervertebral hernia” or “osteochondrosis”;
• you have a cold in your back;
• you are overweight, which causes the load on the spine to be unevenly distributed;
• you are pregnant and your back is subjected to a slowly growing load;
• you experience stress and constant overwork.

For back pain of any intensity is strictly prohibited:

• Go to the bathhouse. Even if you suspect that the pain is associated with hypothermia, you should not resort to warming procedures in the first two days.
• Go for a massage without prior consultation and examination by a doctor.
• Contact chiropractors who were found through advertisements in a newspaper or the Internet. Only certified clinics and certified specialists.
• With back pain, it is important to quickly establish the causes and establish treatment tactics. 30% of neurosurgery or trauma patients tried home treatments on themselves and ended up in a hospital ward. Do not ignore the symptoms of back pain and seek diagnosis in a timely manner.

Make an appointment with a traumatologist, orthopedist, neurosurgeon of our center by phone +7 (495) 477-55-40 or online.

Sports and Rehabilitation Center “New Step”:

Our main goal is to bring back the joy of an active life to you!

Back and lower back pain – why does the back hurt in the lumbar region, back pain treatment price

8 out of 10 people know firsthand what it is – back pain. Almost everyone has experienced it at least once in their life. In most cases, these are non-specific pain sensations provoked by excessive muscle tension, prolonged stay in an uncomfortable position, a cold or hypothermia, or repeated repetition of any movement. Such pains in the back and lower back disappear quite quickly – after the exclusion of the cause that provoked the discomfort, and the start of treatment, it usually takes no more than three months for the pain to cease to remind of itself. However, in the absence of treatment, the pain syndrome can become a constant companion of the patient, intensifying during recurrent exacerbations.

Factors causing back pain

There are the following common reasons why the back hurts in the lumbar region or in other parts of the spine:

• pinching of spinal nerve roots;
• swelling and enlargement of ligaments and/or muscles;
• irritation of nerves located near the spine, etc.

Primary back pain is the result of injuries or dystrophic age-related changes in the joints of the vertebrae and intervertebral discs, as well as ligaments, tendons and muscles adjacent to the spine. Osteochondrosis and sciatica are diseases that are responsible for the appearance of not only the syndrome of the anterior scalene muscle, but also back pain – in more than half of the cases. Here are diseases of the spine, which are accompanied by back pain of varying degrees of intensity:

• sciatica;
• osteochondrosis;
• spondylopathy – a disease caused by hormonal failure, most often affects women during or after the onset of menopause;
• ankylosing spondylitis;
• injuries and violations of the integrity of the vertebrae – bruises and fractures of the spine, ruptures of nearby ligaments, etc.

Another common reason why the back hurts – such a reason in this case is considered secondary – is a disease of some internal organ. In addition, diseases provoked by the growth of tumors in the spinal column or the presence of an infectious agent in it can be attributed to the causes of persistent pain syndrome. Often, pain in the back and lower back is caused by pathologies of the vascular and nervous systems, as well as kidney diseases. Sometimes such symptoms are caused by the following diseases, which are treated by specialists – a gynecologist and a urologist:

• female – uterine fibroids, amenorrhea, inflammation of the ovaries and endometriosis;
• male – chronic prostatitis.

Therefore, back pain can be one of the symptoms of serious diseases, the treatment of which should be started immediately.

Diagnosis and treatment of back pain in ON CLINIC in Ryazan

In order to identify the cause of pain, examinations such as:

• CT to assess the state of bone tissue;
• MRI to study the condition of all layers of soft tissues;
• x-ray;
• ultrasound.

Treatment is prescribed by a neurologist based on the severity of the patient’s condition, his individual characteristics and the causes that provoked the pain syndrome. Truly effective therapy is complex and may include:

• treatment with pharmaceuticals;
• intramuscular and intravenous injections to relieve the patient of back pain and restore the natural functions of nerves and muscles;
• some physical therapy methods;
• in especially severe cases – surgical intervention.