A Guide for Understanding Back Pain.

T he spine is designed in such a way as to provide protection to the highly sensitive spinal cord and nerve roots along with strength and flexibility providing for mobility in all directions. However there are many different parts of the spine that can produce back pain, such as irritation to the large nerve roots that run down the legs and arms, irritation to small nerves inside the spine, strains to the large back muscles, as well as any injury to the disc, bones, joints or ligaments in the spine.

There are two types of pain:

•    Acute lower back pain is short term, comes on suddenly and usually lasts from a few days to a few weeks.
•    Chronic lower back pain is generally defined as pain that persists for more than three months. It may be progressive or may occasionally increase for a period of days or weeks and then return to a lower level of pain. With chronic pain, the exact cause of the pain can sometimes be difficult to determine.

Back pain can take on a wide variety of characteristics:
The pain may be constant, intermittent, or only occur with certain positions or activities
The pain may remain in one spot or refer or radiate to other areas
It may be a dull ache, or a sharp or piercing or burning sensation
The problem could be anywhere along the spine for example in the neck or low back but the pain may radiate into arm or hand or even the leg or foot.
Back or neck pain symptoms may include weakness, numbness or tingling or a combination of all of these.
Certain causes of lower back pain have a tendency to occur more often in younger individuals versus older adults:

•    Younger adults (e.g. 25 to 60 year olds) are more likely to experience back pain from degenerative disc disease or a lumbar disc herniation or from a back muscle strain or other soft tissue strain.
•    Older adults (e.g. over 60) are more likely to suffer from pain related to joint degeneration (e.g. Osteoarthritis or spinal stenosis).

Additional Diagnostic Tests for Lower Back Pain
When pain is severe and is not relieved within 6 to 12 weeks, a specific diagnosis becomes more important to determine further treatment. Additional diagnostic tools include:

•    X-ray. Provides information on the bones in the spine; used to test for spinal instability and fractures.
•    MRI scan. Displays detailed cross-section of the components of the spine. Useful to assess issues with lumbar discs and nerve roots, as well as ruling out causes of lower back pain.
•    CT scan. Captures cross-section images of the vertebrae and spinal discs; can be used to check for herniated disc or spinal stenosis.
•    Myelogram. Allows identification of problems within the spine, spinal cord and nerve roots. An injection of contrast dye illuminates the spine prior to an x-ray or CT scan.

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