Back Pain Causes

Mechanical

Most of the back pains are due to activity related and because of the abnormal bio-mechanics of your spine. It may be due to spasm in the muscles supporting your spine column or over-loading of your spinal ligaments. This will be usually relieved by rest and may get worse with activities. The back pain is a protective mechanism of your body to restrict your activity level and prevent further damage to your back.

Fractures may occur in your spine as a result of direct or indirect injuries. These fractures are more easily occurred in the aged and those with softer bones, as in osteoporosis (Figure 1).

Dislocation of the joints in spine (Figure 4) are rare in your back as compared to that in your neck, but still the injuries may give rise to weakness in legs and loss of control of bowel and urine due to compression over the spinal cord.

With aging, every individual undergoes some wear and tear (degeneration). This wear and tear can be accelerated depending on individual’s activities and genetics. Smoking has been shown in studies to have an adverse effect too. The degeneration of the jelly-like discs (degenerative disc disease) makes them pop out under pressure, causing a constriction of the canal (Figure 5) available for the nerves and spinal cord (prolapsed or herniated intervertebral disc).

Abnormal loading of the bones due to wear and tear of the intervening jelly-like cushion causes formation of bony spurs which may further reduce the available space for the nerves.

Unbalanced wear and tear may cause your spine to bend/tilt towards one side causing a condition known as degenerative scoliosis (Figure 5).

Degeneration may also cause wear and tear of the joints of your spine (facet arthrosis), leading to a slip of a vertebra from its normal alignment, known as degenerative spondylolisthesis(Figure 7). This condition may also be caused by trauma or may be due to discontinuity in the bony stabilizer (pars interarticularis) from young.

Lumbar canal stenosis (Figure 8) is a condition caused by narrowing of the space for spinal canal. It may be present right from your birth or may be developed over the years of aging. In the front, there may be some compression from the popping-out of jelly-like cushion (intervertebral disc), with worsening of the condition by over-growth of ligaments (ligamentum flavum) and joints (facets) at the back.

Infections of the spine are common conditions giving rise to non-mechanical back pain. It is more common to see spine infections if you are suffering from diabetes mellitus, or other illnesses that lower your immunity. Infection can be either due to pus-forming organisms (pyogenic) or slow growing infections like tuberculosis (Figure 9). Infections of the spine are unique in the sense that there may be no other symptom except back pain. It is not necessary for you to have fever or other symptoms as seen with infection elsewhere in your body.

Consulting your spine specialist cannot be emphasized enough in such cases of back pain. If not treated timely, it may cause vast destruction of your back bones leading to gross instability and risk to the nerves.

Inflammatory (reaction of your body to various tissues) causes of back pain are commonly seen in conditions like ankylosing spondylitis or rheumatoid arthritis.

Other dreaded causes of your back pain may be spine tumor (Figure 10). Tumors may be either arising from your back itself or may have migrated to your back from other sites of tumor (secondaries or metastasis).

Some of the common sites of tumor giving rise to deposits in your back bones are lung, thyroid, kidney, prostate, and breast.

Your specialist may need to do some tests to rule these out if there is a suspicion or symptoms to suggest presence of any spine tumor.

Some of back pain may be caused by the deformities in your spine either from your birth or acquired later on in life.

These deformities may be either hunch-back (Figure 11) deformity (kyphosis) or lateral (Figure 12) deformity (scoliosis).

These deformities stretch one part of your back more when compared to normal balanced spine, thereby causing pain.

Learn more about the  Symptoms of Back Pain, Back Pain Diagnosis, Non-Surgical Back Treatment and Surgical Treatment for Back Pain.

Our spine specialist has helped patients throughout Southeast Asia, including Indonesia and Vietnam.

For a comprehensive consultation to decide which surgical back pain treatment is best suited for your health, contact our spine specialist at Pinnacle Spine & Scoliosis Centre today.