Acıbadem Comprehensive Spine Center

Back pain

Studies have shown that one out of five people suffered back pain sometime in their lives. Back pain results mostly from problems of muscular causes, yet it may be a messenger of more serious diseases.

Causes of back pain:
Sedentary lifestyle
Most back pain results from a sedentary lifestyle which fails to keep regular sports and exercise as a part of our lives. Poor posture, sitting on a table/computer for extended periods, lack of physical fitness and weakness of the back muscles may be associated with pain.

Sports injuries, traffic accidents, and similar injuries are the second most common causes of back pain. Pain may occur due to injuries that have a wide spectrum. Injuries range from simple injuries, such as crush or tractional injuries of the muscles, to various fractures. These types of injuries may be accompanied by nerve injuries and may pose a risk for the development of nerve damage in the long term.

Fibromyalgia is a frequently encountered condition that develops due to the current lifestyle conditions of todays communities, and results in pain in the back and shoulder blade bones that may also radiate to the shoulders, and also pain all over the body. Stress, anxiety, and similar factors may also increase fibromyalgia. The presence of also morning stiffness, exacerbation in cold and humid weather, association with fatigue, lack of concentration and headache are not uncommon. These symptoms may not be simultaneosly present altogether, and may differ from one individual to another. It may be seen in both sexes at any age. The cause is not known exactly.

Upper back hernia
Hernias of the discs, cushions in between the vertebrae, are seen more commonly in the neck or the lower back. Hernias may occur more rarely in the upper back. Depending on the area that it originates from, the hernia compresses the nerve root and results in a bandlike pain or tingling in certain areas of the chest wall. If the resultant hernia compresses the spinal cord, there may difficulty in walking and a decrease in the walking distance.

Bone loss
This is increased fragility of the bones due to their decreased mineral density. This occurs most commonly in the vertebra. These compression fractures may be a source of back pain. Although the condition affects both sexes, it is more common in females.

Rheumatoid diseases
These are the group of disorders that originate from the bones and their neighboring connective tissues. They manifest with bone-muscle-joint pain. Ankylozing spondylitis and similar rheumatoid diseases may involve the back and cause back pain. As opposed to general opinion, they are not the diseases of only the elderly. Rheumatoid diseases can be seen at all ages.

Deformity (Scoliosis, kyphosis, etc.)
Scoliosis of unknown cause is generally not a cause of pain. Moderate degree curves that do not require surgery may be a cause of pain when joint degeneration is added with advanced  age.
In Scheurmann’s disease, when the kyphosis angle reaches 60-75 degrees, it may a cause of paint in patients with poor physical fitnees. Muscles that try to hold the body erect all day long may develop fatigue type of pain.

Benign and malignant tumors originating from the bones or nerves of the spine may cause back pain. In addition, tumors of organs including the breast, lung, prostate, etc. may spread to the spine and cause back pain. Important characteristics of the pain are the emergence at night and lack of alleviation with rest. Fever, weight loss, and fatigue are the symptoms that may be associated.

Degenerative changes
Along with aging, detoriation and arthrosis may occur in the joints and discs between the vertebrae. The discs may lose their water content and bulge. These changes may result in back pain. These changes in the joints, bones, and discs may decrease the area bearing the spinal cord, resulting in narrow canal and nerve pain.

Referred Pain
Apart from muscle and bones, back pain may be caused also by “referred pain” that originates from the organs located elsewhere in the body. In such conditions, your back pain may be in fact a messenger of lung diseases, heart diseases, stomach problems, and similar conditions.

Other causes
Various metabolic and microbic conditions may be also a cause for back pain.

Red flag signs:
Symptoms that are listed below and named red flags, may be a messenger that your back pain is not a “simple” back pain. In the presence of red flags, it is absolutely important that you consult to your physician and investigate the underlying cause.

What can be done to eliminate back pain?  
It should not be forgotten that especially those people working at a desk are under risk. If you are working on a computer, precautions named office ergonomics must be taken. You should prefer chairs with a high back and that support your lower back, and place your computer screen to your eye level. Every 1.5-2 hours, you should leave your desk and make “active resting” for 5-10 minutes.
Avoiding stress and preventing excessive weight gain are also important in being protected from back pain.
Failure to perform sports and exercises will lead to a poor physical fitness, and weakness of your back and abdominal muscles. This condition may render you a candidate for back and lower back pain. On the other hand, as much as failure to do sports, spending all week at work or home, without any movement, and then performing sports excessively and competitively may be risky with respect to risk of injury. This condition is named “weekend warrior”.

The recommendation is to turn sports and exercise into parts of your daily life, and perform sports regularly 3 to 4 days a week. Regular stretching, strengthening, and making aerobic exercises is better than making excessive exercises at certain intervals. Your regular sports activity may be composed of brisk walking, or may include running, swimming, yoga, and etc. Increase in your physical fitness, strengthening of your back and abdominal muscles may be help you in attaining a better posture.

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