I often see patients really concerned about knowing the cause of their back pain, and rightly so, we all like to know what is going on with our bodies – especially if it’s causing us pain! So I have put together a little bit of information on common causes of back pain and things that we can do to relieve it.
Muscle Strain or Ligament Sprain
So a muscle strain occurs when the fibres of a muscle begin to tear from being over stretched or overused. Muscles may feel tender to touch, they may spasm or crampand contract too tightly which can cause intense pain. People often think that a muscle strain is a less serious diagnosis but it can be an extremely painful back condition. Ligament Sprain occurs when the strong fibrous ligamentous tissues, that attach bones and stabilise joints, are overstretched or torn. Both have similar symptoms and require similar treatment.
These conditions tend to come on very acutely and are extremely painful initially. They start to ease after a few days and gradually improve over some weeks. They respond really well to manual treatment such as Osteopathy and in many cases the sooner treatment progresses the sooner the injury will recover.
Lumber Herniated Disc – also known as a Slipped Disc
This occurs when the jelly like centre of a lumber disc can break through the more fibrous tougher outer layer and aggravate a nerve root that runs close by. The disc tissue itself, and the inflammation that gathers when an injury occurs can aggravate and press on to the nerve root which can cause intense pain at the site of compression in the lower back, and also along the length that the nerve travels, for example along the length of the sciatic nerve which could cause pain and neurological symptoms (such as pins and needles, numbness or weakness) in the buttock and the back of the leg, sometimes continuing all the way down to the foot.
There is often a gradual onset, with no obvious cause, the onset of pain can also commonly come from a lifting and twisting movement. A lumber disc herniation can cause very severe and debilitating pain. A herniated disc can take a little longer to settle than some back conditions, especially when they come along with severe leg pain or neurological symptoms.
Degenerative Disc Disease
This occurs when there is long term degeneration of the intervertebral discs, that can be age or activity related. At birth the discs are full of water and at their healthiest. As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The dehydration and weakening of the discs can cause them to collapse which decreases the nice shock absorbing gap that they create between each vertebrae and can lead to the holes where spinal nerves exit to become smaller and start to irritate or press on the nerves.
Facet Joint Dysfunction
This occurs when there is some sort of irritation, strain or locking of the facet joints. There are two facet joints behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a small capsular ligament, which is richly innervated by nerves. Dysfunction in these joints can occur when there is some degenerative change or arthritis, which can lead to roughening of the joint surfaces, or through strain, excessive, or repetitive movements, or traumatic injury. These joints can be painful by themselves, or in conjunction with disc pain, and it will usually cause the surrounding muscles to tighten or spasm. The pain from this sort of condition can come on very suddenly, or more gradually. It is usually associated with certain movements that effect the joint. The length of time it will take to recover can depend upon a few things, for example, how much structural degeneration there is, how long pain has been there for, and a patients age and fitness level.
Sacro-iliac Joint Dysfunction
The sacroiliac joint connects the sacrum at the bottom of the spine to each side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The sacroiliac joint can become painful if it becomes inflamed or if there is too much or too little motion of the joint. It can often be caused by a jolt to the joint for example slipping down a curb, or stairs, or overstretching getting into a car. It can also come on gradually. The pain can be extremely severe and radiate into the buttock, hip and upper leg and is often associated with pain during back movement, or movements that require lifting or moving the leg.
This condition results from wear and tear of the disc and facet joints. It causes pain, inflammation, instability, and narrowing of the little holes either side of the spinewhere nerves exit. It can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is also referred to as spondylosis or degenerative joint disease. It can feel very sore, and the area can often feel quite inflamed. Just because you have a degenerative joint condition it does not mean that it is not possible to alleviate the pain. Some people live with arthritis pain free.
How to look after your back at home
You can help to reduce pain at home by resting and giving you body a good opportunity to repair, without becoming completely immobile, so get up to walk around and take some gentle steps every 30-60mins depending on the severity of the pain and how difficult you find it to move. Drinking lots of fluids will keep your body well hydrated and promote healing. Eating well with plenty of protein and fibre will give the body the nutrients it needs to repair. Some gently back stretches 1-2 timesdaily will help to reduce muscle spasms. See my blog on Basic Back Stretches.
Pilates exercises are a great way to release muscle tensions caused by protective spasms in disc injuries and to promote core strength and stability that will take some pressure off the area and allow the disc injury to heal. Icing can help to reduce the inflammation and help the condition to settle down. See my blog on Ice and Heat for injuryto see how to best use ice and heat for injuries.
Manual therapy is a great way to alleviate all of these types of pain, and Osteopathy is recommended by NICE (Nation Institute for Health and Care Excellence – this body provides guidance to the NHS about what treatment to use for different conditions) as a manual therapy that has proven results for the management of lower back pain. If you would like to find out if Osteopathy would be the right treatment for you then please call our clinic on 07919163053 or visit the website at www.so-osteopathsyoarm.co.uk
Sorrel O’Malley is the principle Osteopath at Sorrel O’Malley Osteopaths in Yarm. She has been working as an Osteopath since 2010 after completing her 4 year BSChonsOstMed at the Surrey Institute of Osteopathic Medicine.