Guest commentary: Back pain is a symptom, not a disease
Just as a headache can represent a range of conditions from stress to a brain tumor, so also can a backache be caused by many conditions.
About 80 percent of the adult population will suffer from a sore back sometime in their lives requiring time off work. Back pain is a common symptom of something wrong with the back, but it is not a diagnosis. The good news is that over 90 percent of people with back pain can be treated successfully without surgery once the cause of the pain is diagnosed.
The lower back is referred to as the lumbar spine and is composed of five vertebrae which are connected by discs and ligaments. Nerves run through the center of the spine and leave at each lumbar level to innervate the muscles and to give feeling to the skin. Injury or diseases to any of these structures can result in back pain.
There are many causes of back pain, including trauma, that is, injury to the soft tissues including the muscles and ligaments, commonly referred to as a sprain (by far the most common cause), or injury to the nerves. Fractures of the vertebrae are a result of more violent injury although people with osteoporosis, with fragile bones, can experience fractures with only minor trauma. Back pain also may be caused by a deteriorated disc which occurs over time from various recreational activities, work or the aging process and may result in arthritis of the spine. A slipped disc (herniated disc) is another source of back pain often associated with a pinched nerve (known as sciatica), in which there is shooting pain into the leg associated with numbness, tingling and sometimes weakness. Less common causes of back pain include spinal infections and tumors. This wide variety of causes of back pain will obviously require different treatments.
If your back pain lasts for more than a few days and/or if it is associated with shooting pains down the leg with or without numbness, tingling or weakness, then assessment by a medical professional should be pursued. A specific diagnosis can then be made so that appropriate treatment can be started. Early treatment results in early recovery in a few days or a few weeks, whereas delayed treatment may result in prolonged pain over many months or, in some cases, the treatment will require surgery.
Remember that back pain, as with headaches, represents a wide variety of causes which need to be diagnosed so that the appropriate type of treatment can be started with the anticipation of an early successful result.
Dr. Stanley Gertzbein is affiliated with Aspen Valley Hospital as well as being on the faculties of the University of Colorado and the University of Texas. He is a spine surgeon specializing in the conservative care of patients with neck and back conditions.
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