According to figures from the US National Library of Medicine, back pain is one of the most widespread medical conditions, affecting eight out of ten people at some period during their lives. The Global Burden of Disease Study (GBD) for 2013, published in The Lancet, also showed that low back pain was one among the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease and asthma combined.
Studies have shown that back pain is also the most common cause of job-related disability and a leading contributor to missed days at work. Men and women are equally plagued by this condition that can cause anything from a mild ache to severe pain that could last from a few days to weeks (acute) or more than three months (chronic).
“Spine trauma, injuries, arthritis and even back surgery or poor posture, a sedentary lifestyle or even infections can cause back pain. However, one of the main causes of back pain is linked to intervertebral disc degeneration,” said Dr. Ali Zahran, Consultant for Anesthesia & Interventional Pain Management at Burjeel Hospital of Advanced Surgery.
“Intervertebral discs are like shock absorbers that support the spine. The water that the discs contain helps cushions the impact of movement on the spine. However, with age or wear and tear, the disc degenerates, losing water and flexibility. The degenerated disc also causes a narrowing of the nerve openings in the spine. These tend to pinch the nerves in the back causing pain. Pressure on the spine and back muscles from sitting for long periods can also lead to pain,” he said. “Pain can also be caused by herniated or ruptured discs; this happens when there’s a rupture in the outer ring of the intervertebral disc, allowing the soft, jelly-like central part to protrude beyond the damaged outer rings.”
Sprains and fractures can cause acute and chronic pain based on the extent of the injury. Sprains, which involve torn ligaments, can occur from twisting suddenly or from lifting heavy objects. These can cause sharp pains. Fractures can result from weak bones seen in patients with osteoporosis, or from a fall or traumatic accident.
“Diseases such as scoliosis (curvature in the spine), ankylosing spondylitis (fusing of the spine due to inflammation) and spinal stenosis (narrowing of the spinal column which puts pressure on nerves in the spinal cord) can cause back pain as can osteoarthritis (causes bones to weaken increasing the chance of them being fracture easily) and rheumatoid arthritis (an auto immune disorder that causes inflammation and pain in the joints),” said Dr. Zahran. “Infections affecting the vertebrae can also cause pain. Osteomyelitis, an infectious condition, can cause inflammation in the discs, resulting in pain. Back pain can also be caused due to pregnancy (due to the strain on the back), kidney stones or infections and
fibromyalgia, a condition of widespread muscle pain and fatigue. Multiple sclerosis can also begin as a dull ache in the lower back region.”
“Injuries to the foot can affect a person’s gait and posture, as a person may adjust their body to compensate to avoid pain. However, that can put more pressure on the nerves in the legs and back, causing lower back pain in the long run. Mental stress or emotional issues can also manifest physically as pain in the back, as it can cause back muscles to tense as a reaction. This can also cause pain, which is often short-lived,” he added.
Doctors can use various imaging techniques to diagnose the cause of back pain ranging from a CAT (computerized tomography) and MRI (magnetic resonance imaging) scan to an X-ray. They may also recommend a bone density test or an EMG (Electromyography) to check nerve impulses.
Treatment options could include anti-inflammatory medication or cortisone injections to give pain relief, physiotherapy and electrical nerve stimulation to improve flexibility and movement as well as surgery depending on the severity of the condition causing the pain.