Back pain or backache is the pain felt in the back that may originate from damage to the muscles, nerves, bones, joints or other structures in the spine. Back pain is one of the most common medical problems experienced by most people at some time in their life. It can be acute, usually lasting from a few days to a few weeks, or chronic, lasting for more than three months.
Characteristics of Back Pain
Back pain can occur as a dull constant pain or a sudden sharp pain. It may be confined to one area or radiate to other areas such as the arm and hand, upper or lower back, and leg or foot.
Other than pain you may experience weakness, numbness or tingling in your arms or legs caused by damage to the spinal cord.
Risk Factors for Back Pain
Athletes participating in sports such as skiing, basketball, football, ice skating, soccer, running, golf or tennis are at a greater risk of developing back pain. During these sports activities, the spine needs to bear more stress, take up more pressure, undergo twisting and turning, as well as bodily impact. This may cause strain on the back that can result in back pain. Athletes are at a high risk of back pain both from trauma and from overuse injuries, especially in sports requiring hyperextension.
Causes of Back Pain
The common causes of back pain in athletes include:
- Musculoligamentous strain: It is the most common sports injury caused by injury to the soft tissues around the spine.
- Spondylolysis: It is most commonly found in athletes who participate in sports such as gymnastics, pole-vaulting, and football. All these activities require frequent hyperextension of the lumbar spine.
- Spondylolisthesis: It is a condition of the spine that occurs when one vertebra is displaced or has slipped forward over the other below it.
- Herniated nucleus pulposus: When an injury occurs, the central core of the disc is pushed through a tear in the outer hard layer of the disc, causing a bulge and pressure on nearby nerves. If the herniated disc presses on a spinal nerve, it can cause back pain.
Other causes include growth-related problems such as scoliosis and Scheuermann's kyphosis.
Diagnosis of Back Pain
Your physician will diagnose back pain by reviewing your history and symptoms and examining your spine. A complete examination includes the examination of the signs of unusual curves of the spine, rib hump, tilted pelvis and tilting of the shoulders, and a test of your sensations. Other diagnostic tests may be needed to confirm the diagnosis.
Treatment for Back Pain
The treatment for back pain is usually non-surgical and includes:
- Anti-inflammatory medications or NSAIDs are recommended to provide relief from pain.
- Cold packs, heat packs or both, applied to your back will help ease much of the discomfort and relieve stiffness as well the pain.
- Sleeping with the pillow between the knees while lying on one side or placing the pillow under your knees when lying on your back may help relieve back pain.
- Exercises to strengthen your trunk and back muscles may be recommended.
These measures help to relieve your back pain; however, in certain conditions, the pain may not be resolved and may require surgical treatment. Your physician will decide on the appropriate surgery based on several factors.
Cervical Spine Anatomy
The spine, also called the backbone, is designed to give us stability, smooth movement, as well as provide a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs.
What is Cervical Radiculopathy/Myelopathy?
Disc protrusion, also called herniated disc, is a condition caused by a tear in an intervertebral disc, allowing the disc contents to bulge out.
Disc protrusions in the cervical or neck area place pressure on nerve roots (nerve root compression) or the spinal cord causing radiculopathy. Radiculopathy is a medical term used to describe the neurological deficits that can occur from pressure on the nerves and spinal cord, such as arm or finger weakness, numbness or pain. Cervical radiculopathy refers to dysfunction of a nerve root caused by injury or compression of a spinal nerve root in the neck. On the other hand, cervical myelopathy refers to compression of the spinal cord within the neck.
Causes of Cervical Radiculopathy/Myelopathy
Conditions that can cause radiculopathy/myelopathy include:
- Degenerative disc disease: Wear and tear of the discs between the vertebrae, causing them to lose their cushioning ability
- Spinal stenosis: Narrowing of the spinal canal as we age, most commonly due to degenerative arthritis
- Degenerative spondylolisthesis: Degeneration (wear and tear) of the vertebral components, usually occurring after age 50, causing slippage of a vertebra onto another, spinal stenosis and narrowing of the spinal canal
Symptoms of Cervical Radiculopathy/Myelopathy
Cervical radiculopathy can result in pain, numbness, or weakness in the shoulder, arm, wrist or hand. Myelopathy presents with weakness, problems manipulating small objects and difficulty with a normal gait.
Diagnosis of Cervical Radiculopathy/Myelopathy
In addition to a complete history and physical examination, your doctor may order spine X-ray, MRI or CT scans, electromyography and nerve conduction studies to diagnose cervical radiculopathy and myelopathy.
Treatment Options for Cervical Radiculopathy/Myelopathy
When conservative treatment measures such as rest, medication, physical therapy, and pain-blocking injections are ineffective, your surgeon may recommend spine surgery.
The most common spine surgery to relieve your symptoms of nerve root compression involves removing the disc and fusing the two vertebrae above and below it with a bone graft. A newer treatment option is now available to replace the herniated disc with an artificial disc. Artificial discs are used in place of a bone fusion to preserve your neck’s movement and flexibility.
A decompressive laminectomy and fusion is a common surgery performed to treat cervical myelopathy. It is a surgical procedure in which a portion of the bone or lamina causing pressure on the nerves is removed. In spinal fusion, a piece of bone taken from another part of your body is transplanted between the adjacent spinal bones (vertebrae). As healing occurs, the bone fuses with the spine.