If you're struggling with back pain, you're not alone. It's a leading cause of disability and ill health worldwide.
Back pain can be caused by a variety of issues – from problems with the intervertebral discs, issues with nerves (radiculopathy) through to simple muscle sprains or strains. To understand what might be causing back pain, whether is is low back pain or upper back pain, it is important to understand how the back works.
What is the back?
The back is generally the term given to the posterior of the body, between the base of the skull and the top of the buttocks, and includes the spine, the spinal cord and the large number of muscles that cover this area. The back is very strong, and flexible.
What is the spine?
At the centre of the back, running from the base of the skull to the top of the pelvis, is the spine. The spine is a complex group of small bones called vertebrae. The vertebrae is shaped a little like a cylinder with small spurs (known as facet joints) jutting outwards.
The spine is grouped into three sections – the cervical spine (the part of the spine that forms the neck), the thoracic spine (the part of the spine that forms the upper back) and the lumbar spine (the part of the spine that forms the lower back).The vertebrae are joined together by muscles and ligaments, and between each vertebrae is a fibrous disc known as an intervertebral disc, often just referred to as “discs”. They act as shock absorbers, and help facilitate movement of the spine, and they are exactly the right height and width for the gap between the vertebrae.
What are intervertebral discs?
Although the discs are tough on the outside, there is a softer substance on the inside, and sometimes this inner substance can extrude through the tougher outer surface, resulting in a herniated disc (this is also sometimes called a slipped disc). A bulging disc happens when – often as part of ageing – a disc expands beyond the edges of the vertebrae above and below it.
The spine is shaped the way it is to surround and protect the spinal cord, a large collection of nerves that run from the base of the skull, down the cervical spine and thoracic spine to the top of the lumbar spine. Some of the nerves exit the spine at the neck (these are the nerves that control the upper body and arms), and some exit at the top of the lumbar spine (these are the nerves that control the lower body and legs).
Should these nerves become compressed or irritated in some way, there can pain or discomfort along the path of the nerve. This is known as radiculopathy, although it is sometimes called sciatica when it occurs in the leg.
Many people have herniated or bulging discs without ever realising – they often do not cause pain, and herniated discs will often “repair” themselves without any intervention.
Back pain can be caused by muscular issues
Although there is a common assumption that back pain is due to issues with the discs, this is often not the case. The majority of back pain comes from issues with the muscles in the back. There are a large number of muscles that cover the back and / or connect to the spine in some way - if these muscles become tight, sprained or strained, back pain can occur.
Back pain can't be caused by 'wear and tear'
Some people believe you can use your back too much - older people with back pain will often point to a physical job in the past as being the cause of their back pain in the present. However, science now tells us that, just like regular exercise makes our bodies fitter and stronger, regularly moving your back (lifting, carrying) helps keeps backs fitter and stronger, assuming this started gradually and is practiced regularly (going from nothing to trying to life a car might cause some issues!).
Pain in the neck can be caused by a number of issues. You can read more about pain in the neck on this page specifically about neck pain and the causes of neck pain.
Upper back pain
Pain in the upper back (the thoracic spine from the bottom of the neck, between the shoulder blades to the base of the rib cage) can be caused by a variety of problems, including muscle and ligament strain, radiculopathy or a sudden injury. One particular posture is rarely to blame – but lack of movement (not changing posture regularly) or carrying out a repetitive movement for a long period of time can play a part.
Lower back pain
Pain in the lower portion of the back is often referred to as Low Back Pain (or LBP), but if there isn’t a specific cause for the Low Back Pain, it is referred to as Non-Specific Low Back Pain (NSLBP). This is often linked to tiredness, anxiety and stress, especially if the pain persists for a long period of time.
Low back pain can seem frightening but it is rarely dangerous. It also isn’t an inevitable aspect of getting older – back pain can be helped at any age and you don’t have to “just live with it”. Just like upper back pain, there can be a variety of causes, but staying mobile can help reduce both the pain and the stress that comes with it.
When is back pain serious?
Back pain can often be a cause of worry for people. It is important to remember that most back pain – whilst an inconvenience – is rarely dangerous or disabling.
Sometimes, pain that feels like it is in the back may not be. For instance, people with kidney stones will often feel a pain in their lower back, but it is not the structures of the back that are causing the problem.
There is a particularly serious back issue, known as cauda equina syndrome, where the nerves that spread out from the lumber spine become compressed to such an extent that bladder or bowel issues can occur, along with numbness between the legs, anus and genitals. This is called Cauda Equina Syndrome (C.E.S.) and although it is rare, it requires urgent medical attention. You can read more about CES on the NHS website here.
If you are concerned that your back pain might be a symptom of something more serious, please call 111 or 999.
Diagnosing back pain
Many people believe that a scan or an X-Ray will help pinpoint the cause of their back pain, but often these scans will show “issues” such as protruding discs or signs of arthritis that aren’t actually the cause of the pain at all (many people have disc issues and no pain). Because of this, doctors are often reluctant to send people for scans or x-rays, and will instead look at medication or physiotherapy via the NHS.
Treating back pain
Home remedies for back pain can include over the counter medication, depending on your personal medical situation, or applying heat to the affected areas (science now shows us that ice is rarely helpful).
Keeping moving as much as possible is helpful, too. Remember that some pain upon returning to movement is normal, but this shouldn’t be excessive.
Here at State 11, we use advanced techniques like sports massage and RAPID NeuroFascial Reset to help with muscular back pain and restricted movement. Kinseology taping and fascial cupping can also be helpful.
Chiropractors and osteopaths are used by some people with back pain, although it is important to understand the difference between what they do.
Serious back pain issues will require treatment by a GP with a possible referral onwards to a physiotherapist or specialist for further diagnosis. If you are worried by your back pain, please seek professional advice.
Who better to tell you if somewhere is good at helping with pain, injury or restricted movement than someone who has already been there? Wondering if we can help you? Why not have a listen to what Anna has to say?
Getting treatment at State 11 Soft Tissue Therapy, Spalding
At State 11 in Spalding, we use a variety of advanced techniques to help people in pain or discomfort.
We are injury and pain specialists, and do not offer relaxation or "spa" style massages.
The techniques we use for reducing your pain include RAPID NeuroFascial Reset - an advanced Canadian technique devised by two Canadian therapists frustrated at not being able to make rapid, lasting change for their clients. This is a clothed technique that does not require removal of clothing, or the use of any waxes or oils. We are the only clinic offering RAPID in Lincolnshire.
We may also use sports massage techniques, kinesiology taping, fascial cupping or Instrument Assisted Massage.