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What You Should Know About Chronic Back Pain

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By Stephen Campbell


Back pain is one of the commonest causes of clinic visits and hospitalizations in Blue Bell, PA. The incidence is highest in the sixth and seventh decades of life with a slightly higher proportion of women being affected. The underlying causes are widely varied. They include, among others, trauma, infections, tumors as well as degenerative changes within spinal components. The pattern of symptoms in chronic back pain is likely to vary slightly depending on the part of the back that is affected and the cause.

Regardless of the exact cause, the discomfort results from a problem affecting spinal column components. These include the bony structures (mainly vertebral bodies) the inter-vertebral disc, ligaments and muscles. The reason as to why the incidence of this problem increases with age is the fact that some of these structures undergo degenerative changes and can no longer function properly. Osteoarthritis is a well-known degenerative bone condition that affects many large joints including those in the spine.

The tumors that cause back ache may originate from the spinal column itself or may be distant metastases from other affected organs. The commonest tumor that originates from bone and is likely to affect the spine is multiple myeloma. Overall, causes that are attributable to the presence of tumors are caused by metastases. Examples of tumors that frequently metastasize to the spine include those from the thyroid, the breasts, the kidneys and the prostate.

The pain that is caused by inter-vertebral disc herniation typically has a sudden onset. It may be severe or mild depending on the extent of displacement. In most cases, this symptom is preceded by a heavy lifting event or blunt force trauma to the back. Symptoms tend to be restricted to one side of the body and are usually worse on movement or when one assumes a seated position. The symptoms may be referred to the upper or lower limbs depending on the level at which slippage occurs.

When you visit your doctor, they will want a detailed history from you so as to figure out what the most likely diagnosis is. They will also take you through a physical examinations with a particular emphasis of the back. The next step is to undergo a series of tests (blood tests as well as radiological images) depending on the pattern of symptoms. A CT scan, an X-ray image and a radionuclide scan are among those that provide the most useful information.

There are a number of treatment options that exist. These are classified into pharmaceutical agents, physical therapies and surgical intervention. Analgesic drugs are chosen depending on the severity of symptoms. In cases of mild symptoms, aspirin, acetaminophen, ibuprofen and other non-steroidal anti-inflammatory drugs are typically used. Stronger drugs such as steroids and opioids are reserved for the severe cases.

Physical therapy targets problems affecting muscles and joints. The main forms of physical therapy that exist include massage, supervised physical activity, heat and cold therapy, electrical stimulation and so on. After a few weeks of these treatments, muscle strength is significantly increased. It is important to note that patients will respond differently to these treatments depending on the type and severity of their condition.

Surgery may also be used but as a last resort. The two main types of surgical operations that may be performed are spinal fusion and decompression. Fusion is used when dealing with a destructive process while decompression is required in case of space occupying lesions.




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