Causes of back pain

Almost everyone gets acquainted with low back pain (i.e. back pain in the lower back) in life, up to 90% of the population is affected by it at least once.

In about 50%, these painful episodes are more common.
Low back pain is primarily a symptom that summarizes the various causes of pain, and not a disease as such.

In most cases, despite a thorough investigation, no specific cause is apparent.

Back pain can occur for a variety of reasons, but often magnetic resonance and other examination procedures do not show results and the stabbing pain disappears on its own. This article lists many causes of back pain and the correct assessment. It is important to talk to the doctor in detail about complaints and symptoms; he will then initiate targeted investigations in order to narrow down the countless possible causes and to make the diagnosis. Individual therapy is also based on this.

Back pain is the second most common cause of sick leave at work after the simple cold. They are also the most common cause of a visit to the doctor or emergency room in the hospital. On the list of neurological diseases, back pain is in second place, headaches are in first place.
In 90% of those affected, the symptoms subside within 2 months, regardless of treatment, even if there is nerve root irritation.
One speaks of acute pain if it lasts less than a month, of chronic pain if it persists longer.

The causes of back pain

Low back pain is a symptom. The most common causes of back pain include muscle contractures or bone and nerve diseases of the spine. Pain caused by disorders of abdominal organs, pelvis or chest can also be felt at the back of the trunk, one speaks here of transferred pain. Many abdominal complaints, such as appendicitis, aneurysms, kidney disease, problems with the ovaries, as well as kidney, bladder, pelvic floor infections can cause back pain.
A normal pregnancy can cause back pain in a number of ways, including overstretched ligaments in the pelvis, irritation of the nerves and overuse of the lower back. The doctor must take these factors into account when examining the pain.
Nerve root syndromes (such as lumboischialgia or lumbocruralgia) cause the symptoms of nerve compression (direct irritation of a nerve).
Often they are caused by a herniated disc (protrusion) in the lumbar spine. Sciatica is an example of the compression of a nerve root.
A pinched nerve causes a stabbing pain, is limited to a specific region, and numbness occurs in the leg, which is innervated by this nerve.

Herniated disc: Intervertebral discs degenerate over time and flatten out. The central part of the disc consists of a gelatinous mass that can press against a nerve root when exiting its seat. The intervertebral discs begin to degenerate from the third decade of life. Herniated discs are recorded in one-third of all adults over the age of 20. But only 3% of them complain of the symptoms of a pinched nerve.

Spondylosis occurs with age because the intervertebral discs lose fluid and volume over time. The height of the intervertebral disc decreases, and the vertebrae approach each other in this way. Now, even small traumas can lead to inflammation and squeezing of the nerve root.
In this situation, classical sciatica can develop without disc rupture.

Degeneration of the intervertebral disc, together with arthrosis of the vertebral joints, can lead to narrowing of the spinal canal: spinal stenosis. These changes to the intervertebral disc and joints can cause serious discomfort and are clearly visible on an X-ray. Those who suffer from spinal stenosis may complain of pain that radiates to the lower extremities during long standing or short walks.

Cauda equina syndrome can be referred to as a medical emergency in which the spinal cord is squeezed. The disc material expands into the spinal canal and compresses the nerves. Those affected feel painful stings, and loss of sensitivity and dysfunction of the intestine and bladder are also possible. Urinary control can also be impaired due to incontinence or problems urinating.

The skeletal muscle pain syndromes that cause back pain are fibromyalgia and myofascial pain syndromes.

Fibromyalgia creates diffuse pain and stiffness throughout the body. Symptoms include a general feeling of stiffness, fatigue and muscle pain.

Myofascial pain is characterized by discomfort and stiffness in certain body zones (trigger points), restriction of movement of the affected muscle groups and pain with specific radiation, but which remain limited to a certain peripheral nerve. Usually, the pain subsides when stretching the affected muscle group. Fiber-muscle pain is often accompanied by muscle contractures.

Bone marrow infections (osteomyelitis) of the spine are a rare cause of acute back pain.

Spinal arthritis: Ankylosing spondylitis (also called rheumatoid spondylitis or ankylosing spondylitis) can cause pain and stiffening of the spine, especially in the morning. Normally, the disease first appears in young adulthood.

Tumors, especially malignant tumors, can be the cause of severe lumbalgia.

Acute nerve inflammation of the spine can be produced by a herpes zoster virus infection. This condition can occur in the chest area and cause pain in the upper back, or in the lumbar region, causing pain in the lower back.

As can be seen from the long, but by no means complete, list of possible causes of back pain, a thorough medical assessment is important in order to carry out the correct diagnostic procedures.

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