Types and causes of back pain

by | Physical Medicine

Q: I have had a terrible time getting a professional to help me better understand my back pain. It has been called “lumbago” in all of my bills from offices and insurance companies. If I ask for explanation, it seems that this word means “low back pain”. But why do I have pain? Is all back pain from the same problem? Please help me get some answers so that I can learn more!

A:  This problem you are having is not uncommon.  Our primary care Doctors are not personally at fault.  Their education has been forced more in the direction of understanding disease management pharmacology than anatomy and their time is strangled due to managed care.  In truth, though, there are different types and causes of back pain:

  • Spondylosis is a type of arthritis characterized by degenerative changes in the aging spine.
  • Spondylitis is the name for chronic back pain and stiffness caused by infection or inflammation of the spinal joints.
  • Spinal stenosis is a narrowing of the space around the spinal cord. Often caused by arthritis, the result can be a painful squeezing of the nerve.
  • A damaged disc—one of the shock absorbers between vertebrae—also can put pressure on a nerve.
  • Sciatica causes a burning, stabbing pain that shoots down the leg. It is usually caused by a very tight muscle in the buttock that puts pressure on the sciatic nerve, which branches off the spinal cord in the lower back and passes through the buttock, the back of the leg and into the calf and foot.
  • Osteoporosis is a disease that causes a loss of bone density. As bones weaken, including those of the spine, fractures can develop…see spondylosis.
  • Stress—and we all know what that is—can tighten muscles and lead to back pain.

Obviously without examination, I cannot be specific to your problem.  But hopefully this helps guide you to some answers in case we never meet.

As a final thought, please don’t blame your healthcare providers.  It is extremely difficult to manage an office that allows proper time for a doctor to educate his patient properly and still can afford to pay their salary, but to effectively communicate the true cause of pain; a doctor needs to have ample time to sit with a patient and show them with pictures, measurements, and x-rays.  It is really as simple as being able to understand how a house is built to understand what forces lead to musculoskeletal back pain.  This kind of effective education is vital to truly fixing the problems (as opposed to merely covering up the pain with medication).  Once you can get that understanding, the doctor can be more effective in helping you… but more importantly, you can be more effective at helping yourself.  I know how hard this kind of quality is to produce in healthcare today because I have dedicated my life to making it a reality for my community.

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