Low Back Pain

Why is back pain important?

Back pain is recognized as one of the main causes of functional incapacity and disability in developed societies. It has been found that 70 to 90% of the world's population experience back pain at some point in their lives. Back pain occurs in all age groups with a frequency of 20-30%, and it is most common in the age group of 40-50. In developed societies, this syndrome ranks second in terms of treatment for chronic diseases, following heart diseases, and is fifth in terms of surgical treatments.

The significance of back pain is particularly apparent in the industrial sector and the working community. The total cost of lost workdays and productivity, diagnosis, treatment, and compensation in countries like the USA can reach 16-20 billion dollars annually.

Despite all these significant figures, especially mechanical back pain, if not due to causes like tumors, infections, or rheumatic diseases, is essentially a benign syndrome. 70-85% of those with back pain recover without any treatment after the first acute attack.

However, 38% of those with an acute back pain episode have a second episode within a year, and 81% of those with chronic back pain experience an acute episode in the same year. The key is to prevent the first acute episode of back pain, and equally important is for those who have experienced the first episode to learn to prevent the second. Because with repetitions, pain becomes chronic, and the patient becomes a victim of chronic pain symptoms.

What is back pain? How does it develop?

A General Look at the Spine

• Your spine consists of 33 bones called vertebrae. It extends from the base of the skull to the coccyx. It evolves in a cylindrical shape to support the head and body. It's surrounded by muscles, ligaments, and other tissues.
• Each vertebra has a hole in it. These holes combine to form a cylinder,a canal  and the spinal cord passes through this cylinder called spinal canal.
• Between each vertebra, there are soft cushions  called as discs to prevent friction and allow mobility.
• Lumbar or cervical hernias occur due to displacement or tearing in these cushions. There are 7 vertebrae in the neck region, balancing between the chest and the head.
• The chest region has 12 vertebrae, balancing between the waist and the head. Ribs and muscles attach to these vertebrae to form the rib cage.
• There are 5 vertebrae in the lumbar region. The most robust and firm vertebrae are in this region. Muscles of the lumbar region and intervertebral ligaments connect to the lumbar vertebrae. Below the lumbar vertebrae are the pelvic bone and coccyx.
• Back pain usually results from the stretching of a ligament or muscle holding a vertebra in its normal position. When these muscles and ligaments weaken, the spine loses its integrity, resulting in pain. As nerves spread from the spinal cord to every part of the body, lumbar problems can cause pain and weakness almost everywhere in the body.
• Back pain may arise due to lifting and carrying heavy objects, standing for long periods, leaning forward, or sitting. It can be due to falls or unusual heavy exercises. Tension and stress causing headaches in some people can also lead to back pain.
• Severe coughing and sneezing can even cause back pain. Overweight people may experience back pain due to the increased load on the back. Back pain can result from infections or immune system problems damaging the muscles, joints, bones, and connective tissues in the back. Joint diseases can cause back pain.
• Loss of bladder or bowel control, difficulty moving the legs, or numbness and tingling in the legs, along with back pain, could indicate damage to the spinal cord and nerves and require urgent treatment.

Common Causes of Back Pain

Back pain can be classified as follows:

1. Lumbar hernia - disc herniation
2. Disc degeneration, degenerative disc disease
3. Narrowing of the spinal canal - narrow canal, spinal stenosis
4. Sciatica - the piriformis muscle compressing the sciatic nerve
5. Calcification of the joints formed by vertebrae - facet disease
6. Failed back surgery syndrome
7. Sacroiliac joint disease
8. Pain originating from the lumbar muscles
9. Spinal cord injuries
10. Disc inflammation - discitis