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WHAT CAUSES BACK PAIN

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BACK pain, both upper and lower, is an incredibly common complaint; in fact, it is one of the most common reasons for people missing work. Lower back pain is the single leading cause of disability worldwide.

When it comes to sources of pain in the back we can simply separate it into pain originatin­g from muscular, joint and neurologic­al structures.

The joints of the spine include the weight-bearing disc and the movement controllin­g facet joints. Injuries to either of these structures can cause localised pain that is exacerbate­d by certain movements.

Disc-related pain is typically worse on forward bending and facet-related pain typically worsens on extension (or backward bending).

If the injury and damage to these structures is great enough there may be resultant compressio­n or injury of nerve roots as they leave the spinal cord and exit the spine.

This may result in both localised pain and radiating pain or symptoms that spread away from the spine, including into arms or legs.

The final piece of the puzzle is the involvemen­t of the muscle that surrounds, stabilises and moves the spine. Direct injury to muscle may result in tears or spasm, while injury to other structures may result in muscle spasm in an attempt to protect the region, or as a result of altered mechanics.

Most back pain will be a combinatio­n of these sources and it is extremely important for a careful history taking and examinatio­n to be done to determine the exact mechanism of injury and particular structures that may be damaged. Only then can an accurate diagnosis be made and appropriat­e treatment be performed or prescribed.

Chiropract­ors are trained specifical­ly in ne urom us cu lo skeletal conditions, making them well equipped to examine and treat back pain.

As primary spinal care practition­ers, their role is to be the first stop for back pain patients, and then provide the appropriat­e care or refer to the relevant specialist­s when needed.

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