These days more and more people are complaining about back pain. Back pain can originate from the spine or the muscles. The spine is mobile and consists of bones and discs made of cartilage and a jelly like substance. In the center of the spine is the spinal canal which houses the spinal cord which is a set of nerves that stretch out and control all the muscles in the body. The spinal cord is a part of the nervous system and is the most protected structure in the body along with the brain.
One source of back pain originates in the spine and is caused by a change in the shape of the spinal canal which houses the spinal cord. The nerves of the spinal cord are very sensitive and any abnormality in the structure of the spine and shape of the spinal canal will compress these nerves and cause numbness, tingling and radiating pain and in severe cases paralysis. There are numerous injuries and conditions that can cause an alteration in the spine significant enough to affect the spinal cord and produce back pain. The most common injuries and conditions are lumbar disc herniation, degenerative disc disease, spinal fractures, spinal stenosis and spondylolisthesis. These conditions are diagnosed by a medical doctor using various methods like neurological examinations, x rays, cat scans and emg tests. Treatment in severe cases for these conditions involves spine surgery to decompress the nerve. However, most cases respond well to more conservative forms of treatment like strengthening and stretching specific muscles of the back as well as improving posture so that the spine has more structural support which reduces the pressure on the nerves. A second form of treatment that is effective is weight loss. Even losing 10lbs will substantially reduce the load on the spine thereby improving pain. The third most effective form of treatment is alternative medicine like acupuncture, massage, magnet therapy and natural medicine.
When structural and neurological factors are ruled out the source of back pain is attributed to pain from the contraction or overburdening of muscles as well as inflammation. There are specific nerve fibers that when activated produce pain, muscle contracture and inflammation in the surrounding area. What is worse is that inflammation and muscle contracture in turn further activates these fibers and this forms a vicious cycle.
These fibers may be activated by an acute injury such as a disc herniation or muscle strain, or may be caused by a chronic condition such as poor posture, muscle imbalance, or repetitive strain injury.
Contracture occurs when a muscle is overworked either too intensely in a short duration or repeatedly for an extended period of time. For example working long hours doing some repetitive physical task will overwork the involved muscles. This case involves dynamic movement; however a muscle can also be overworked without any movement such as when you try to maintain a faulty posture for an extended length of time. Indeed the most common complaints of computer work are back pain and carpal tunnel syndrome. Both are examples of repetitive strain resulting in pain and inflammation.
Contracture can be made worse when the contracted muscle compresses an artery which decreases blood flow to that area; this creates another vicious cycle because a muscle with less blood supply contracts more easily and lower blood volume also actives the pain nerves. Contracture in these cases can be treated through ergonomic modifications as well as ultrasound treatment, electronic muscle stimulation, stretching, strengthening and massage therapy.
Contracture can also happen when there is a muscular imbalance. A muscular imbalance occurs when some muscle groups are tight and other muscle groups are weak. The tight muscle groups have to work harder which predisposes them to contracture. The most common muscular imbalances that cause back pain are upper cross syndrome and lower cross syndrome. These are diagnosed by postural assessments and muscular imbalance testing and treated with a specific exercise program that aims to strengthen the weak muscles and stretch the tight muscles.