Overview of Back Pain – from Back Pain Doctors in NJ


BackPainIf you suffer from back pain, you are not alone. Almost everyone has back pain at one time or another. For most people, back pain is only temporary (acute), lasting a few days. This type of pain occurs from an injury, as with lifting something that is heavy, or it may occur after a sports injury or motor vehicle accident. For others, however, the pain persists for much longer, which is considered chronic back pain.

Structure of the Back

The back is made of tissues, muscles, and bones that work together to function as the trunk of the body. The centerpiece of the back is the spinal column, which supports the body’s weight and protects the spinal cord. The cord is a nervous system structure that controls body movements and carries various sensory signals to the brain.

The spine consists of 24 vertebrae, which are stacked one on top of the other. The vertebral bones protect the nerves that emerge from the spaces between the vertebrae and branch off to the extremities. Between each vertebra is a spongy disc that works as a shock absorber. The regions of the spine include:

  • 7 cervical (neck) vertebrae (C1-C7)
  • 12 thoracic (mid-back) vertebrae (T1-T12)
  • 5 lumbar (low back) vertebrae (L1-L5)
  • Sacrum and coccyx – Bones at the base of the spine fused together.

Causes of Back Pain

  • Strains and sprains – Pain can occur from a sprained back muscle or a strained ligament in the back. This often occurs when someone lifts something heavy.

 

  • Degenerative disc disease – With this condition, the bones lose strength and the cushioning disc lose chronic failed back painflexibility and fluid. When this occurs, the discs do not provide enough shock absorption and the bones rub together.

 

  • Bulging disc – As the disc lose fluid, the spine can becomes strained or compressed, causing a disc to bulge outward. This puts pressure on nerve roots, sending pain signals to the brain.

 

  • Scar tissue – A buildup of scar tissue from repeated back injuries will eventually weaken the vertebrae, discs, and other structures, resulting in pain and weakness.

 

  • Diabetic neuropathy – People with diabetes often have high levels of circulating glucose, leading to decreased blood flow to the legs. With time, the poor circulation leads to damage of the peripheral nerves (those that go down the legs). This causes radiating pain in the back and down the extremities.

 

Who is at Risk for Back Pain?

  • Gender – Men and women are both at risk for back pain.
  • Age – Back pain mostly affects people between the ages of 30 and 50 years. In addition, as a person ages, the risk of spine degeneration increases.
  • Activity – Athletes are prone to frequent back injuries, as are laborers and those who participate in weight lifting activities.
  • Disorders – Several disorders increase the likelihood of back pain, such as spinal degeneration, spinal stenosis, osteoporosis, scoliosis, fibromyalgia, facet joint syndrome, spine osteoarthritis, and spondylosis.

Treatment for Back Pain from a Bulging Disc

  • Epidural steroid injection (ESI) – Performed on the neck or back to decrease inflammation, the ESI involves injection of a steroid and/or anesthetic into the epidural space near the inflamed back region. If the bulging is either pinching on a nerve root or causing inflammation that is leading to Facet Joint Injection Use thisradiculopathy/sciatica, then an epidural injection may work wonders for pain relief. This is done using x-ray guidance, and side effects include temporary numbness and soreness of the back and/or legs.

 

  • Intradiscal Injection – Steroid injections into the disc have been shown to provide excellent back pain relief for months at a time.

 

  • Facet Injection/Medial Branch Block – depending on whether or not there is facet related pain to go along with the bulging disc, the procedures may offer exceptional benefit. To assist with spine mobility, the doctor injects a steroid and/or anesthetic directly into the facet joint of the spine. Done under x-ray guidance, this procedure can offer relief to patients with facet joint syndrome. FJI can be used as a diagnostic block, so the doctor can locate the exaction area of the pain. In recent clinical studies, around 80-85% of patients had functional improvement and notable relief of pain following a facet joint injection.

 

  • Physical Therapy

 

Resources

 

National Institute of Neurological Disorders (2014). Low back pain fact sheet. Retrieved from: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

 

Veizi E & Hayek S (2014). Interventional therapies for chronic low back pain. Neuromodulation, 17(2), 31-45.