Incapacitating back pain is either acute or chronic in duration. Back pain may be localized over neck, mid back, lower back, and sacrum. A severe dreadful back pain along the vertebral column is also known as dorsalgia (back pain). Incapacitating chronic pain of neck, mid back, or lower back can originate from skin, subcutaneous tissue, tendons, muscles, cartilage, bones, and nerves.
Layers from skin to spinal cord are skin, subcutaneous tissue, supra-spinous ligament, inter-spinous ligament and posterior longitudinal ligament. Anterior to the spinal cord is anterior longitudinal ligament. There are several muscles attached to vertebrae. Muscles originate from vertebral body anteriorly, transverse process laterally, and spinous process posteriorly.
Disabling and dreadful chronic back pain also results following back surgery. Post surgical pain in the neck, mid back, or lower back is also known as failed back syndrome.(1)
Incapacitating Back Pain Due to Failed Back Syndrome
Failed back syndrome is caused by one of the following reason such as scar tissue pinching the nerves, weakness in facet joint, and traumatic injury of nerve. Healing of soft tissue after surgery can cause severe scarring of tendon, muscles or fatty adipose tissue. Scarring of adipose tissue, tendon, and muscles can cause pressure or pinching of surrounding nerve.
Low back pain is more common than mid back pain or neck pain. Dreadful severe pain in any segment of vertebral column often causes short term or long-term disability.
Disability and Back Pain
After neck, mid back, or lower back injury there is often a question raised by individual suffering with chronic dreadful pain not responding to any treatment “Am I Disabled?” Answer is not simple. Disability is evaluated following optimization of treatment.(2) Treatment choice is medications, physical therapy, injection treatment, and surgery. Patient is considered disabled if treatments are not giving adequate pain relief or patient has permanent impairment.
Painless accomplishment of daily activities depends on correct alignment of vertebrae, muscles and ligaments during the mechanics of ambulation. Disparity in mechanics of weight bearing as well as joint movements such as flexion, extension, and rotation of vertebral column may result in chronic pain. Incapacitating back pain is the fifth most common reason to visit physician’s office. Even though back pain can affect people of any age, nonspecific benign backache causing incapacitating disability is significantly more common among working class adults aged between 35 and 55 years.