Why Is My Back Hurting All Of A Sudden?
Most cases (approximately 90%) of back pain, no matter in which segment it occurs, can be classified of mechanic type and its prognosis is good.1
Usually the origin of the pain is not clear. But this uncertainty is not an obstacle to act since the handling is similar regardless the cause of the mechanical pain.
Structures That Can Cause Pain:
The annular fibers of the intervertebral disc, the anterior or intersomatic joints, the posterior or interapofisary articulations, the soft parts (muscles, ligaments, tendons and bursae), the spinal roots as they pass through the hole and the spinal cord if compressed in the medullary canal: all these structures can be the cause of back pain.
Origin of Pain:
Bone and ligamentous degenerative processes on one hand and overload and/or muscular contracture due to abuse or misuse of the musculature are the most frequent causes that cause the back pain that doctors define as mechanical. They can coincide or act separately.
In clinical practice it is, in most cases, very difficult to determine the origin of back pain.
The compression of the spinal roots and the spinal cord are the origin of the back pain extended outside the spine and with neurological manifestations. The most common cause of compression of the roots and marrow are disc hernias and stenosis (constriction or narrowing of a body orifice or duct) of the medullary canal. Less frequently, infections and tumors compress roots and marrow.
The Soft Parts:
The muscles, ligaments, tendons and bursae surround and form a unit with the bony part of the column. And they are also the source of pain. The tendons suffer degenerative processes that can cause pain; abuse or use in inappropriate muscle positions causes muscle fatigue and pain. Psychological stress is also recognized as a cause of muscle pain.
The fact of not being seen in radiographs and the scant predicament they enjoy, between patients and physicians, as a cause of “not valid disease” of pain, it causes their diagnosis to be underestimated. Although there are no epidemiological studies in this regard, among other reasons because of the difficulty involved in this task, many professionals believe that a large majority of back pains originate in soft tissues.
Depending on the type of pain, whether it extends beyond the back and whether or not it is accompanied by a neurological condition, we arrive at an eminently clinical and very practical classification: it clusters the patients into groups that require common management, without knowing the precise origin of the pain.
Type of Pain:
-Mechanical: Non-continuous pain, which occurs with the mobilization of sore structure; it improves frankly with rest. It can hinder the onset of sleep if the patient lies down with the pain but once he falls asleep there is nothing able to wake him up.
It is caused by bone or ligamentous degenerative processes, or by overload or contractures of the soft tissues.
-Inflammatory: Continuous pain, which is exacerbated by movements; it does not improve or do so sparingly with rest. The pain wakes up the patient preventing him from sleeping. It is caused by the presence of an inflammatory joint process (synovitis) or by infections or neoplasms.
-Radicular: Continuous pain that can increase with certain movements, of lacerating character and that is accompanied by paresthesias (sensation such as tingling, tickling, pricking, numbness or burning of a person’s skin with no apparent physical cause); it extends by the metamera of a root or territory of a peripheral nerve.
The so-called mechanical pain can originate either in bony or muscular structures. In most of the cases the component of soft parts is the one that predominates.
The search and correction of the triggers and aggravating factors of the back pain is imperative to prevent recurrences. Physical exercise is one of the pillars in the management of mechanic back pain.
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