Less Common Causes of Back Pain

On our web resource, we have provided a wealth of information on the most common causes of back pain, including conditions such as soft tissue injuries, disc herniations, bone fractures, sciatica, scoliosis, and spinal stenosis. In the vast majority of cases, back pain is caused by sprains of the back ligaments, and strains of the back muscles. In other cases, back conditions such as sciatica and herniations of the intervertebral discs cause the spaces that allow for the passages of the spinal nerves to become restricted, resulting in nerve pain as well as associated impairments such as numbness and muscular deconditioning. Also in a large percentage of cases, the root cause of the back pain is never discovered, and the pain goes away on its own. The less common causes of back pain typically involve conditions in which rare diseases cause the symptom of pain as well as other medical problems that affect the body. There rare medical conditions which infect the back include infections, cancer, neurologic disease, neuromuscular disease, and systemic diseases that cause systemic inflammation of the joints throughout the body. In some cases, a person's emotional health play a large role in affecting how much pain the patient experiences as a result of their condition. In other cases, patients experience pain as a secondary complication to treatment that he or she received to treat their back problem or another medical condition. In some cases, patients experience back pain due to a temporary medical condition, such as pregnancy related back pain. Let's take a look at some of the less common causes of back pain, how they are diagnosed, and how their symptoms are treated.

Non-Discogenic pain: When patients present at their medical appointments for chronic back pain or severe acute pain, doctors will likely order X-Rays of the spine in order to confirm or rule out certain spinal disorders. X-Rays are very good at showing the curvatures of the spine, and whether or not they are in the normal rage. Spine X-Rays are also very good at showing the healthy and shape of the vertebral bones, and of the spaces between the vertebral bodies. An adequate amount of spacing between the vertebral bodies indicates that the vertebral bodies are healthy, and a narrowed space indicates some type of degenerative disc disease. If degenerative disc disease is indicated on X-Rays, doctors may then order MRI (Magnetic Resonance Imaging) tests to see what effects that the disc degeneration has on the spinal nerves. Patients may experience back pain directly due to the degeneration of the discs themselves, or if the movement of the disc material as a result of the degenerative processes results in the constriction of the nerve roots that exit the spine.



In other cases, a patient may report significant back pain in spite of MRI and CT Scan medical imaging coming back negative for disc disease conditions. Until recently, doctors were vexed by these types of patients and had a difficult time treating them in the absence of a clear diagnosis. Today, doctors recognize and test for non-discogenic causes of back pain. One of these conditions that may be diagnosed as a less common cause of back pain is Posterior Rami Syndrome . Posterior Rami Syndrome is when the dorsal ramus of a spinal nerve becomes spontaneously activated, without evidence of an injury. This activation of the Dorsal Ramus causes pain near the site of activation, and possibly referred pain along the length of that nerve. This syndrome may present in the thoracic or lumbar spine, as well as the gluteals and upper leg. The effects of this condition include nerve pain, and a skin condition known as cellulagia. With cellulalgia, the skin may thicken, develop nodules, and become puffy near the skin surfaces where the spinal nerve terminates. This condition is known as LDRS Lumbar Dorsal Ramus Syndrome) when it affects a nerve in the lumbar spine.

Cancer: Cancer is a rare but serious medical condition in which back pain may be an early symptom of disease. The cancer of the spine may lodge within the vertebral bones themselves, within the layers of the spinal canal that house the spinal cord, or within the nerves of the spinal cord themselves. Spinal cancers and tumors may originate in the spine, or spread to the spine from another part of the body. Spinal tumors may be benign or metastatic. The three types of spinal tumors are vertebral column tumors, Intradural-extramedullary tumors, and intramedullary tumors.

Cauda Equina Syndrome: Though bony portion of the spine extends from the base of the skull to the sacrum/coccyx (tailbone)within the pelvic cavity, the spinal cord itself ends at the T12-L2 level of the spine (top of the lower back). Though the spinal cord ends there, the spinal nerves continue downwards and through the sides of the lumbar spine and sides of the foramen. Just below the bottom of the spinal cord is a bundle of nerves known as the cauda equine. Due to several different medical factors, there nerves may be affected due to significant pressure and swelling that occurs around this nerve bundle. Symptoms of cauda Equina syndrome include severe weakness in the lower extremities, and a loss of sensation between the top of the buttocks to the thighs (the parts of the body that would come in contact with the saddle while riding a horse).