Classification of Back Pain
Classification of back pain may be based on where the symptoms originate, the length of time that symptoms persist, the type of pain (somatic or neuropathic), and the specific symptoms.
Back pain can be classified based on where the symptoms present and from what location the source of the problem is coming from. Back pain can thus be categorized by region: tailbone pain, lower back pain, middle back pain, upper back pain, neck pain. Tailbone pain usually involves a person slipping and landing directly on their tailbone. The sacrum and coccyx (tailbone) are two separate structures that are fused together in adults and form the bottom of the spine. the sacrum/coccyx are continuous with the last lumbar vertebra and the L5-S1 intervertebral disc. The sacrum/coccyx is located in the pelvic cavity and held in place on each side of the ilia of the pelvis by two sacroiliac joints. Falls which cause a person to land hard on their bottom may cause a condition known as coccydynea, otherwise known as tailbone pain. Lower back pain is the most common form of back pain. Lower back pain is the most common form of back pain because of the added gravitational pressures they must absorb due to the unique physiology of the human spine and body. Symptoms of lower back pain include sharp pain, and tingling and weakness in the legs when the nerve roots in the lumbar spine are affected. Pain, numbness, and tingling associated with the lumbar spine is commonly known as sciatica. Middle back pain, upper back pain, and neck pain is classified according to the level of the spine where the pain is experienced, and due to possible referred pain in other body structures.
Back pain may also be classified by the length of time symptoms persist. Back pain that is labeled by time criteria is also described as levels of back pain. Some textbooks, science journals differentiate between acute back pain. For example, the book Healing Joint and Back injuries classifies between acute back pain as the persistence of symptoms from a few days to a few months, and chronic back pain as the persistence of symptoms lasting from three two 6 months or more. Some websites and journals, Like Medscape.com, makes the additional classification of subacute back pain. Medscape classifies back pain due related to time as:
- Acute - lasting less than 6 weeks
- Subacute back pain lasting between 6-12 weeks
- Chronic back pain that persists for longer than 12 weeks
Using length of time as a classification doesn't tell us that much in the way diagnosis or treatment options, but it is informative in a number of ways. If the person has acute back pain that resolves on its own in a couple of days, with the possible aids of conservative treatments such as anti-inflammatories and massage, that person and their doctor will know that the cause of the pain was most likely due to sprain or strain of the muscles or soft tissues. sprain and strain injuries typically heal on their own and do not require any aggressive medical intervention. By the time a person's back pain continues for longer than 6 weeks, the problem may be more of a concern, and degenerative changes to the spine may be considered. The prognosis becomes worse the longer the person suffers from symptoms. While acute back pain is usually caused by injury to the body structures other than the nerves outside the spinal cord, chronic back pain may be somatic or neuropathic. Somatic pain is pain that originates in the body tissues which causes the nerve endings in the injured area to relay a pain signal to the brain as a response. Neuropathic pain is pain that originates in the nerves themselves, which fire pain signals to the brain in the absence of an injury. The nerves may misfire pain signals in the absence of an apparent injury due to a systemic disease such as multiple sclerosis, or when nerves that originally responded to an injury in the body keep firing after the original injury has resolved itself.