What Causes Back Pain?

What causes back pain? That is a question that many patients consider about their own condition, and it is also a question considered by many doctors to this day. If the nature of the cause of the disease and the cure for it was so easy to understand and implement, why are there so many branches of orthopedic medicine, and why is chiropractic medicine and other "alternative" therapies for back pain becoming increasingly favored. Today, you are reading about new therapies and breakthroughs for back pain all the time, from doctors, chiropractors, and various "inventors" selling their latest cutting edge products on late night infomercials.

What I can tell you from experience is that doctors are putting their best foot forward towards providing all of their patients with excellent patient care, diagnostics, and treatments. Back pain, though, appears to be a complex condition that is sometimes resistant to the best high resolutions medical images and treatments. Let's take the examples MRIs and physical therapy. If you were to 1000 people, aged 35-70, off the streets, and offer them free X-Ray and MRI imaging of their lower backs, you would most likely find that 30% of those people would present with evidence of degenerative disc disease or herniated discs on their medical images. Of those 30% of people with degeneration presenting on their medical images, 30% of those people would likely report having lower back pain, while 70% of those people would likely report feeling fine. If degenerative disc disease is the leading cause of back pain, then why do so many people with it report no symptoms?

The example provided above was not given as a suggestion that doctors are on the wrong path in diagnosing and treating back pain, but rather that this is a complicated back condition that we are all still learning about.

Things that can tell us what causes back pain

One interesting thing about back pain and chronic back conditions is that acute back pain is very common but continuous chronic back pain is relatively rare. Most people experience back pain as the degenerative changes are taking place, in areas such as the ligaments, intervertebral discs, and facet joints. Once the degenerative changes stabilize, the person is usually able to stabilize and experience relief. This fact highlights the importance of having patience while managing an acute outbreak of back pain.

More that 90 percent of cases of back pain are caused by:
  1. Changes to the ligaments of the spine. Ligaments may lose their strength with age, or stretching caused by injury or poor postures.
  2. Normal degenerative changes of the intervertebral discs.
  3. Changes to the facet joints due to normal wear and tear. Changes to the height of discs, slackening of the ligaments, and reduced lubrication of the discs may cause osteoarthritis of the facet joints.
  4. Osteophytes, or bony growths, that grow on the surfaces of the vertebral bodies facing each other or in the facet joints as they become worn down by a disease process.
  5. Weak or strained back muscles or muscles that go into spasm could cause back pain. Muscle strains could be the primary cause of pain that the nerves respond to. Pain could also be felt in the muscles as a secondary cause when compressed nerve branches send signals to the back muscles telling them to stiffen.