Back pain is a very common problem with studies suggesting that the majority of us will experience it at some stage in our lives. According to Backcare.org, around 5.6 million working days are lost to back pain each year.
Back pain can affect all ages and be present for a short (acute) or long period (chronic) of time. The spine is a complex area of anatomy consisting of muscles, ligaments joints and importantly, discs. Luckily, although painful and often debilitating, back pain is not usually serious and will often resolve on its own accord with a few weeks. Below is an outline of the most common causes of back pain. Due to the interrelationship between the areas and structures of the back, there can be some overlap of causes.
The disc is the structure located between two spinal bones. In the low back they are relatively big and in the neck they are relatively small. The disc consists two main components; the soft core and the fibrous outside. Discs act as shock absorbers and therefore are vulnerable to damage through repeated or over compression. This can occur through poor lifting, poor posture and in sports for example. Damage to the disc is commonly termed ’a slipped disc’, although this does not accurately describe what occurs. The disc normally bulges outwards and occasionally splits and its core pushes out. This can be acutely painful and can cause nerve compression. In the neck this could cause pain travelling into the arms and in the low back pain travelling into the legs (see Sciatica). The most common place for problems with the disc in in the base of the low back.
Osteoarthritis or ‘wear and tear’ is very often a normal ageing process. We use our bodies and the longer we live, the more they wear out. There are certain genetic factors that may influence the rate and progression of degeneration, as do a history of injury, poor posture, obesity etc. Discs lose their height and therefore the facet joints sit closer together which increases their susceptibility to degenerative change. The pain resulting from wear and tear in the spine can range from little to extreme.
Facet Joint Problems
The facet joints are the small joints in the spine that link the vertebrae together. There is a right and a left facet joint throughout the whole length of the spine. They work along side the discs to regulate spinal movement and allow flexibility. They can normally become irritable due to degeneration with increased age (arthritis), however they may also sustain injury due to accidents such as whiplash. Patients often present with very stiff necks after sleeping awkwardly and this can be due to the capsule surrounding the facet joint becoming inflamed and irritated. Patients often say their neck feels “locked”.
Nerve compressions and Sciatica
The spine well protects the spinal cord. Between each level of spinal bones, the spinal cord sends a nerve out, right and left, to various parts of the body. In the neck, the nerves generally travel into the arms and in the low back, the nerves generally travel into the legs and pelvis. Nerves can become physically compressed due to spinal injury. They be also become irritated due to the inflammation from an injury close to where they travel. This can cause pain, tingling, numbness or muscle weakness into the area where the nerve runs. In the legs, this is known as sciatica. The scenario may occur whereby a patient has minimal back pain but severe leg pain. This could arise from an injury in the spine and osteopaths are experts at working this out.
How can Osteopathy help with Back Pain?
Osteopaths are expertly trained to help treat back pain. We use a number of different techniques to help us depending on the patient and the diagnosis. These may range from gentle stretching, joint mobilisation, soft tissue massage and manipulation. We also aim to provide advice on individual exercises as well as the use of ice, heat and posture. Sometimes it is necessary to request x-rays, blood tests or MRI scans. The clinic has good relationships with orthopaedic consultants within the Bath area.