What causes back pain?

Posted June, 2008

That's a fairly complicated question. The answer depends on many variables the question itself didn't clearly establish.

For example:

How and when did the pain start?

Do you have any degenerative diseases of the spine? (You may have such a problem and not yet know it.)

Or were you injured in an automobile accident or fall?

    So now let's take a brief look at the spine and what might cause back pain.

A quick back pain primer

The spine is a complex organic machine made of many parts that must work well together. In simple terms, back pain is often caused by the misplacement of some part (or parts) of the spinal structure. This can be caused by the bones of your spine, or by the shock-absorbing discs (because of injury or disease), or by other soft tissue that holds the spine together. The bones, discs, or soft tissue can become fractured, displaced or ruptured, or torn, respectively.

You could also have a disease that causes a bone or group of bones to produce abnormal protrusions called osteophytes (basically "bumps" on your vertebral bones). You could suffer an impact injury to the spinal column, leaving you with nerve impingement and subsequent pain due to a soft tissue growth. You may have Facet Joint Disease if the pain you experience is localized and appears mainly when you twist your back (or neck). The causes of back pain are many. The result is almost always the same: pain, and lots of it.

The ultimate result of such an injury or other ailment is that the spine's parts are not in their proper locations. Or they have developed other structural problems. Because of these things, there's inappropriate pressure on the nerves that exit from certain locations of the spinal column as they wend their way to the rest of the body.

Most folks know that these critically-important nerves transmit signals your body uses in order to feel sensations (such as hot and cold) and for muscle control, as well as for numerous other purposes. When something's gotten "out of place" along the spinal column it can press on these nerves. In the worst cases it can even sever them.

With pressure there's often intense pain sometimes accompanied by changes in the sense of touch. Frequently the back pain patient experiences malfunctions of other important bodily functions, too, (depending on where the nervous impingement is located).

Sometimes what starts as mild back pain can become agonizing. It can even turn into what patients report as, "unbearable." Pain comes to dominate every aspect of the patient's life. Quality of life suffers. The patient becomes miserable, hopeless, and severe back pain can even trigger bouts of depression, which aggravates the sensation of pain. When we're depressed everything unpleasant, including pain, is more intense. In these cases we've got to fight the depression as well as the pain, because they're tightly linked and, in a way, they're feeding off of each other.

We've seen this sad situation many times: the "typical back fix" makes the patient's pain worse. Most of us have friends who've had two, three, or more operations to "fix" a chronic back pain issue. Some long-suffering souls have had ten or more of such, "fixes." We've treated people who weathered fifteen back operations and who were—upon arrival here—still in severe unrelieved pain.

Click here to read why surgery often fails back pain patients.