Basics of Back Pain

Classification based on duration:

  • Acute back pain: This usually lasts from one to seven days. Pain may be mild or severe and occasionally may be caused by an accident or injury. 
  • Subacute back pain: This usually lasts from seven days to seven weeks and usually is mild; occasionally it's severe. 
  • Chronic back pain: This usually lasts more than three months and may be mild or severe. It may be related to other illnesses you may have or may have no identifiable cause.  

Immediate Medical Attention: 
If your back pain is accompanied by any of the following, see a doctor today:
  • Weakness or numbness in one or both legs
  • Pain going down one leg below the knee
  • Back pain from a fall or injury
  • Back pain accompanied by fever without flu-like aches
  • Pain that continues to interrupt sleep after three nights

Anatomy of the back:
  • The Spine: The backbone is not one bone. It consists of 24 sperate bones called vertebrae. These vertebrae are stacked on top of each other to form the backbone or vertebral column. We refer to this backbone as vertebral column, spinal column or spine.
  • Facet Joints: The points where two vertebrae or bones fit together are called joints. They make it possible for the spine to move and turn in many different directions. Healthy facet joints have cartilage, which allows your vertebrae to move smoothly against each other without grinding. Each joint is lubricated with synovial fluid for additional protection against wear and tear. When your facet joints become swollen and painful due to osteoarthritis, it is called facet joint syndrome.
  • Discs: The discs located between two vertebrae. These discs are made of cartilage, which is a soft, elastic material. Discs act as cushions, or shock absorbers, much like the shock absorbers in your car. Their main job is to protect the joints from wearing out. 
  • Muscles: The back is held upright by muscles attached to the backbone. Your backbone, with all its parts, cannot hold itself upright. It needs strong muscles, tendons, and ligaments for support. Muscles help you move or hold your position. Tendons fasten muscles to bones. And ligaments stretch from one bone to another to hold bones together.  
  • Spinal Cord: The spinal cord is very important because it transmits electrical signals between the brain and the nerves in your legs, arms, back, and other parts of your body. The spinal cord runs through a hole in each vertebra of the upper and middle parts of your backbone, much like a piece of string through a beaded necklace. The space it runs through is called the spinal canal.  

Causes of back pain
Anything that puts pressure on your back muscles, bones or nerves can cause pain. Any illness or damage to your spine also can cause pain. Emotional stress may add to the pain, especially since it slows the rate of recovery. Other possible causes of back pain are listed below.

If you have been suffering from low back pain for a while, you may have explored several treatment options by now! Most of the patients that I see in my practice have had pain pills, shots or physical/massage therapy or some other therapy but their pain still persists.

It is not because those therapists were not good or they have some health condition which cannot get better. For most of them, the treatment of the focus was on reducing the symptoms and not eliminating the root cause of the problem.

Pain pills and shots may eliminate the pain for some time but they will not improve the range of the motion or increase the core strength. If you have stiff joints and poor core strength, your pain may come back. 

Physical therapy or massage therapy may help improve range of motion, reduce the muscle tension but the benefits are limited to the physical body. They do not address the mental and emotional stress and anxiety. I believe that the physical body holds a lot of mental stress. So if that is not addressed, the treatment often remains incomplete.