Lower, middle, and upper back pain appear because of mechanical factors like disc rupture and muscle or ligament tear, due to age-related decline of the spinal structures, bad posture, osteoporosis and similar conditions that affect the bones, and even pain related to kidney, liver and heart.
Doctors usually ask the following three questions when treating patient with back pain:
- Where is the exact location of your pain?
- How long have you had it?
- How bad does it hurt?
They ask these questions to diagnose your pain better, as there are different types of back pain.
Duration of the Pain
- Acute pain can last one, two, or three months, and disappear on its own, and then return once again. Although it’s a temporary pain, it can make you miss work.
- Chronic back pain is one that lasts more than 3 months even after you have been treated for acute pain, or for an injury.
Back Pain Location
The vertebral column can be separated into 3 parts: lumbar or lower (with the bones l1 to l5), thoracic or middle (with the bones th1 to th12), and cervical or upper (with the bones c1 to c7). The spinal bones are separated from each other by cartilage-made rubbery disks, but besides them, there are number of associated nerves, tendons, ligaments, and muscles.
Any injury, deformity, or degeneration of any of these can be the reason for your back pain. There are cases when people don’t feel any pain in their back, but they actually have more serious condition.
Upper Back Pain
Cervical pain or upper back pain is pain between the shoulder blades. If your doctor eliminates the chance of spine deformities like kyphosis that leads to a hunchback, or scoliosis that curves the spine sideways, considering your structure, daily activities, and history of injury, s/he will probably focus on muscle strain or muscle irritation.
Middle aged patients are usually asked to do a diagnostic test for spinal stenosis and spinal osteoarthritis, and rarely, to check for herniated disc and cervical radiculopathy.Muscle Irritation
– Muscle irritation might be the cause for your tenderness and tightness in the upper back that you fell for several weeks, and which keeps worsening in stationary positions like sitting and driving. It occurs when the tendons connecting your spine and back muscles get inflamed as a result of bad posture, overuse, poor bone or muscle strength, or improver bending, lifting, or twisting.
– Muscle Strain and Sprain. What if your reason for visiting the doctor is a sudden sharp stabbing pain, and you can trace its onset to a sudden violent movement?
If you feel sudden sharp stabbing pain in your upper back when you make some sudden violent movement, you probably have muscle strain. In such case, the muscles are pressed by the sudden movement, and its fibers get snapped. Usually, this won’t take you to the emergency room, although painful, unless the entire muscle has ruptured. Muscle sprain is tearing of the ligament that connects two bones.
– Spinal Osteoarthritis usually occurs with aging, but in cases of traumatic injury, it can occur in younger people as well. This condition also called as degenerative joint disease, is more serious than the previous ones. It’s an arthritis of the facet joints that makes you prone to spinal stenosis and herniated disks.
As we age, the discs between vertebrae which help us bend, flex, and twist our back wear off, and become unable to cushion friction between the bones in our spine during movements. Consequently, the facet joints which connect the vertebrae wear off, causing inflammation and chronic back pain. Our body tries to compensate for the joint wearing off by forming bone projections on the spine known as osteophytes. This causes additional friction and pain.
It’s good if the patient feels the symptoms at the beginning of the condition, as many don’t feel anything until their spinal osteoarthritis reaches the ultimate stage.
– Spinal Stenosis. The osteophytes can narrow the spinal canal in the cervical and lumbar region, which further presses the nerves, resulting in pain. If the narrowing is in the cervical region, there are more chances of pressing the spinal cord, causing myelopathy, or severe spinal cord dysfunction. The symptoms include shooting pain in the legs and arms, and difficulty walking. Notice if you have started having problems with your shirt buttons, or your handwriting got worse.
If the narrowing pinches the root of the nerves, it will cause cervical radiculopathy. This can appear even from herniated disc. You will feel pain along the pinched nerve, as well as upper back pain and numbness or tingling in the fingers.
– Herniated Discs. If the disc core spills onto a nearby nerve, it pinches the nerve and causes pain, and sometimes numbness in the arms and shoulders. In this way you get slipped, ruptured, or herniated disc. Your upper back will hurt if the rupture is in the middle region, especially when sneezing or coughing. Slipped discs are usually caused by years of bad posture. However, there are instances when they appear as a result of a sudden improper twisting or lifting. This condition doesn’t always hurt, so we recommend regular check-up.
Middle Back Pain
Doctors usually eliminate the possibility of degenerative diseases when the patient feels pain in the middle region, as this part of the vertebrae doesn’t move a lot, so degeneration related to friction is uncommon. One of the vertebrae functions is to protect the organs in this region like the lungs, heart, and liver.
– Strain and Sprain. If your pain is worsened by movement, and there’s tenderness, bruising, and swelling, you probably have muscle strain and sprain. This is in fact torn ligament, so you shouldn’t worry about disc problems like herniated discs, unless you feel tingling, numbness, or radiating pain.
– Herniated Discs. Although rare, herniated disc in this region can occur because of osteoporosis or an injury. It can affect the functions of the nerves and cause chronic pain. Usually, the patient doesn’t feel any symptoms.
Low Back Pain
Around 20 percent of people with acute pain in their lower back graduate to the chronic type. Low back pain is more common that the pain in the other two regions of the back. It’s the leading cause of disability in the world according to the 2010 Global Burden of Disease by WHO. Each year, Americans spend around $50 billion on back pain.
In most cases, this pain is not attributed to inflammatory arthritis, fracture, infection, or cancer. If your diagnosis is non-specific back pain, your pain is probably caused by mechanical factors. Therefore, your doctor will ask you a series of questions regarding your history of injuries, your lifestyle, and your daily activities or inactivity.
Although the mechanical factors are almost the same as in the middle and upper part of the back, the risk of lower back damage is higher. The reason for this is because the angles of the twisting or bending movements in this part bear more pressure, and are much greater.
– Spondylolisthesis and Spondylolysis. Spondylolisthesis might be the cause of your lower back pain, if you participate in activities where you overstretch your spine, like football, weightlifting, or gymnastics.
Those with former stress fracture in the 5th lumbar bone have more chances of spondylolysis, which can eventually lead to spondylolisthesis. Spondylolisthesis occurs when a spinal bone slides forward, over the bone below it. Although spondylolysis might not cause any symptoms, once it aggravates to spondylolisthesis, the person will feel radiating pain in the lower back, buttocks, and one or both legs, making some activities like bending or walking difficult.
– Ankylosing Spondylitis. Ankylosing spondylitis is still in the early stages if your doctor links your stiff spine and low back pain to this condition. In the later stages, the restriction on movement and the pain continues to the neck. It’s actually inflammatory arthritis of the spine, causing fuse of vertebrae with each other. Men are more prone to this condition, which can occur even at the age of 17. It can cause narrowing of the spinal column once it reaches the cervical region, thus affecting the spinal cord.
Underlying Medical Conditions
Back pain can also be caused by some underlying medical conditions. Osteoporosis can progress to spinal compression fractures, causing sharp pain in the middle and lower part of the back, especially in women Web MD. The pain can be felt across the whole spine.
Referred Pain
A referred pain is one that doesn’t originate in the back area where you feel it. If your upper back pain increases when you twist your back, it’s probably caused by a mechanical factor. But, if it doesn’t, and it increases when you cough or breathe deeply, it might be caused by a lung infection or even something more serious.
Severe back pain that appears suddenly, along with arm pain, chest discomfort, cold sweat, or nausea, can be a sign of a heart attack, especially in women (2). Your upper or middle back pain, as well as pain in the right shoulder and right side of the body, can indicate problems with your gallbladder or liver. Another possible reason for your low back pain are kidney stones.
Infections and Other Factors
Osteomyelitis is a rare infection of the vertebrae, while discitis is an infection of the discs. They can both cause back pain. Another uncommon reason for your back pain is tumor which have spread from a cancer in some other area in your body.
Genetic tendency, age, and even race can all be factors for back pain. Spondylolisthesis is more common in black women than in white, by 2 or 3 times. Nevertheless, regardless of the intensity, duration, and location of your back pain, the doctor will probably ask you to do the following things:
- Eliminate your high-fat, high-calorie diet to prevent obesity. Obese people have more chances of back pain since their stomach puts more pressure on the lower part of the back (3).
- Consume foods rich in omega-3 fatty acid like Atlantic mackerel, salmon, trout, sardines coffee, red grapes, and cherries to lower your back pain. Add loads of turmeric in your diet to stop the joint inflammation caused by arthritis (4).
- Smoking slows the healing from back injuries and contributes to spinal disc degeneration as it decreases the blood flow to the lower part of the spine. Therefore, quit this unhealthy habit.
- Keep the health and flexibility of spine and back muscles by doing yoga poses or some stretching exercises for the back, on a regular basis.
- Avoid running on hard surfaces and lifting heavy objects.
- Address your anxiety and stress issues.
Intensity
The intensity of the back pain is not necessarily a reliable metric. The reason is because people have different pain thresholds, and disc herniation or other serious spine conditions can sometimes be painless. Your doctor will ask you about the frequency, nature, and intensity of the pain, before prescribing you any medication.
When to Visit a Doctor?
Regular check-ups are highly recommended when it comes to back pain, even if it’s the smallest one or you don’t feel any pain in this part of your body. Degenerative conditions can only aggravate in time, so don’t stay on the thought that time will heal your pain.
In cases your back pain is accompanied with numbness, fever, weight loss, loss of bowel control and reflex, it’s imperative that you consult a doctor.
Via Cure Joy