What You Should Know About Chronic Back Pain

By Stephen Campbell


One of the leading causes of hospital visits in Blue Bell, PA is back pain. The symptom has been shown to significantly contribute to work absenteeism. In terms of epidimiology, it is seen mostly in persons that are in their sixth and seventh decades in life. The incidence is slightly higher in women than men. The causes of this problem are many and include trauma, tumors, infective processes, degenerative conditions and trauma among others. The symptomatic pattern of chronic back pain may vary depending on the underlying cause.

In general the discomfort originates from the spinal components. These include the body skeleton (vertebral bodies), the muscles, ligaments, and the inter-vertebral disc. The incidence appears to increase with age because of degenerative changes that affect these structures. Osteoarthritis is one of the most common condition under the degenerative conditions category. It is the result of wear and tear at the inter-vertebral joints.

The tumors that cause back ache may originate from the spinal column itself or may be distant metastases from other affected organs. The commonest tumor that originates from bone and is likely to affect the spine is multiple myeloma. Overall, causes that are attributable to the presence of tumors are caused by metastases. Examples of tumors that frequently metastasize to the spine include those from the thyroid, the breasts, the kidneys and the prostate.

The pain that is caused by inter-vertebral disc herniation typically has a sudden onset. It may be severe or mild depending on the extent of displacement. In most cases, this symptom is preceded by a heavy lifting event or blunt force trauma to the back. Symptoms tend to be restricted to one side of the body and are usually worse on movement or when one assumes a seated position. The symptoms may be referred to the upper or lower limbs depending on the level at which slippage occurs.

To establish what the cause of the problem is, one has to give a comprehensive medical history and undergo a systemic physical exam. At the same time, several investigations have to be done as guided by the pattern of symptoms and the findings of the physical examination. Radiological images such as the X-ray, the CT scan and radionuclide studies are vital to the diagnostic process and are almost always a requirement.

There are different types of treatments that exist. They are broadly classified into drugs, surgery and physical therapy. Drugs are used to help minimize the discomfort, inflammation or to clear infections. For mild discomfort, simple non-steroidal anti-inflammatory drugs, NSAIDs such as naproxen, acetaminophen and aspirin can be used. More severe symptoms require stronger analgesic agents such as opioids and steroids.

Physical therapies are of different forms. They are mainly targeted and correcting conditions affecting muscles and joints. Examples of those that are used commonly include electrical stimulation, heat and cold treatments, massage and physical exercise. Increased muscle strength is one of the benefits likely to be realized. It is important to note that patients will exhibit varied responses depending on the severity of their illness.

Surgery is usually used as a last resort. There are two main types of surguries that can be performed namely; spinal fusion and decompression. When the cause of symptoms is a prolapsed disc or vertebral components, surgery tends to yield good results.




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