by Melissa Yuan-Innes, M.D. and author of The Emergency Doctor’s Guide to a Pain-Free Back: Fast Tips and Exercises for Healing and Relief.
What is back pain a symptom of?
- Muscle strain: : the most common culprit. You strained or even tore the muscles in your back. Happens to athletes, couch potatoes, weekend warriors…we all hurt muscles at one point or another.
- Soft tissue injury, like ligaments (which hold two bones together) and tendons (which connect muscle to bone) can get inflamed, pulled, or sheared off.
Together, muscle and soft tissue injuries probably account for 70 percent of pain.
- Bone (vertebrae) problem. About 4 percent of back pain comes from osteoporotic fractures.
Ah, the intervertebral discs. The cushiony discs between the bones that can squish like a jelly doughnut. Everyone always asks, “Is it my disc?” But actually, only 4 percent of back pain patients have a disc herniation.
5. Facet Joints: If you think of the vertebrae like Lego bricks locking into each other, the facet joints are the hook-ups in the back.
When the discs start to wear down, these joints wear down, too, and get osteoarthritis. It’s estimated that degeneration of facet and discs together account for about 10 percent of back pain patients.
Neural means nerve, and stenosis means the bone is narrowing down, but which nerve and which bone are you talking about?
6a. ￼Foraminal stenosis: narrowing of the little tunnels where your nerve roots exit your spinal cord.
6b. Spinal stenosis: narrowing of the canal for the actual spinal cord. About 3 percent of people have spinal stenosis.
In other words, your spinal cord or spinal nerve roots are being squeezed by bone. Sounds scary, but usually it just means that the bone hole is a bit smaller, yet not pressing on the spinal cord or roots, which is really the end point we’re interested in. This is something that happens over time, gradually. Arthritis, basically.
So there you have it. Six causes of back pain.
Remember, I’m a doctor, but I’m not your doctor, so you’ll have to consult your own health care practitioner.
For more details, preorder The Emergency Doctor’s Guide to a Pain-Free Back: Fast Tips and Exercises for Healing and Relief at 40% off, as well as Jack Stern’s book, Ending Back Pain.
 Harris RI, Macnab I. Structural changes in the lumbar intervertebral discs; their relationship to low back pain and sciatica. J Bone Joint Surg Br. 1954 May. 36-B(2):304-22.
OTTAWA: Chapters Rideau April 21 @ 7 p.m. with Crime Writers of Canada
CORNWALL: Cornwall and Area Pop Event, April 23-24
BRANTFORD: Mystery Guest of Honour, Brantford Library, May 11
For my newsletter subscribers, I created a thank you page with the opening of HUMAN REMAINS, the fifth Hope Sze novel, which was supposed to be hidden, but was accidentally broadcast to my blog followers and perhaps to the world at large. So now the page is password-protected.