There are two types of back pain: mechanical pain and neurological pain.
Mechanical pain
Mechanical pain is caused by the collapsing of the intervertebral discs and occurs, in particular, after an activity. Back pain can spread into the buttocks, hips and thighs, but does not lead to numbness or weakness in the leg as there are no “trapped” spinal nerves.
Lumbago
What is lumbago?
Incorrectly known as a “cricked back”, this type of pain is muscular and caused by an abnormal muscle contraction.
Lumbago (lumbar region) occurs suddenly following (sometimes minimal) effort, with bad posture, twisting, tripping while carrying a heavy object or repetitive movements.
Diagnosis
An X-ray of the lumbar spine is taken to confirm the presence of lumbago.
The people most susceptible to this type of back pain are those who have poor physical fitness, or those who perform physical jobs that often involve carrying heavy loads.
Treatment
The pain is intense but eases quickly after a few days, before disappearing completely after one to two weeks.
Disc compression
What is disc compression?
Disc compression can occur following an impact or repeated strain on the intervertebral disc.
The disc is compressed as the gelatinous substance that serves as a cushion no longer fulfils its role as a shock absorber, which leads to contraction of the vertebrae and thus back pain. The discs most commonly affected by compression are those located between vertebrae L5 and S1. However, compression can also occur in the cervical, dorsal or lumbar regions and can involve several discs.
Diagnosis
Once an X-ray has been taken, a deformed vertebra, which sags and has a curve to the top edge, is identified.
Treatments
The standard treatments prescribed to patients with disc compression are painkillers, corticosteroid infiltration in the spine, physiotherapy and surgery.
Physiotherapy can provide long-term improvement as the exercises carried out during a session enable certain imbalances or muscle weaknesses, which are partly responsible for the disc compression, to be corrected.
If an intervertebral disc is too damaged, a surgeon can remove it and replace it with a prosthesis. However, if the collapsing of the vertebra has caused nerve compression, this is referred to as neurological pain (for more information, refer to the neurological pain section).
Osteoarthritis
What is osteoarthritis?
Osteoarthritis affects the cartilage in the joints. In the case of the spinal column, the cartilage is the intervertebral discs. Vertebral osteoarthritis includes cervical osteoarthritis and lumbar osteoarthritis. The symptoms depend on the location of the vertebrae.
Causes and symptoms
Depending on its location, osteoarthritis does not cause any symptoms. In fact, almost 80% of patients over 50 years of age present with signs of cervical or lumbar osteoarthritis in an X-ray without feeling any pain associated with this. Osteoarthritis can also be caused by excess weight or the repeated use of a joint during sport.
There are rare but disabling complications associated with osteoarthritis. Naturally, the vertebrae have an opening through which the spinal cord passes. However, this channel can sometimes be narrowed by osteoarthritis. This compresses the spinal cord, which is no longer able to transmit nerve messages correctly. The symptoms are pain in the legs, difficulty walking or paralysis in more extreme cases.
Treatment
In these rare cases, this is referred to as neurological pain requiring a surgical procedure.
Neurological pain
However, neurological pain is due to a compressed or “trapped” spinal nerve, which causes weakness or numbness in the limbs (leg or foot) and, in the longer term, muscle weakness and slower reflexes. Spinal surgery addresses this neurological pain. These problems lead to compression of the cervical nerves or compression of the spinal cord.
Herniated disc
What is a herniated disc?
A herniated lumbar or cervical disc occurs if an intervertebral disc moves in the spinal column.
Causes and symptoms
In general, a movement of this kind is caused by degeneration of the disc associated with age, following trauma or repeated strain. The pain runs down the leg to the foot as the nerve is pinched by the herniated disc at the level of the vertebrae.
Disc degeneration is caused by the normal wear of the disc or following an injury. In the absence of the disc, the spinal column is no longer able to absorb impacts between the vertebrae, leading to mechanical back pain (see the respective section). A weakened disc is the source of herniated discs caused by compression of a nerve near the spine. This compression causes pain in all areas through which the respective nerve passes.
If the deformity of the disc (due to a herniated disc) affects the sciatic nerve, this is referred to as sciatica, which causes a sharp pain in the legs.
Treatment
In the event of a herniated disc, a surgical procedure may be required.
Spinal stenosis
What is spinal stenosis?
Spinal stenosis corresponds to a narrowing of the cervical spinal canal.
Causes and symptoms
The spinal canal passes through the middle of each vertebra and protects the spinal cord. This canal is generally large, but a birth defect or joint osteoarthritis can cause a narrowing and compress the content of the canal, i.e. the spinal cord and the nerve roots.
This problem is characterised by pain with weakness in the legs when walking.
Treatment
In some cases, a surgical procedure may be required.