Summary of mechanical and pathological causes of back pain
Almost all cases of back pain fall into two broad groups:
- This group has clear physical signs suggestive of a clinical condition
(degeneration, disease or dislocation) with or without distinctive
radiographic changes or other abnormal findings. A definite diagnosis can
be made following physical examination and investigations thus
facilitating a rational treatment plan. Roughly 10% of all back-pain
sufferers fall in this category. Treatment of the specific condition,
either medical or surgical, is required to obtain relief from pain, either
temporarily or permanently.
In the first group, there are a number of medical conditions that can affect the spinal
column resulting in pain. These must be excluded as a cause of the pain, prior to
commencement of physiotherapy or active exercises to strengthen the back, otherwise it
could result in further pain and even permanent damage to the spinal column.
- The second group has no clear findings on clinical and radiographic
examination or the symptoms and signs do not match with the findings
seen in X-rays or MRI of the spine. Diagnosis in these cases is mostly
guesswork and treatments range from nothing to exotic complementary
therapies or even psychiatry. Most muscular spasms and strains discussed
in the previous chapter fall in this category. Nearly 90% of back pains
are due to muscle spasm and/ or sprain. It is in this large group that
a combination of posture correction, extension exercises and weight
management will get rid of back pin, ONCE AND FOR ALL.