Understanding Your Spinal Pain
Back pain can range from a slight twinge to a relentless, debilitating condition. About 1 in 5 of us experience it in any given year while 50-80% of us can expect to have at least one bout of back pain over the course of our lifetime. What’s going on?
Understanding your spine
Your spine is an intricate structure of bones (vertebrae), joints, ligaments, muscles, discs and nerves. It does an amazing job, providing structure and support to your body so you can stand upright, move freely and bend with flexibility.
Your spine also protects your spinal cord, a column of nerves that enables communication between your brain and body so that you can control your movements and receive feedback from your neural receptors in your tissues including skin, muscle, tendon and joints.
Understanding spine pain
As you can see, your spine is vital to all your activities. Unfortunately, it’s also vulnerable to many different kinds of damage, whether through accident, injury or ill-health.
You can compress nerves, rupture discs, strain or sprain the muscles and ligaments that support your spine, and overload your joints.
Sporting injuries, falls and accidents can cause spine injury and pain but sometimes the simplest movement can trigger pain without overt injury. Common conditions like obesity, stress, arthritis and poor posture can also be related to back pain.
Rarely (<1%) there might be significant underlying damage coming from infection or tumours that requires urgent diagnosis and treatment.
Understanding the different types of back pain
Your spine stretches from your neck to your pelvis. Doctors commonly think of it in three main sections to help identify which area of the spine is causing your pain.
Upper spine pain
Your cervical spine or neck has 7 small vertebrae known as C1-C7. It’s a surprisingly delicate structure to support the heavy and important load of your head.
- Whiplash injury sustained in a rear-end collision that jerks your head forwards then rapidly back and strains the soft tissues in your neck.
- Strained muscles due to poor posture at your computer, too long spent looking down at your phone
- Wear and tear on your joints known as osteoarthritis which causes the cartilage between your vertebrae to deteriorate
- Medical conditions like rheumatoid arthritis, cancer or infections.
Middle spine pain
Your thoracic spine or chest has 12 vertebrae known as T1-T12. Your ribs attach to this part of your spine.
Thoracic spine pain means discomfort in the middle to upper part of your back. This part of your spine is less easily injured than your upper or lower spine because it is more rigid and supported by the rib cage.
However, you can still experience a range of spine problems in this area, including:
- Fractures, often due to osteoporosis
- Spinal stenosis, a narrowing of the spinal canal that can cause nerve pain
- Osteoarthritis and other degenerative conditions
- Infection and tumours
Soft tissue injuries may cause sharp pain, spasms, aches or weakness. Nerve-related issues often cause tingling, shooting or burning pain or may cause numbness.
Lower spine pain
Your lumbar spine or lower back has 5 large vertebrae named L1 to L5 which bear the bulk of your body’s weight. The intervertebral discs take approximately 80% of the axial load with the facet joints sharing the remainder.
The disc is the most commonly implicated pain generator in the low back when there is persistent pain. It naturally undergoes a process of degeneration with aging that in some patients become painful. It can develop tears in the outer annulus or rupture the inner disc into the canal and cause nerve root pain or sciatica. Sometimes as the discs collapse a deformity can develop called degenerate scoliosis.
The facet joints in your lower back are often involved in osteoarthritis and may take increased load if your discs begin to degenerate or if your hips develop stiffness that leads to a “sway” back. For most people the arthritis can result in minimal or no pain but the swelling of the joint and surrounding structures can gradually reduce the space for the nerve roots and cause spinal stenosis.
Soft tissue injuries are also a common cause of lower back pain. Because this part of your spine bears your weight and is used regularly to help you move, twist or bend, it is easily hurt, either through a sudden injury or gradual overuse.
You may strain muscles or sprain the ligaments that connect to your bones. That inflammation of your soft tissues causes pain and may cause spasms.
Though it can be very painful, this type of spinal pain is usually short-lived. You’re likely to recover with over-the-counter pain medication, rest and physiotherapy.
Understanding the treatments for spinal pain
The right treatment for spinal pain will obviously depend on its cause.
The good news is that back surgery is often not needed for either acute (short-term) or chronic (long-term) back pain.
Non-surgical treatments for back pain include:
- Core-strengthening exercises
- Postural adjustment
- Dry needling
- Steroid injections to your nerves or facet joints
- Radiofrequency denervation
In most cases, you’ll be advised to try non-surgical options first, only beginning to consider surgery if you’re still in debilitating pain.
Back surgery can be particularly helpful if you’re experiencing nerve-related pain, tingling or numbness relating to a compressed disc or a bony overgrowth.
How The Victorian Orthopaedic Spine Service can help
Dr Edis can investigate and diagnose the cause of your spinal pain then advise you on treatment options to relieve it.
At the Victorian Orthopaedic Spine Service, our care pathway is designed to ensure you only progress to surgery if you really need it. Often, we will guide you towards non-surgical treatments first, which will hopefully provide the relief you need. If not, we can consider the pros and cons of surgery and help you reach an informed choice about your options.
Please contact us today.
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.
About Dr David Edis
Dr David Edis is an Orthopaedic and Spine Surgeon. David’s areas of special interest include the management of adult spinal conditions as well as hip and knee replacements. He has extensive experience in all facets of spine surgery from simple to complex, covering cervical to lumbo-pelvic conditions. He is an active researcher and medical educator and believes in lifelong learning. He is constantly updating his skills and helping other surgeons.