Spine Pain: Causes, Symptoms & types of back pain

By Dr. Mihir Bapat in Institute for Bone, Joint Replacement, Orthopaedics Spine and Sports Medicine , Spine Surgery Unit

Apr 24 , 2023 | 5 min read

Spine Pain:

Spine is the strongest part of the human body that balances the entire body weight and our work load. It suffers a lot of wear and tear continuously throughout life. Before the age of 30, we can jump/run and endure long hours of work and play. This is because the spine and muscles are strong. All we feel is a tired ache or cramp due to over activity that is relieved with rest. After 30, the spine starts getting weaker and stiffer thereby losing its performance endurance and strength. Hence the muscles need to gear up to support the spine better. Like any other machine, the load (body weight) and servicing (the muscles) decide our activity limits.

Common Symptoms of Back Pain

Following are some common symptoms of back pain:
Aching
Throbbing pain
Tightness or stiffness in the lower back
Muscle spasms during different activities or at rest
Significant loss of motor function
Inability to retain the normal posture

Types of Pain:

Benign mechanical pain: this contributes to 80 % of pain. All of us get back pain. This is due to spine and muscle fatigue during our daily work. Ability to perform long uninterrupted hours of work reduces with age, lack of exercise and weight gain. So, losing weight and getting into the rhythm of exercise is the long-term solution. Intermittently for pain control one can use pain killers, heat pads, ointments or physiotherapy modalities. Mattress/pillows to relax your muscles, ergonomic chairs, adjusting work postures and taking rest breaks also help.
Certain pain doesn’t improve with rest and medications. The intensity keeps increasing and one may find it difficult to maintain normal activity level. The pain may track down into the arms or the legs. Sleep is disturbed. This pain demands to been seen by a spine surgeon. The common causes (slipped disc, stenosis, slippage of bones, fracture, infection, tumour) have to be ruled out.

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Back Pain/Spine Pain Causes

The most common spine pain causes include:

Fractures or imbalances of the spine caused by injury
Muscle tears caused by an over-exerting force on your muscles
Sciatica or pain caused by strained nerves in the lower back
Spinal stenosis
Herniated disc

The less common causes of spine pain include:

Spondylolisthesis
Spondylosis
Spinal cancer
Arthritis
Fracture of a vertebra
Osteoporosis
Scoliosis of the spine

The rare causes of spine pain include:

Spinal tuberculosis
Ganglial tumors

Diagnostic Testing

You must see your physician for a proper diagnosis. This will include a history, physical exam, and the following diagnostic tests:

X-rays

X-rays are the most common medical test used to diagnose back pain. An X-ray will help your physician determine whether you have a fracture or a cracked vertebra. If you have no apparent fracture but are experiencing significant pain, your physician may prescribe other tests to find the root cause of your back pain.

Magnetic resonance imaging (MRI)

MRI is a form of imaging where a strong magnet and radio waves are used to generate computerized images of various body organs. This test is best suited to detect spinal tumors and multiple sclerosis.

CT scan with 3-D reconstruction

A CT scan or computed tomography scan is a series of X-rays that are used to diagnose internal injuries. It can also reveal the severity and cause of your back pain.

Electromyography or nerve conduction velocity testing

This test measures tiny electrical currents that are conducted through the peripheral nerve or muscles. This is the best test to determine the cause of sciatica and back pain when no other diagnostics can be done.

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Goals of Treatment:

Treatment always begins with a conservative approach. A brief period of rest coupled with pain killers and physiotherapy is the first line of therapy. Epidural steroids injections (nerve blocks) are used to reduce severe nerve radiation pain. A plan to re-condition the spine muscles with exercises, postural adjustments and diet modification is mandatory.

Role of Surgery:

Progressive deteriorating pain or onset of weakness in the hand or the legs is ominous signs. If the conservative treatment does not provide adequate relief, surgery is required to restore quality of life. Many people tend to keep adjusting to their pain & disability and experience a significant drop in their quality of life. The advances in spine surgery allow quick relief of pain and very early restoration of function. The satisfaction after getting rid of crippling nerve pain is unparalleled.

The 5 common conditions that require surgery are-

Slipped or herniated disc
Stenosis or narrowing of nerves in the elderly
Slippage of bone or Listhesis
Infection
Trauma or fractures

Most people tend to self-diagnose themselves when they experience such symptoms that lead to further complications. Therefore, the best step is to visit the best doctor in India and get immediate treatment for a better recovery.

Advances in Technology:

This has revolutionised spine surgery. More and more elderly patients who are young at heart and keen to remain active are helped with modern surgery. Small children with crippling deformities of the spine can now smile. Some of the niche technological solutions available now are

Magnification of nerves using a microscope or endoscope improves clarity and precision. This has allowed key-hole operations with great accuracy.
Computer guided navigation allows guiding of screws in a precise manner around the nerves. Complex spine deformity has an effective solution.
3 D C-arm is like viewing the spine in a 3-dimensional plane during surgery. This has greatly helped in complex problems that require extra vision.
Neuro-monitoring. The safety of monitoring the nerves during the surgery cannot be over-emphasized. This has come a long way in minimising (1-2%) the risk of nerve complications during surgery.
Advances in anaesthesia and Hospital care is of paramount importance to help the most painful and disabled patient get holistic care and new leash of life.

Self-assessment	Point 0	Point 1
Age	Less than 40	More than 40
Pain	New	Repetitive more than 1-2mths
Work Hours	Manageable with extra pain	Requires rest breaks
Radiation	Intermittent	Continuous into arm / legs
Sleep	Once asleep pain not felt	Sleep disturbed while changing position
Subjective weakness / numbness in the hands / legs	No	yes
Pain killers	occasional	Often and dose increased
Previous similar episode / MRI diagnosis	no	yes
Previous spine surgery	no	yes
Outdoor recreational or exercises reduced	no	yes
Regular exercises	No / intermittent / walking	Yes walking + upper body
Weight as per height	Up to 10kgs overweight	More than 10kgs over weight
Blood pressure / thyroid / diabetes / other health issues	no	yes
Point Tally > 6	Regular Exercise / diet / pain management / physiotherapy	See a SPINE SURGEON

Our Motto: “Back” to Health

Always make sure that you select only the best and most reliable healthcare center to undergo spine surgery. Nanavati Max Super Specialty is the best spine surgery hospitals in Mumbai, India. Here, we have advanced medical and surgical equipment, along with a staff of extremely well-trained and experienced spine surgeons, which ensure that each patient gets the best treatment.

Conclusion

Back pain can range in severity from mild to severe, with some types of back pain lasting for a few days while others may last weeks or even months. If you experience any of the symptoms of spine pain, you should see a physician immediately. Spine pain is best treated early before it becomes chronic or serious.