The cases of back pain are steadily on the rise. Going by the statistics based on certain studies, 12–14 percent of adult Americans are estimated to consult their physician for back pain. Though exact numbers are not available, a very high number of back pain sufferers are estimated to be knocking on the doors of chiropractors and physical therapists. In 2012, more than 52.3 million patients visited a physician with complaints of back pain, compared to 44.6 million in 2004.1 The 2010 Global Burden of Disease Study estimated that low back pain is among the top 10 diseases and injuries that account for the highest number of disability-adjusted life years or (DALYs) worldwide. In the United States, an estimated 149 million work days are lost every year because of low back pain, with total costs estimated to be US $100 to 200 billion a year.2
Understanding Your Back
Before we delve deep into the subject, it is important to understand the back anatomy to fully gauge what could prompt it to give up. The upper body is supported by the spinal column that gives it the flexibility. The spine has 24 vertebrae—7 vertebrae in the neck, 12 in the thoracic or upper spine, and 5 in the lower or lumbar spine. Below the lumbar vertebrae is the sacrum that comprises five bones fused together. The sacrum and the two pelvic bones form the base of the trunk. The tailbone or coccyx below them completes the structure. All the bones are kept in alignment by the muscles around them3.
Any injury on any of these bones, muscles, or ligaments that hold it all together can be classified as a back injury. While an acute back pain could signal an injury, if it persists longer to be classified as a chronic back pain is when the case for an injury gets stronger. Though chronic back pain constitutes only 1 to 5 percent of back pain cases, it can be debilitating.
Here is a list of common back injuries:
1. Back Sprain Or Strain
Usually, the lower back is the worst hit as it takes a good load of the stress of our everyday movements like lifting and twisting. Most back injuries are found to occur on the lumbar spine. Unfortunately, lumbar sprains and strains are way too common.
Lumbar strain: This happens when the muscle fibers around the back are abnormally stretched or torn.
Lumbar sprain: A sprain is caused when the bands of tissue that hold the bones together called ligaments are torn from their attachments.
The causes for these conditions are often determined by taking the patient’s medical history and recent physical activities into account. Even overuse of the lower back over a long period of time, as it may be required in the cases of certain occupations, can lead to these conditions. Lumbar sprain or strain results in the inflammation of soft tissues around the area. The acute pain you experience after an injury is due to this inflammation.
When you have a persistent lower back pain that radiates to the buttocks for more than 10 days, coupled with stiffness in the area, which restricts your movement, the alarm bell for a sprain should go off. The condition, however, is confirmed with an X-ray or magnetic resonance imaging or MRI. If bed rest, as recommended by the doctor, does not improve the condition, the doctor would determine the right treatment for the back sprain.
2. Herniated Disc
Herniated disc or slipped disc is another back injury to watch out for. Intervertebral discs or small cushions of cartilage separate vertebrae on the spinal column from each other. These discs are largely made of water (80 percent of it); the blood vessels near it provide all the nourishment needed for it. A herniated disc occurs when one or more of these discs tear and the cartilage and its contents spill out to put pressure on the surrounding nerves.
Sciatica—a sharp, shooting pain that radiates from the buttocks down to the back of one leg—is often the first sign of a herniated disc. Other symptoms include weakness in one leg. Some people even complain about a tingling or ‘pins and needles’ sensation in one leg or the buttocks. In seriously painful cases, patients have reported loss of bowel or/and bladder control.
Age is a major factor in causing herniated disc. That is because the discs lose much water as we age and are more prone to rupture. Children and young adults, however, are not immune to it. Improper lifting, smoking, overweight/obesity, sudden pressure on the back, and repetitive stress on the area could lead to herniated disc in anyone.
This is a condition in which one bone in the vertebral column or the spine slides over the bone below it. One cannot ignore spondylolisthesis because of the severe pain felt in the lower back or the buttocks. Some people might even limp a little because of the pain radiating to their legs. In rare cases, patients have also reported losing bladder or bowel control. Such cases demand immediate attention of a doctor.
The terms spondylolisthesis and spondylolysis are often used interchangeably. Though both form part of the same injury, it is important to know the difference. Spondylolysis is a stress fracture in one of the bones or vertebrae in the spinal column. It mostly affects the fifth lumbar vertebra and sometimes, even the fourth lumbar vertebra. Spondylolisthesis, on the other hand, is when this injured vertebra shifts out of position due to the severity of the stress fracture.4
4. Cervical Radiculopathy Or Pinched Nerve
A disturbance or damage of nerve function resulting from the compression of the nerve roots near the cervical vertebrae results in this condition. It is characterized by radiating pain from the neck to the shoulder region. Other than this, patients might also experience muscle weakness and/or numbness or a tingling sensation in their hands, reaching down to the fingers. This is mostly seen in middle-aged adults with herniated or slipped discs. This may occur when too much force is exerted on an otherwise healthy intervertebral disc.
Back Injuries In Children
If your child complains of a back pain, you might ignore it or ask her to dab some pain-relieving gel on the back. Little would you suspect a back injury because it’s an adult thing, isn’t it? You would be surprised to know that in the USA, of all the spinal injuries that get reported, 2 to 5 percent are that of children. What makes it even worse is the extent of morbidity the injuries are associated with. The spinal injuries in children are significantly different from that of adults, primarily because it is the cervical area that often gets hurt as against the lumbar injuries common among adults. Automotive injuries are the most common cause followed by sports injuries.567
Moreover, these spinal cord injuries are often crude and sometimes, complete, which means they can result in total loss of sensation and movement below the level of the injury. Other types of spinal cord injuries in children, which are incomplete can be one of the following:
- Anterior cord syndrome: Injury to the motor and sensory pathways in the anterior cord
- Central cord syndrome: Injury to nerve cells and pathways in the center of the cervical spinal cord
- Brown-Squard syndrome: Injury to the right or left half of the cord
- Spinal concussion: Momentary loss of bodily function, which is often resolved within a day or two
- Cauda equina syndrome: Injury to the lumbosacral nerve roots caused by central lumbar disk herniation8
There are many causes of spinal cord injuries in children. Birth injuries, which typically affect the spinal cord in the neck area, falls, vehicle accidents, sports injuries, trampoline accidents, and infections that form an abscess on the spinal cord are some of them. It doesn’t matter if you are a child or an adult, everyone needs to take adequate precautions to avoid back injuries. Spending a good part of your life unproductive in bed could be the last thing you want to happen to you, right?
|↑1||United States Bone and Joint Decade: The Burden of Musculoskeletal Diseases in the United States, First Edition. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2008, p. 42.|
|↑3||Hayes, M. D. William. Abernathy, 1980.|
|↑4||Kalichman, Leonid, David H. Kim, Ling Li, Ali Guermazi, Valery Berkin, and David J. Hunter. “Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population.” Spine 34, no. 2 (2009): 199.|
|↑5||Brown, Rebeccah L., Margie A. Brunn, and Victor F. Garcia. “Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center.” Journal of pediatric surgery 36, no. 8 (2001): 1107–1114|
|↑6||Cirak, Bayram, Suzan Ziegfeld, Vinita Misra Knight, David Chang, Anthony M. Avellino, and Charles N. Paidas. “Spinal injuries in children.”Journal of pediatric surgery 39, no. 4 (2004): 607–612|
|↑7||Eleraky, Mohammed A., Nicholas Theodore, Mark Adams, Harold L. Rekate, and Volker KH Sonntag. “Pediatric cervical spine injuries: report of 102 cases and review of the literature.” Journal of Neurosurgery: Spine 92, no. 1 (2000): 12–17.|
|↑8||Hayes, Janice S., and Trish Arriola. Pediatric spinal injuries. Pediatric nursing 31, no. 6 (2005): 464–468.|