The spine is made up of strong bones called vertebrae. A vertebra can break, however, just like any other bone in the body. When a vertebra breaks and then collapses, it is called a vertebral compression fracture. Compression fractures happen most commonly in the thoracic spine (the middle portion of the spine). In the worst cases, such fractures and the resulting compression of the spine can put pressure on the spinal cord and nerves, either from the compression itself or from the protrusion of bone into the nerves of the spinal cord.
The back is one of our most important anatomic structures, providing support and facilitating mobility and balance for the entire body, as well as protecting the spinal cord. Because of the loads placed on it each and every day, it's no surprise this well-designed structure, consisting of bones (vertebrae), discs, muscles, tendons, ligaments and nerves, is particularly susceptible to injury and other conditions that may have you reaching for the heating pad - or your doctor's phone number.
Acute Pain vs. Chronic Pain
Acute pain is commonly described as sharp and severe; it tends to come on suddenly but also improve with time and short-term conservative treatment, such as medication, exercise, physical therapy or rest. Chronic pain is commonly described as a deep, aching, dull or burning pain, and may be accompanied by numbness, tingling and/or weakness that extends into the extremities. Chronic pain tends to last a long time and is not relieved by conservative care. When you feel pain, it's your body's natural reaction to signals transmitted from the pain source, which travel through the nerves in the spinal cord and up to the brain, where they are perceived as pain.
Many sudden attacks of acute back pain are the result of overstretched muscles (strains) or ligaments (sprains). The pain may be most severe immediately after injury, or it may worsen gradually over a few hours. In most instances, back pain as a result of strain or sprain can be resolved following a conservative course of treatment - usually within two to six weeks - provided there are no serious underlying medical conditions.
Common causes of strains and sprains that can trigger acute back pain include:
- Improper lifting
- Sudden, strenuous physical effort
- Accident, sports injury or fall
- Sleeping position and/or pillow positioning
- Poor sitting or standing posture
- Bending forward too long
- Hiking" your shoulder to hold the phone receiver to your ear
- Carrying a heavy purse, briefcase or backpack
- Stress and muscle tension
Physical conditions that can possibly contribute to the onset of acute back pain include:
- Lack of muscle tone
- Excess weight
Other causes of back pain include:
Mechanical Disorders: Many people who suffer from back problems are experiencing mechanical pain, which means that a specific part of their spine, such as an intervertebral disc, a ligament, or a joint is damaged and is not working correctly. Examples of spinal mechanical disorders include degenerative disc disease, herniated disc, spondylolysis/spondylolysthesis, arthritis and spinal stenosis.
Developmental Disorders: Developmental disorders of the lower back are caused by abnormalities in the formation and growth of the skeleton. Although the treatment for many of these conditions is conservative, surgery may be required to keep some disorders from worsening, and in order to prevent long-term disability and or deformity. Scoliosis and kyphosis are examples of developmental disorders of the spine.
Inflammatory and Infectious Disorders: Infections of the spinal column are not common, but they are important because they are difficult to diagnose and there are serious consequences in the delay of an accurate diagnosis.
Tumors: Cancers and tumors of the spine and spinal cord are relatively rare. The most common symptom that patients with a spinal tumor have is pain. Because back pain is very common, it is also not a specific symptom of any one disease or medical condition.
Trauma: Trauma to the spine refers to injury that has occurred to the bony elements, soft tissues and/or neurological structures, resulting in instability of the vertebral column and actual or potential neurological injury
When Should I See My Doctor?
When your back hurts, the first step is to assess the severity and cause of your back pain to determine whether you need to see a physician.
Consult a physician immediately if you:
- Are experiencing back pain as a result of a physical trauma involving your spine, such as a fall or car accident
- Are experiencing numbness in, or having difficulty moving, your extremities
- Experience bladder control loss or impairment
- Develop a fever or severe headache
- Are over 60 and have been taking steroids for a long period of time
- Experience chest pain or pain in the left arm
- Are pregnant
- In instances of acute back pain, do not experience any improvement after 72 hours of self-treatment at home
- Have experienced chronic back pain for more than 6 weeks
If you are experiencing back pain, talk to your doctor about appropriate treatment options. Identifying the cause of your back pain, alleviating the pain - either at home or with your physician's help - and avoiding re-injury are key to the healing process.