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Video: America and back pain

By
TODAY contributor
updated 11/8/2007 10:39:43 AM ET 2007-11-08T15:39:43

Do you or a loved one suffer from back pain? If so, do you know the causes of the discomfort? You should: Understanding your aches can ultimately help you manage your pain. Here, spine specialist Dr. Mark Weidenbaum outlines the basics of back pain and explains which symptoms may be signs of more serious conditions.

Q: What is back pain?

A: Back pain generally refers to pain, discomfort or tension in the area of the upper or lower part of the back, often including the buttocks or the pelvis.

While pain can occur anywhere along the spine, it is most common in the lower spine (referred to as the lumbar region) since this area carries the most weight and undergoes the most movement. It’s important to remember that back pain is different from pain that shoots down the leg below the knee. This is called sciatica. Back pain and sciatica can occur together.

Q: Is back pain common?

A: Yes, back pain is extremely common.

According to the National Institute of Health, back pain is the number two reason that Americans see their doctors, second only to colds and the flu! Nearly everyone will have at least one backache at some point during their life.

Q: Will the pain get better?

A: Much of the time, yes.

Fortunately, most back pain is temporary and will resolve with time. However, there are times when the pain can be caused by very serious conditions such as compressed nerves, tumors, infections, fractures or problems with internal organs. Persistent back pain needs to be checked by your doctor, as does any kind of numbness (loss of feeling) or weakness.

Video: Dr. Nancy answers your e-mails

Q: Why does my back hurt if I didn’t do anything to injure it?

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A: The spine contains bones, joints, nerves and soft tissues, and it’s the soft tissues that often cause back pain.

Many people have heard of the “disc.” This refers to the inter-vertebral disc, the structure that lies between the vertebrae (spinal bones) at each level of the spine. Although the disc can be the source of pain, there are also many other soft tissues in the back such as muscles and ligaments. Since these soft tissues are constantly moving, they can sometimes get pulled or strained. While strains may happen suddenly (as in a fall or while lifting something very heavy) they more commonly come on slowly as a result of normal activities that involve many repetitious movements. Examples would include simple activities such as picking up or carrying small children, gardening or even just sitting in traffic.

Q: Why is back pain so common?

A:Gravity and movement: Our muscles have to work constantly to hold us upright against gravity and to move us around — even when we are sitting or lying down. These muscles can get tired. This is especially true if we make their job harder by being overweight or being out of shape. Strong muscles, especially in the trunk region (central part of the body), help to carry body weight and to prevent the spine from getting overloaded. However, when these muscles get weak, the spine must compensate and do extra work, thereby causing pain.

Sitting, muscle spasm and stress: We all sit a lot. We sit at work, in school, in our cars, at our computers, watching TV, you name it. It might seem hard to believe, but sitting can actually be worse for the back than standing. Why? This is because when we stand, the load at each level of the spine is shared between the disc and two small joints (facet joints). However, when we sit, more of the load shifts onto the disc since most people lean forward while sitting. When muscles become fatigued (tired) less oxygen reaches the muscle and more wastes build up in the muscle than when it is rested. These changes can trigger the muscle to go into a spasm, where the muscle keeps firing on its own. Lots of other factors such as stress or tension further tighten up the muscles, making them more susceptible to injury.

Dr. Mark Weidenbaum is the director of orthopedic spine surgery at the Columbia University Medical Center campus of NewYork-Presbyterian Hospital. He is also an associate professor of orthopedic surgery at Columbia University College of Physicians and Surgeons.

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