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What is Causing My Back Pain?

What causes back pain? In short, there are many causes of back pain and each case of back pain may have different causes. Back pain is a complex, multifactorial musculoskeletal disorder that will affect up to 80% of individuals within the general population at some time in their lives. The back is made of up many structures that can be injured leading to pain such as muscles, tendons, ligaments, capsules, nerves and intervertebral discs. Pain can be classified by timeframe and includes sudden (i.e., acute), recurrent (i.e., sub-acute) or longstanding (i.e., chronic). Back pain is also categorised into 3 main types: (1) non-specific or mechanical back pain; (2) radiculopathy; and, (3) specific back pain pathology (i.e., red flag). There are also many intrinsic and extrinsic factors causes of back pain.

Tissues that cause back pain

The back comprises a strong, supportive structure of many different tissue types, all of which can becoming injured leading to back pain. Examples of tissue that commonly cause back pain include:

  • Muscles. These include the paraspinal muscles (i.e., Iliocostalis, longissimus and spinalis), erector spinae, latissimus doris, quadratus lumborum and more. Generally speaking, these muscles function to keep you upright and facilitate movement at the back (mostly extending, side bending and rotating). Examples of types of muscle back injuries include muscle strains, ruptures and bruising or swelling.
  • Tendons. Tendons attach muscles to bones and act as springs to manage load distributed through the muscle. Examples of types of tendon back injuries include tendon rupture, tendinitis and tendinopathies.
  • Joint capsules. At every synovial joint (i.e., joins bones with a fibrous joint capsule that is continuous with thin tissue layer of the bones) there is a joint capsule, which is a synovial fluid-filled sac that functions to lubricate the joint and provides shock-absorption. Examples of types of joint capsule back injuries include facet capsulitis and impingement.
  • Bones. These include mostly the vertebrae of which there are 33 in total (7 in the neck, 12 in the mid-back, 5 in the low back, 5 in the sacrum and 4 in the tailbone). Examples of types of bone back injuries include osteoarthritis, osteoporosis, fractures and dislocations.
  • Intervertebral discs. These are the strong, shock-absorbing and flexible discs that sit in between most of the vertebral bones. Examples of types of disc back injuries include annular tears, disc bulging and disc herniation.
  • Ligaments. Strong, fibrous tissues that connects two bones or cartilages or holds together a joint. Examples of types of ligaments back injuries include ligament rupture and sprains.
  • Nerves. There are numerous nerves in the back. All branch off the main one held within the spinal cord column of the vertebrae. As these nerves branch off, they often become smaller as they weave in between tissues. In the back, they branch off the spinal cord, becoming nerve roots, then trunks, divisions, cords and then finally branches. Examples of types of nerve back injuries include radiculopathy and lower motor neuron lesions.

Other causes of back pain

How these tissue injuries arise varies considerably, from overuse or repetitive strains, to sporting injuries and accidents, and even genetic factors. They are very common and conservative management from your chiropractor is recommended as the first line of management. There are also some other things to contend with in regards to causes of back pain including:

  • Chronicity (i.e., chronic pain vs. acute pain)
  • Co-morbidity (i.e., conditions that can co-exist with back pain that complicates the case)
  • Individual- and work-related factors (i.e., predisposition to back pain due to genetics, and working conditions that facilitate and exacerbate conditions).

Check out our blogs below for more information on the different causes of back pain.

Back pain triage

Back pain can be classified into 3 main types based on the severity of the injury:

  1. Non-specific back pain. This is by far the most common of the three types and accounts for between 90-95% of all cases. This type of back pain is commonly treated with conservative management from your chiropractor.
  2. Radiculopathy. This refers to the irritation or injury of the exiting nerve root from the spinal cord and the varying levels of the spinal column. The most common reason for radiculopathy is disc injury. In this case, the disc itself can press against the nerve root causing pain, or the inflammation from a disc injury can cause a chemical radiculopathy. It accounts for 5-10% of all cases.
  3. Specific back pain pathology. This is by far the least common type of back pain accounting for less than 1% of all cases. It refers to the presence of ‘red flag’ pathology. In other words, there is a serious cause for the back pain such as a cancer, tumour, fracture or infection and at times requires medical emergency. If your clinician suspects a pathological cause to your back pain, they should refer for immediate further investigation.

At Sydney Spine & Sports Centre (S3C), our chiropractors are highly trained to identify, differentially diagnose and conservatively manage a wide range of musculoskeletal back pain disorders. If you have back pain, visit our Inner West clinic today.

More information

Please visit our website and blog pages for more information on what causes back pain:

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Martin Frutiger chiro

Martin Frutiger

Martin is an experienced and qualified chiropractor, remedial massage therapist and has completed a Masters of Research. He has an active interest in sports conditions, over use injuries and problems related to the spine such as neck and back pain.