Solving the Puzzle of Back Pain
An estimated eight out of ten people in the United States will
injure their back at some point during their lives. Few of these
problems will require extended treatment, but back problems are
invariably painful.
Managing and relieving back pain is not a simple process. The
experience of pain is subjective; it cannot be measured from the
outside. Health providers who treat back pain find it
challenging to obtain the objective or measurable signs that
verify and diagnose a patient's painful back symptoms.
Additionally, everyone's experience of pain is different. Pain
descriptors encompass numerous adjectives - dull, sharp,
throbbing, pulsating, stabbing and shock-like, just to name a
few.
People experience and describe pain so differently partly due to
its varied and complex origins. In fact, pain originates from
numerous places in the body, such as muscles, bones, nerves,
organs or blood vessels.
Pain is also described as acute or chronic. The word "acute"
derives from the Latin word for needles and is usually described
as a severe, sharp sensation. The initial stage of an injury is
called the acute phase.
The word "chronic", on the other hand, originated from the Greek
word for time. Chronic pain is pain that persists after a length
of time, often months to years. Many back injuries tend to
become chronic, especially when not treated properly during the
acute phase. Chronic pain is often experienced as a dull ache or
constant nagging irritant.
Acute and chronic pain sensations also travel different nervous
system pathways inside the body. When you injure muscles or
ligaments in your back, nerve endings called pain receptors pick
up the pain impulses and transmit them to the spinal cord. From
here, the pain message ascends to the brain. This process takes
place at varying rates of speed depending on the size of the
nerve fiber involved.
Acute pain tends to travel on faster, larger diameter fibers,
while chronic pain prefers smaller, slower pain fibers. Experts
suggest that chronic pain affects the brain's limbic system,
which is associated with emotional states. Anyone who has ever
had a long-term painful injury knows that negative or
distressing emotions may accompany or perpetuate the initial
injury.
The best way to treat chronic back pain syndromes is to prevent
them. Although proficient early treatment does not always
prevent an acute injury from turning into a chronic problem, it
is a good insurance policy. Early treatment is especially
important with injuries to the soft tissues (muscles, tendons
and ligaments) to prevent them from becoming weaker, less
elastic and more pain-sensitive.
One of the best ways to treat both acute and chronic soft tissue
injuries is a hands-on approach that works to repair the injured
tissues. Some examples are joint and soft tissue manipulation
and mobilization, typically performed by a doctor of
chiropractic or osteopath. Other good options are massage and
physical therapy. A formal rehabilitation program at a health
club or therapy clinic may also help to strengthen weakened and
damaged muscles, especially the core stabilizers of the back.