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Evaluating low back pain in patients can be extremely difficult. Thankfully, 90% of acute back pain resolves within three months no matter what the treatment. However, if appropriate pain management treatment is instituted pain relief can potentially be achieved sooner rather than later.

Statistics show that over 30% of the time, medical providers cannot give an accurate low back pain diagnosis with regards to the pain generator. Even in this day and age of such modern technology as MRI and CT scans and EMG testing, low back pain still remains a conundrum in many cases.

The main categories of pain generation include fracture, infection, tumor, trauma, arthritis, soft tissue, or neuropathic.

Fracture or Trauma – Vertebral Compression Fractures are seen as a result of an axial load on the spinal column. The number one cause is osteoporosis, number two is a traumatic event like a car accident or fall from a height. These fractures are typically seen on plain x-rays, and also very easy to see on an MRI. Traumatic injuries also can result in soft tissue sprains/strains with damaged ligaments, tendons, or spinal musculature.

Infection – There are two areas of infection around the spine. One is the vertebra itself, which is called vertebral osteomyelitis. Another is infection in the intervertebral disc, which is called discitis. Infections occur post-surgical, post-procedure, and also in immunocompromised patients such as diabetics.

Tumor – There are various tumors that affect the spine and cause low back pain. Most commonly, the spine has a tumor from metastasis of a tumor elsewhere, such as the breast or lung. There are some tumors that occur primarily in the spine, such as multiple myeloma.

Arthritis – Just as degenerative arthritis occurs in the knee and hip, it also occurs in the spinal column. The joints of the spine are called facet joints, and they are about the size of a thumbnail. The facet joints are located on each side of each level of the spine. For instance the L3-L4 facet joint is the one located between the third lumbar and fourth lumbar vertebra. When arthritis occurs in facet joints, it is called facet syndrome or simply facet arthritis.

Soft tissue – The soft tissue areas of the spine include the following: Intervertebral disc, spinal ligaments, and also the para-spinal musculature with its tendons. Patients involved in a trauma can experience spinal ligament injury with resultant pain. Para-spinal musculature strain is extremely common. Often times the para-spinal mucles will react to other injuries such as fractures, ligament sprains, etc by going into spasm. This is called muscle guarding. Pain from the intervertebral disc itself is a result of disc injury. This can be chronic, called degenerative disc disease, or more acute. The outer part of the intervertebral disc contains pain fibers. This area of the disc is called the annulus and an annular tear can cause significant pain in the low back.

Neuropathic – This refers to pain emanating from an intervertebral disc herniation that is impinging on a nerve root. The pinched nerve sparks up inflammation and causes pain to radiate down the leg, called sciatica.

Evaluating a patient with low back pain takes determination and thoroughness with a specific algorhithm. If done correctly, it will give patients the best chance of success by leading to an appropriate treatment regimen.

If you suffer from upper back muscle pain, you are like over a million other Americans. A sedentary lifestyle, with too much time on couches or in front of computers has created what amounts to an epidemic.

Causes of Upper Back Muscle Pain

In more than 80% of cases the actual cause of pain in this area is never determined. Some of the most common causes are:

Poor Posture. Remember when your mother told you to stand straight? The upper back muscle group is designed to support the body. When we stand in a stoop-shouldered position, it puts strain on the muscles, bones and ligaments which can cause pain.

Over Exertion. Activity such as painting, or other exercise that puts stress on the arms and upper body can also cause back pain in the upper back.

Large Breasts. This, naturally, afflicts women rather than men. While the silicone-enhanced breasts might be a turn-on for some, without proper support they can strain the muscles in the back and cause extreme discomfort.

Injury. Sports like tennis and golf require a lot of extreme movement of the upper body. Untreated injury can lead to chronic upper back muscle pain.

Disease. Some diseases like osteoporosis can cause bones to become brittle. When this happens, the support structure of the upper back is weakened which can cause extreme pain and discomfort.

Treatments

If your pain is caused by something simple, such as poor posture or a minor injury, treatment is relatively simple and effective.

Massage. Deep massage of the affected area gives some relief.

Cold Treatment. An ice bag strapped to your upper back will help relieve pain. Depending upon the severity of the pain, this might take a few days for total pain relief.

Stand up Straight. This is one of the simplest ways to relieve strain. Back straight and shoulders back, just like your mother always told you to stand.

Take a Break. If your pain is from overexertion, scale back your activities for a while until the pain goes away. When you resume activity, pace yourself and watch for signs of muscle strain.

A Sports Bra. For large-breasted women, a reinforced sports bra is the best way to relive the strain on the upper back.

Avoid Contortion. You might like the way you look diving for that low drive on the tennis court, but such moves can exact a heavy price. Take it easy, and don’t try to put your body into positions that are too stressful.

Cures

Chronic pain in the upper back that is not relieved by any of the above treatments can be a sign of a more serious condition. If this is the case, consult a doctor. You might be suffering from scoliosis (misalignment of the spine), which can be corrected surgically. If you have seriously injured your back muscles, your doctor might also try ultrasound treatments for a deep muscle massage.