Back Pain Part 3

OsteoarthritisOverloading, injury, and aging can slowly deteriorate cartilage, the soft, elastic material that covers the surface of vertebral joints and other joints in the body (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002). Discs between vertebrae may become worn,narrowing the space between vertebrae, leading to a gradual stiffening of the back and loss of flexibility. Joints may also rub together, compress, and become irregular. When the cartilage becomes worn, pain may result. This wear and pain is known as osteoarthritis. Lower back pain may become worse if osteoarthritis affects the hips or knees.
Osteoarthritis can also directly affect the spine, causing muscles, tendons, or ligaments to become strained, leading to back and/or neck pain (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002).

Osteoporosis (compression fractures)

Osteoporosis is a disease that causes bones to become more porous due to calcium loss, which gradually makes them weaker and more brittle. Healthy bone is dense and strong, able to withstand a great deal of pressure. With osteoporosis, bones become fragile and can break more easily. In particular, osteoporosis contributes to compression fractures, or spinal fractures where the vertebrae become flattened (University
of Washington Department of Orthopaedics and Sports Medicine, 2002). One in three women older than 50 is
affected by compression fractures as a result of osteoporosis. Progressive compression of the vertebrae often
leads to gradual loss of height, and sometimes structural changes to the spinal column that cause one to have a stooped posture or a dowager’s hump (Mayo Clinic, 1997).

Injuries and Accidents
Many back injuries are caused by an unexpected twist or sudden motion (University of Washington Department of Orthopaedics and Sports Medicine, 2002), most often resulting in muscle strain and spasms. Muscle spasms are a common response to injury, and are designed to immobilize the painful area and
prevent further damage (Mayo Clinic, 2000). With injury or accident, severe muscle spasms usually last 48-72 hours, followed by days or weeks of less severe pain, and 2-4 weeks for complete recovery from mild
back injury. For more severe injury, involving strained ligaments, it could take 6-12 weeks for recovery. Severe back injury involving a fall or other accident may require hospitalization and a longer recovery period
(University of Washington Department of Orthopaedics and Sports Medicine, 2002).

Fibromyalgia
Fibromyalgia is a syndrome characterized by achy pain, tenderness, and stiffness in muscles and areas where tendons insert into bones, especially in the upper back and neck. Pain often worsens with inactivity and
can be improved with movement (Mayo Clinic, 1997; University of Washington Department of Orthopaedics and Sports Medicine, 2002).

Ankylosing Spondylitis
Ankylosing Spondylitis is a form of arthritis initially causing pain and stiffness in the joints of the spine, followed by a fusing together (growing together) of these joints, limiting back movement (University of Washington Department of Orthopaedics and Sports Medicine, 2002). This is an uncommon type
of back problem that typically affects young men ( Mayo Clinic, 1997)

Spinal Stenosis
Spinal stenosis involves a narrowing of the spinal canal, which can develop because of a congenital defect or from osteoarthritis. As discs are worn and vertebrae and soft tissue are pushed into the spinal canal,
nerves are compressed (Mayo Clinic, 1997). This nerve compression causes back pain, and can also cause numbness, pain, and weakness in the legs. The most common sign of spinal stenosis is pain that worsens
when walking and subsides when sitting down (University of Washington Department of Orthopaedics and Sports Medicine, 2002).

Rheumatoid disorders
Rheumatic disorders that create acute and chronic inflammation, muscle soreness and stiffness, and pain in the joints and associated structures (Tabers, 1997), such as rheumatoid arthritis and Polymyalgia
Rheumatica (PMR) commonly cause back and neck pain problems.