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Management of Back Pain

There can be many causes of back pain including accidents, strains, and injuries. Two types of back injury are spondylolisthesis and cervical radiculopathy. Both have their own set of symptoms, causes, and treatments.

The spine, or backbone, is made up of a column of 33 bones and tissue extending from the skull to the pelvis. These bones, or vertebrae, enclose and protect a cylinder of nerve tissues known as the spinal cord. Between each one of the vertebra is an intervertebral disk, or band of cartilage serving as a shock absorber between the vertebrae. The types of vertebrae are:

  • Cervical vertebrae: the seven vertebrae forming the upper part of the spine
  • Thoracic vertebrae: the 12 bones between the neck and the lower back
  • Lumbar vertebrae: the five largest and strongest vertebrae located in the lower back between the chest and hips
  • The sacrum and coccyx are the bones at the base of the spine. The sacrum is made up of five vertebrae fused together, while the coccyx (tailbone) is formed from four fused vertebrae.

What Causes Back Pain?

The causes of back pain can be complex. Some causes of back pain include accidents, muscle strains, and sports injuries.

How Is Back Pain Diagnosed?

In addition to performing a complete history and physical exam for your back pain, your doctor may suggest one of the following diagnostic studies:

  • X-rays, which can be used to provide detail of the bone structures in the spine and to check for instability (such as spondylolisthesis, see below), tumors, and fractures.
  • CT scans, which can identify specific conditions, such as a herniated disc or spinal stenosis.
  • MRI scans, which can provide details about the backs' discs and nerve roots. MRI scans are most commonly used for pre-surgical planning.

A number of other imaging and electrical studies may also be used to identify back problems, and some injections are used for diagnostic purposes as well as for pain relief.

Types of Back Injury

Two main types of back injury include:

  • Spondylolisthesis: This is a slipping of vertebra that occurs, in most cases, at the base of the spine. Spondylolysis, which is a defect or fracture of one or both wing-shaped parts of a vertebra, can result in vertebrae slipping backward, forward, or over a bone below.
  • Cervical Radiculopathy: Cervical radiculopathy is the damage or disturbance of nerve function that results if one of the nerve roots near the cervical vertebrae is compressed. Damage to nerve roots in the cervical area can cause pain, weakness, and the loss of sensation in the neck, arms, or shoulders, depending on where the damaged roots are located.

 

Causes of Spondylolithesis

There are many causes for spondylolithesis. A vertebra might be defective from the time a person is born, or a vertebra may be broken by trauma or a stress fracture. In addition, vertebrae can be broken down by infection or disease.

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