Spinecare Topics

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Understanding Back Pain
Causes of Back and Neck Pain

Muscle Spasms: Overworking of muscles of the back can lead to muscle inflammation and result in involuntary contraction or muscle spasm associated with pain.  Muscle contraction or spasm can occur due to primary muscle compromise or without muscle compromise secondary to a nerve reflex response. This latter form of muscle spasms is the body’s method of protecting itself from further injury. Spinal pain will induce muscle guarding or spasm around the region of pain which results in varying degrees of immobilization of the area. Even though muscle spasms can be very painful, the pain may appear worse than the causative underlying injury.

Poor Posture (Postural Strain): The pain associated with abnormal posture is the result of many hours, days or even years of sustained strain placed upon the one or more intervertebral discs, ligaments, joints and muscles of the spine. The pain results from physical compromise and inflammation of muscle fibers, ligament fibers and other supportive elements of the spine such as bone and intervertebral disc. For example, chronic rounding of the back and slumping of the shoulders places abnormal pressures upon the spine, particularly the intervertebral disc.

Joint Stiffness and Pain: The facet joints and joint capsules of the spine are lined with a pain sensitive membrane called the synovial lining. The outer layer of tough supportive tissue, which lies over the synovial membrane is referred to as the joint capsule. The joint capsule is also pain sensitive. Any position or injury, which leads to stretching, distension or compression of these tissues, usually results in back pain. The synovial membrane secretes fluid into the joint, which helps reduce the friction across joint surfaces during movement. The joint (synovial) fluid also has nutrients which are made available to the joint tissues. If the synovial lining is inflamed or compromised is may secrete too much fluid leading to distension of the membrane and a resultant increase of spinal joint pain. A loss of disc height can lead to buckling of the spinal joint membrane thus increasing the risk for the membrane becoming pinched in certain positions or postures. This would often be associated with pain, usually classified as mechanical pain because of the way it is induced.  

Chronic stress placed upon the thick and stronger joint capsules can lead to tissue changes which promote less flexibility, subsequently leading to joint stiffness. Abnormal vertebral movement such as hypermobility or instability (severe increase in movement) may be enough of a stressor to cause spinal joint pain and resultant stiffness. Chronic joint inflammation and mechanical stress placed upon the spinal joints may influence the rate and degree of degenerative changes.

Coccydynia: The term coccydynia refers to tailbone pain which can be caused by a number of different conditions.  This is most often associated with a history of falling directly upon the buttock region. Sitting for a long time on a hard surface may also provoke coccydynia.

Facet Syndrome: The term facet syndrome refers to pain arising from one or more of spinal joints, which are the fluid filled cartilage lined structures that lie on the back side of the vertebral column.  This pain tends to be worse upon extension and rotation, because the joint surfaces are compressed in that position. The pain from facet syndrome often feels a little better during the initial phase of bending forward.

Muscle Tension:  Muscle tension can occur due to chronic muscle guarding secondary to pain arising from non-muscular tissues of the spine.

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