Most people will experience a form of backache at some point during their lives. This type of pain can be uniquely complex and difficult to diagnose and treat. This is because there are many different reasons for discomfort and a wide range of treatments that may or may not work for the same condition. While resting, painkillers like Cipladon effervescent paracetamol and non-invasive treatment at home can bring relief for many, more serious conditions may require physiotherapy or even surgery. At the end of the day, with the right treatment approach from your doctor, you can effectively manage back pain and reduce the negative impact it has on your life.

Different types of backache

Your back is subjected to strong forces every day, from twisting, sudden jolts, or even poor posture when sitting hunched over at a desk. Any of your spine’s many interconnected and overlapping structures are capable of becoming injured and triggering back pain. There are several different types of back pain, depending on the causes and symptoms experienced:¹

• Flexion Dominant Back Pain:

  This type of back pain is described in terms of injury to the disc (though this is not always the case). Symptoms are made worse by sitting, bending, lifting and improving after standing and walking for short durations.

• Extension Dominant Back Pain:

  This is often described in terms of the joints at the back of the spine called the zygapophyseal joints (or Z-joints). Again, this is often part of the problem, but not always.

• Neurogenic Claudication:

  This is a specific type of Extension Dominant back pain that tends to affect older individuals (60+). It’s caused by the nerves being compressed when the patient is standing and walking, and can significantly limit a patient’s ability to walk for long distances.

• Inflammatory Back Pain:

  This pain is less common than mechanical back pain, this type of backache is often misdiagnosed. It’s caused by excessive inflammation in the spinal joints, secondary to a medical condition causing the immune system to attack the joints of the spine.

• Chronic Pain Disorders:

  This is one of the more challenging types of back pain for medical professionals to treat. The nervous system is interpreting stimuli not normally harmful to the body as dangerous, in turn registering it as painful. It’s a complex issue requiring a profound understanding of the patient, and what has led them to this place both physically and psychologically.

What causes backache?

It is usually difficult for the brain to distinguish between injury to one spinal structure versus another nearby. For example, a torn or herniated disc may feel similar to an arthritic facet joint. This is due to their close proximity. In some cases, the same nerve root can be compressed or irritated by different structures, such as a disc or bone spur. Here are some of the more common causes of backache and pain:²

Pulled muscles or tendons:

Perhaps the most common cause of backache is lifting heavy objects with improper technique, such as with a bent, hunched-over back. The pain is usually a sign of an injury to the muscles or tendons in the back, and can often recover with rest.³

Osteoporosis:

In osteoporosis, the bone tissue deteriorates due to low bone mass, leading to an increased risk of fractures. These fractures can occur in the spine, ribs, hips, and wrists. When these fractures heal, they can be the cause of chronic pain.⁴

Arthritis:

Joint pain and stiffness are common symptoms of osteoarthritis, which is a degenerative joint disease stemming from the deterioration of cartilage and bone. Among other areas, it commonly occurs in the lower back, neck, and hips.⁵

Slipped discs:

Slipped discs cause sudden and severe lower back pain. The disc can also put pressure on a nerve, which in turn can cause pain, tingling, and numbness in a leg. When a disc is said to have slipped, the soft inner part of the disc herniates through a weak part of the exterior of the disc. This herniation is what causes pain and inflammation.⁶

How to treat backache?

Backaches are commonly treated in a variety of ways based on the severity and type of the pain. Medication is usually the first course of treatment, and can also be combined with other treatment modalities. Over-the-counter pain medication, such as Cipladon effervescent paracetamol can be successful in alleviating backache. Topical pain relievers, such as muscle rubs, can also provide a reduction of symptoms.

In cases of severe pain, opioid-containing medicine could be prescribed for short-term use. These need to be taken cautiously, and only as prescribed.

Physiotherapy can also help in the treatment and rehabilitation of backaches. Finally, surgery is the last resort in the treatment of backaches and is usually only necessary if there’s physical damage that doesn’t respond to other treatments.⁷

Backache that won’t go away

While backaches are often not serious, there are cases in which certain symptoms should be cause for concern and this is especially true if they are ongoing. In these cases, you should seek medical help right away. For example, if you experience sharp pain, it could be a sign that you’ve torn a muscle or a ligament, or that there’s some intestinal problem on the side of the pain. Pain that shoots through the legs or buttocks could be a sign of nerve compression. Ultimately, you will want to be safe rather than sorry and speak to your doctor about your symptoms.
 

Disclaimer: The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Sources:

1. Brown, A. BScPT MClScPT. Cornerstone Physiotherapy [online] Available at: <https://cornerstonephysio.com/resources/5-types-of-back-pain/> (18/07/2020).
2. Larry Parker, M. Symptoms and Diagnosis of Facet Joint Disorders. Spine-health [online] Available at: <https://www.spine-health.com/conditions/arthritis/symptoms-and-diagnosis-facet-joint-disorders>
3. Back pain – Symptoms and causes. Mayo Clinic [online] Available at: <https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906#:~:text=Repeated%20heavy%20lifting%20or%20a,(vertebrae)%20in%20your%20spine> (21/09/2020).
4. Back pain – Symptoms and causes. Mayo Clinic [online] Available at: <https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906#:~:text=Repeated%20heavy%20lifting%20or%20a,(vertebrae)%20in%20your%20spine.> (21/09/2020).
5. Back pain – Symptoms and causes. Mayo Clinic [online] Available at: <https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906#:~:text=Repeated%20heavy%20lifting%20or%20a,(vertebrae)%20in%20your%20spine> (21/09/2020).
6. Back pain – Symptoms and causes. Mayo Clinic [online] Available at: <https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906#:~:text=Repeated%20heavy%20lifting%20or%20a,(vertebrae)%20in%20your%20spine> (21/09/2020).
7. Take Care of your Back. kznhealth.gov.za [online] Available at: <http://www.kznhealth.gov.za/back.htm> (04/01/2022).