Low Back Pain

Accidents waiting to happen

Back injuries can range from mild recurring pain and annoying stiffness to severe disabling conditions that are so far gone that surgery and extensive rehabilitation are required.

Most injuries to the spine are from mechanical forces which cause damage to the spine's supporting tissues including ligaments, spinal joints and muscles as well as the disc. The result is local pain in the injured body tissues and improper position or motion of the spinal bones (vertebrae). Referred pain from pressure or irritation to the spinal nerves may also be present if the injury is severe enough.

Referred pain is often called a "pinched nerve". This usually causes pain to be felt along the distribution of an affected spinal nerve and since different nerves go to different areas, referred pain from the lower back may be felt in the leg, buttock, groin or lower abdomen, depending on which nerve is affected by the injury.

Lower back injuries are extremely common in athletes, especially those involved in contact sports.

The severity of the local and the referred pain usually matches the severity of the injury; it can range from mild discomfort to extremely severe pain that can make movement almost impossible.

In athletes, severe back injuries often occur suddenly and without a lot of warning; frequently while doing things that had previously been done a thousand times before without any difficulty. This is especially frustrating for the athlete who feels that they didn't do anything to merit an injury. My frustration as a chiropractor is knowing how easy severe injuries often are to prevent, and then having to pick up the pieces after the injuries have already occurred.

What very few people know is that tissue damage and changes in vertebral position or motion can occur gradually from the cumulative effect of several small injuries that may go almost unnoticed as well as from the sudden effect of a large injury. With small, numerous injuries temporary pain or stiffness without any referred pain may be the only warning signs, but it is important to know that these are the injuries that can eventually lead to big problems because they result in loss of strength and flexibility in the tissues that support the spine.

Here's how it works: during every single episode back pain, whether mild or severe, the resulting pain is due to the inflammation (swelling) that is the body's first response to tissue damage. Swelling "cleans up the debris" left over from the injury and triggers the formation of scar tissue to reinforce the tissue that has been damaged. Scar tissue is now permanently present in the spine. The more significant the injury, the more inflammation present and the more scar tissue required to reinforce the injured area.

The effects of these injuries add up: the spine needs adequate strength and mobility to perform properly and scar tissue is always less flexible and less strong than the original tissue it reinforces. This leaves a tight spot in the spine at the site of the old injury which is also weaker than the tissue surrounding it. As a result of the scar tissue, the spine is left more susceptible to a serious future injury since its ability to perform has been reduced.

It only makes sense to try to prevent and quickly correct minor episodes of back pain in order to minimize the cumulative damage they can cause and also to treat small problems rather than procrastinate until they have progressed into big problems that will require much more time, effort and resources to correct.