This is the commonest cause of back pain and is caused by damage or wear and tear affecting the vertebral discs, facet joints or muscles and ligaments supporting the spine. Sometimes the pain can spread into the arm or leg if the nerves that supply the limbs are irritated and there can be associated numbness and tingling.
Treatment: Bed rest should be avoided if possible and it is important to take pain killers to keep moving in the acute phase. If the symptoms persist manipulation of the spine by Physiotherapists, Osteopaths or Chiropracters can be considered as can spinal injections or surgery.
Inflammation can also affect the spine. Ankylosing spondylitis is most common in men, usually develops between 20 and 40 and is associated with marked stiffness of the spine initially in the morning. There may be a history of eye problems such as iritis or conjunctivitis or skin problems such as psoriasis. Sometimes peripheral joints may also be involved. Inflammatory pain responds well to injections of anti-TNF which suppress the inflammation.
Malignancy and infection
These are usually associated with ‘red flag’ features which include
Constant, unremitting pain with no precipitating or relieving factors
Systemic symptoms eg fever, weight loss, night sweats
Widespread numbness or weakness
If you are experiencing any of these associated ‘red flag’ features seek urgent medical advice
This is painful if a fracture occurs in one or more of the vertebrae. Sometimes it can cause increased curvature of the spine and height loss (see separate section)